Prevalence of Hepatitis D and Its Impact on the Clinical Efficacy of Antiretroviral Therapy in People With HBV/HIV-1 in Guangdong Province, China.

BACKGROUND

Research on HDV prevalence among people with HBV/HIV coinfection in China is limited. The impact of HDV on antiretroviral therapy (ART) efficacy and liver disease progression in this population remains unclear.

METHODS

This retrospective cohort study included people with HBV/HIV-1 between 2005 and 2022. Baseline plasma was tested for HDV IgM/IgG; HDV RNA was measured if antibodies were positive. Demographics, liver complications, and ART responses were compared by HDV status.

RESULTS

Overall, 1130 people with HBV/HIV-1 were included, of whom 84 (7.4%) tested positive for HDV antibodies. Among these, 19 (22.6%) were HDV RNA-positive. Approximately 41.7% of HDV antibody-positive individuals had HCV coinfection. The median duration of ART was 7.4 years (interquartile range [IQR]: 5.1, 9.9). Longitudinal samples were available from 14 individuals with HDV RNA positivity. Baseline HDV RNA was 2.98 (IQR: 2.17, 4.78) log10 IU/mL. After a rapid decline during ART, 92.8% (13/14) of individuals reached undetectable levels at 7 years. When adjusted for HCV infection, HIV and HBV virological suppression, HBsAg clearance, and immunological nonresponders were comparable between HDV antibody-positive and -negative individuals (all P > .05), and between HDV RNA-positive and -negative individuals (all P > .05). The incidence rates of newly developed cirrhosis and hepatocellular carcinoma were also similar.

CONCLUSIONS

HDV coinfection was observed in 7.4% of people with HBV/HIV-1, as a defective virus reliant on HBV, HDV RNA declined rapidly during long-term ART and HDV coinfection did not compromise HIV or HBV treatment efficacy.