Impact of Low Hepatitis Delta Virus Screening Rates on the Accurate Estimation of Seroprevalence in Florida: A Retrospective Observational Study.

BACKGROUND: Hepatitis delta virus (HDV) is a hepatotropic virus that can accelerate the progression of liver disease to cirrhosis and is associated with an increased risk of liver-related mortality and liver cancer. As a defective single-stranded RNA virus, it can only occur with acute hepatitis B or in patients with chronic hepatitis B virus (HBV) infections. In light of these risks, current screening guidelines recommend universal screening in all hepatitis B surface antigen (HBsAg)-positive individuals and those at risk for HDV. Unfortunately, HDV seroprevalence data remains limited due to low rates of HDV screening in the US and worldwide.

AIM: The aim of this study is to determine HDV regional screening rates, prevalence, and associated factors using OneFlorida research data.

METHODS: Adult patients aged 18-99 with a previous HBV diagnosis were identified using OneFlorida+ Clinical Research Network data. Using International Classification of Diseases codes, HBV-positive patients were categorized as definite, probable, or possible. This data was then analyzed using a two-sample t-test to determine possible associations with race, gender, or age.

RESULTS: We found that among patients who were tested, HDV seroprevalence was 4.7%. Of the total of 8,744 individuals included in the study, only 225 (2.6%) underwent HDV antibody testing. Although there was no significant difference in age or race, males were more likely to undergo HDV testing.

CONCLUSION: Despite a low screening rate, HDV seroprevalence in Florida was approximate to previous estimations of HDV positivity.