Hospitalizations of hepatitis D in the United States were uncommon with no significant changes in hospitalization rates overall in the 2010–2015 and 2015–2018 periods. Additionally, the burden of hepatitis D was disproportionately greater in certain demographics and geographic regions. Hepatitis D hospitalizations did not result in increased frequencies of mortality compared to HBV only hospitalizations; however, complications such as liver failure were significantly more frequent in the hepatitis D cohort. Nevertheless, we found that within the hepatitis D cohort, older age and the presence of alcoholic cirrhosis were both major risk factors of mortality. And while pregnant persons and their foetuses/neonates did not seem to be at increased risk for morbidity or mortality if they were infected with hepatitis D compared to HBV only, further research is needed with larger cohorts.
Hepatitis D appeared to be largely underdiagnosed in the United States. There is a need for routine hepatitis D testing after a confirmed chronic hepatitis B diagnosis, especially considering the severity of the disease as well as the future availability of hepatitis D-specific therapy.
CI, confidence interval; HBV, hepatitis B virus; HCUP, Healthcare Cost and Utilization Project; HCV, hepatitis C virus; HDV, hepatitis D virus; HIV, human immunodeficiency virus; ICD-9, International Classification of Diseases, Ninth Revision; ICD-10, International Classification of Diseases, Tenth Revision; IQR, interquartile range; IRR, incidence rate ratio; OR, odds ratio.
We would like to thank Dr. Philip Spradling and Dr. Nelson Adekoya from the Centers for Disease Control and Prevention for reviewing and providing important feedback on this study. Open Access funding enabled and organized by Projekt DEAL.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
J Viral Hepat. 2022;29(3):218-226. © 2022 Blackwell Publishing