未经证实:HDV影响全球4.5-13%的慢性乙型肝炎(CHB)患者,然而,加拿大HDV感染的患病率尚不清楚。为了调查患病率,基因型,人口统计,和加拿大HDV的临床特征,我们进行了回顾性分析(1)在参考标本中HDV抗体和RNA阳性,和(2)135HDV血清阳性+/-RNA(HDV+)患者的横断面子集研究与加拿大HBV网络中的5,132HBV单感染患者相比。
UNASSIGNED:在2012年至2019年之间收集的抗HDVIgG阳性标本进行RNA测试并确定基因型。参加加拿大HBV网络的患者年龄>18岁,HBsAg阳性。收集的临床数据包括危险因素,人口统计,合并症,治疗,纤维化评估,和肝脏并发症。
未经批准:转诊患者,338/7,080(4.8%,95%CI4.3-5.3)为HDV血清阳性,219/338RNA阳性(64.8%,95%CI59.6-69.7)。HDV+队列更有可能出生在加拿大,白人或黑人/非洲/加勒比比亚洲,报告高风险行为,与HBV单感染患者相比。肝硬化,终末期肝病的并发症,和肝移植在HDV+队列中明显更频繁。HDV病毒血症与肝转氨酶升高和肝硬化显着相关。在转诊患者中观察到5种HDV基因型,但在HDV+队列中未检测到基因型与临床结果之间的关联。
未经证实:近5%的加拿大HBV转诊人群为HDV血清阳性。HDV感染与风险行为以及国内和国外出生的CHB患者高度相关。HDV与进行性肝病显着相关,突显了加拿大增加HDV筛查和监测的必要性。
未经证实:在约5%的感染HBV的加拿大人中观察到HDV感染的证据转诊给医学专家。HDV阳性患者更可能是男性,出生在加拿大,或白色或黑色/非洲/加勒比海与亚洲相比,并且与仅感染HBV的患者相比,报告了注射或鼻内药物使用或高风险性接触等高风险活动。感染HDV的患者也更有可能患有严重的肝病,包括肝癌,与HBV单感染患者相比。
UNASSIGNED: HDV affects 4.5-13% of chronic hepatitis B (CHB) patients globally, yet the prevalence of HDV infection in Canada is unknown. To investigate the prevalence, genotype, demographics, and clinical characteristics of HDV in Canada, we conducted a retrospective analysis of (1) HDV antibody and RNA positivity among referred specimens, and (2) a cross-sectional subset study of 135 HDV seropositive +/-RNA (HDV+) patients compared with 5,132 HBV mono-infected patients in the Canadian HBV Network.
UNASSIGNED: Anti-HDV IgG-positive specimens collected between 2012 and 2019 were RNA tested and the genotype determined. Patients enrolled in the Canadian HBV Network were >18 years of age and HBsAg-positive. Clinical data collected included risk factors, demographics, comorbidities, treatment, fibrosis assessment, and hepatic complications.
UNASSIGNED: Of the referred patients, 338/7,080 (4.8%, 95% CI 4.3-5.3) were HDV seropositive, with 219/338 RNA-positive (64.8%, 95% CI 59.6-69.7). The HDV+ cohort were more likely to be born in Canada, to be White or Black/African/Caribbean than Asian, and reporting high-risk behaviours, compared with HBV mono-infected patients. Cirrhosis, complications of end-stage liver disease, and liver transplantation were significantly more frequent in the HDV+ cohort. HDV viraemia was significantly associated with elevated liver transaminases and cirrhosis. Five HDV genotypes were observed among referred patients but no association between genotype and clinical outcome was detected within the HDV+ cohort.
UNASSIGNED: Nearly 5% of the Canadian HBV referral population is HDV seropositive. HDV infection is highly associated with risk behaviours and both domestic and foreign-born patients with CHB. HDV was significantly associated with progressive liver disease highlighting the need for increased screening and surveillance of HDV in Canada.
UNASSIGNED: Evidence of HDV infection was observed in approximately 5% of Canadians who were infected with HBV referred to medical specialists. HDV-positive patients were more likely to be male, born in Canada, or White or Black/African/Caribbean compared to Asian, and to have reported high-risk activities such as injection or intranasal drug use or high-risk sexual contact compared with patients infected with only HBV. Patients infected with HDV were also more likely to suffer severe liver disease, including liver cancer, compared with HBV mono-infected patients.