LAUSR

Hepatitis Delta virus (HDV) infection leads to is the most aggressive form of human viral hepatitis. It only occurs as coinfection with chronic hepatitis B virus (HBV), and is associated with rapid progression of fibrosis, early development of cirrhosis, liver decompensation and hepatocellular carcinoma. Globally, it is estimated that 15-20 million people have HDV/HBV coinfection and it has been approximated that 4.3% to 5.7% of chronic HBV patients will also have HDV. A single center study in Northern California reported a prevalence rate of HDV/HBV coinfection of 8% (Gish 2013). A lower prevalence – 3.4% was identified in the US Veterans Affairs system (Kushner 2015), although testing for HDV was incomplete. Recent data from the CDC estimates the prevalence of all HBV in the US at ≈730,000 people (95% CI 550,000 – 940,000) (Wasley 2010). The true rate of HDV/HBV coinfection in the US is likely underestimated due to low levels of HDV testing. BACKGROUND