Hepatitis D-Associated Hospitalizations in the United States: 2010–2018

Paul Wasuwanich; Catherine W. Striley; Saleem Kamili; Eyasu H. Teshale; Eric C. Seaberg; Wikrom Karnsakul


J Viral Hepat. 2022;29(3):218-226. 

In This Article


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.