Hepatitis delta: Rare or underdiagnosed?

Recent data suggest a higher-than-expected prevalence in the US¹

Typical prevalence estimates for hepatitis delta in the United States range from 3% to 8% of HBsAg+ persons²
A recent analysis of NHANES data estimates that 42% of HBsAg carriers have antibodies to hepatitis delta¹

Hep D prevalence estimates in the US are limited by lack of screening^1-3

Pie chart of 12% tested for HDV 88% not tested for HDV

Lack of hep B awareness contributes to underscreening of HDV

Among those not tested are high-risk HBsAg carriers who are unaware of their hep B infection and/or not engaged in care

In the US, as many as 7 in 10 people with hep B are unaware they are infected

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HBsAg=hepatitis B surface antigen; NHANES=National Health and Nutrition Examination Survey.

References: 1. Patel EU, Thio CL, Boon D, Thomas DL, Tobian AAR. Prevalence of hepatitis B and hepatitis D virus infections in the United States, 2011–2016. Clin Infect Dis. 2019;69(4):709-712. doi:10.1093/cid/ciz001 2. Safaie P, Razeghi S, Rouster SD, Privitera I, Sherman KE. Hepatitis D diagnostics: utilization and testing in the United States. Virus Res. 2018;250:114-117. doi:10.1016/j.virusres.2018.03.013 3. Cohen C, Holmberg SD, McMahon BJ, et al. Is chronic hepatitis B being undertreated in the United States? J Viral Hepat. 2011;18(6):377-383. doi:10.1111/j.1365-2893.2010.01401.x