Sasaki Takashi, Suda Goki, Ohara Masatsugu, Hosoda Shunichi, Kawagishi Naoki, Kohya Risako, Yoda Tomoka, Maehara Osamu, Ohnishi Shunsuke, Yoshida Sonoe, Fu Qingjie, Yang Zijian, Tokuchi Yoshimasa, Kitagataya Takashi, Suzuki Kazuharu, Nakai Masato, Sho Takuya, Natsuizaka Mitsuteru, Komukai Sho, Ogawa Koji, Sakamoto Naoya
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Laboratory of Molecular and Cellular Medicine, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan.
Hepatol Res. 2023 Oct;53(10):960-967. doi: 10.1111/hepr.13936. Epub 2023 Jul 3.
Although hepatitis delta virus (HDV) coinfection with hepatitis B virus (HBV) is a global health concern, the global prevalence of HDV infections remains unknown due to insufficient data in many countries. In Japan, HDV prevalence has not been updated for over 20 years. We aimed to investigate the recent prevalence of HDV infections in Japan.
We screened 1264 consecutive patients with HBV infection at Hokkaido University Hospital between 2006 and 2022. Patients' serums were preserved and subsequently tested for HDV antibody (immunoglobulin-G). Available clinical information was collected and analyzed. We compared the changes in liver fibrosis using the Fibrosis-4 (FIB-4) index between propensity-matched patients with and without the evidence of anti-HDV antibodies and corrected for baseline FIB-4 index, nucleoside/nucleotide analog treatment, alcohol intake, sex, HIV coinfection, liver cirrhosis, and age.
After excluding patients without properly stored serums and those lacking appropriate clinical information, 601 patients with HBV were included. Of these, 1.7% of patients had detectable anti-HDV antibodies. Patients with anti-HDV antibody serum positivity had a significantly higher prevalence of liver cirrhosis, significantly lower prothrombin time, and a higher prevalence of HIV coinfection than those who demonstrated serum anti-HDV antibody negativity. A propensity-matched longitudinal analysis revealed that liver fibrosis (FIB-4 index) progressed more rapidly in patients with positive results for anti-HDV antibody tests.
The recent prevalence of HDV infections in Japanese patients with HBV was 1.7% (10/601). These patients experienced rapid liver fibrosis progression, highlighting the importance of routine HDV testing.
尽管丁型肝炎病毒（HDV）与乙型肝炎病毒（HBV）合并感染是一个全球关注的健康问题，但由于许多国家的数据不足，HDV感染的全球流行率仍不清楚。在日本，HDV流行率已有20多年未更新。我们旨在调查日本近期HDV感染的流行率。
我们对2006年至2022年期间北海道大学医院连续1264例HBV感染患者进行了筛查。保存患者血清，随后检测HDV抗体（免疫球蛋白G）。收集并分析可用的临床信息。我们使用纤维化-4（FIB-4）指数比较了倾向匹配的有和没有抗HDV抗体证据的患者之间肝纤维化的变化，并对基线FIB-4指数、核苷/核苷酸类似物治疗、酒精摄入、性别、HIV合并感染、肝硬化和年龄进行了校正。
在排除血清保存不当的患者和缺乏适当临床信息的患者后，纳入了601例HBV患者。其中，1.7%的患者抗HDV抗体检测呈阳性。抗HDV抗体血清阳性的患者肝硬化患病率显著更高，凝血酶原时间显著更低，HIV合并感染患病率高于抗HDV抗体血清阴性的患者。倾向匹配的纵向分析显示，抗HDV抗体检测结果为阳性的患者肝纤维化（FIB-4指数）进展更快。
日本HBV患者近期HDV感染的流行率为1.7%（10/601）。这些患者肝纤维化进展迅速，凸显了常规HDV检测的重要性。
