Risk Factors for Delta Hepatitis in a North American Cohort: Who Should Be Screened?

INTRODUCTION The American Association for the Study of Liver Diseases recommends hepatitis D virus (HDV) screening in certain high-risk groups; however, the effectiveness is unknown. METHODS A study of North American patients with hepatitis B (HBV) referred to the NIH was performed to identify risk factors associated with HDV infection. Active HDV was "confirmed" by serum HDV RNA or histologic HDV antigen staining. RESULTS Six hundred fifty-two were studied, of which 91 were HDV "confirmed." Independent risk factors for HDV included: intravenous drug users, HBV-DNA <2,000 IU/mL, alanine aminotransferase >40 U/L, and HDV endemic country of origin. DISUSSION North American patients with HBV and significant risk factors should be screened for HDV.