S1454 Prevalence and Clinical Characteristics of Hepatitis Delta Virus (HDV) Infected Individuals in British Columbia
Bibliographic record
Abstract
Introduction: Globally, HDV is reported in 4.5-13% of chronic hepatitis B (CHB) patients. HDV and HBV co-infection is associated with progression to cirrhosis and higher risk of hepatocellular carcinoma (HCC). HDV prevalence in Canada is not fully elucidated. The purpose of the study was to describe the prevalence and clinical characteristics of HDV infection in CHB patients in a tertiary care centre. Methods: Retrospective study of HBsAg-positive patients >18 years of age tested for HDV Ab between April 2013 and October 2022. Data collected included HDV Ab status, patient demographics, comorbidities, alcohol use, fibrosis stage, and therapies utilized. Results: Among 663 HBsAg-positive patients tested for HDV Ab,10/663 (1.5%, 95% confidence interval [CI] 0.58-2.44) were HDV-Ab (+), with 8/10 (80%, 95% CI 0.55-1.05) of those confirmed HDV RNA(+). Average age of HDV patients was 57.8 (95% CI 52.7- 62.9) years, similar to HBV patients. Compared to HBV mono-infected patients, HBV-HDV co-infected patients were more likely to be male (90.0% vs 57.6%; P = 0.04), have decompensated liver disease (30.0% vs 1.4%; P < 0.0001) and less likely to be Asian (50.0% vs 80.9%; P = 0.014). One HBV-HDV co-infected patient was also HIV/HCV co-infected, and 2 had cleared HCV. One HDV patient had a known history of IVDU (10%, 95% CI 0.09 – 0.28). Mean ALT in HDV patients was 55.9, vs 34.3 in HBV mono group (P = 0.0508). 50% of HDV patients consumed any lifetime alcohol compared to 31.9% of HBV mono-infected patients (P = 0.22). HDV patients were more likely to have liver stiffness measurements >9.0 kPa 30% vs 8.9%, P = 0.02), and equally likely to have HCC 10% vs 2.5% (P = 0.13). Conclusion: The prevalence of HDV positivity in CHB patients in this tertiary care centre was 1.5%. This was less than a previously noted 4.8% prevalence of HDV positivity amongst HBsAg-positive patients enrolled in in the Canadian HBV Network between 2011-2019. Persons with HDV were more likely to be male, and have decompensated liver disease and less likely to be Asian than those with HBV mono-infection. Further studies to understand the burden of disease in other regions are needed. Table 1. - Comparison of additional demographics, hepatic outcomes, laboratory values, antiviral treatment experience, and co-morbidities in HBV mono-infected individuals (n = 653) compared with HDV–HBV co-infected individuals (n = 10) HDV-HBV co-infected (n = 10) HBV mono-infected (n = 653) P-value Ethnicity Asian 50% (5/10) 81% (529/653) 0.014 Caucasian 30% (3/10) 8.27% (54/653) 0.015 Middle Eastern 20% (2/10) 3.06% (20/653) 0.003 East Asian 0% 2.45% (16/653) 0.62 Black/African/Caribbean 0% 3.83% (25/653) 0.53 Hispanic 0% 1.38% (9/653) 0.71 BMI 26.8 (95% CI 24.26-29.34, n = 7) 24.17 (95% CI 23.8-24.53, n = 456) 0.08 Hepatic Outcomes Cirrhosis 20% (2/10) 3.68% (24/653) 0.008 Fatty Liver/Steatosis > = S1 57.14% (4/7) 53.89% (291/540) 0.86 Labs* GFR 80.8 (95% CI 65.35-96.25, n = 10) 90.58 (95% CI 8.94-92.22, n = 650) 0.15 HBeAb+ 25% (2/8) 22.17% (100/451) 0.85 HBV DNA Detectable 20% (2/10) 47.3% (307/649) 0.09 Current Treatment Antiviral therapy against HBV 60% (6/10) 50.08% (327/653) 0.53 Interferon 0% 0.15% (1/653) 0.9 Lamivudine 10% (1/10) 6.12% (40/653) 0.61 Tenofovir (TDF or TAF) 50% (5/10) 34.9% (228/653) 0.32 Entecavir 0% 7.5% (49/653) 0.37 Nucleos(t)ide inhibitor 0% 0.15% (1/653) 0.9 Comorbidities Diabetes 10% (1/10) 7.5% (49/653) 0.77 Hypertension 10% (1/10) 17.76% (116/653) 0.52 Dyslipidemia 0% 11.18% (73/653) 0.26 Continuous data are presented as mean (95% CI, n known). Categorical data are presented as mean % (n/n known). T tests were used for continuous data and chi-square tests were used for categorical data. Values of P < 0.05 are designated as significant.*Labs defined as most recent as of May 2023.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".