A screening study carried out at MedUni Vienna has shown that the rare but dangerous infection with the hepatitis D virus remained often undetected. Seamless testing at University Hospital Vienna for the presence of a hepatitis D infection increases the diagnosis rate of this now treatable disease. The results of
It is estimated that more than 40,000 people in Austria are chronically infected with the hepatitis B virus. Around one percent of those affected in Austria are co-infected with the hepatitis D virus, which is considered the most aggressive form of chronic viral hepatitis. However, due to a lack of testing, the disease, for which new antiviral treatment options became available, often remains undetected. A team from MedUni Vienna conducted a large-scale screening study for hepatitis D in 560 hepatitis B patients at University Hospital Vienna. The results of this study, led by Johannes Bernhard and Michael Schwarz (both from MedUni Vienna’s Clinical Division of Gastroenterology and Hepatology), have now been published in the journal "Scientific Reports".
Hepatitis B - think D immediately
Patients who have no classic risk factors are often never tested for co-infection with the hepatitis D virus, or are only tested late in life. In some hepatitis B patients, the disease often remains undetected for a long time. "This can have serious consequences, especially for patients with rapidly progressing courses of the disease, which can often be prevented by early diagnosis and rapid establishment of antiviral therapy," says Mathias Jachs, coordinating last author of the now published study.
The study showed that up to 6 percent of hepatitis B cases at specialist hospitals such as Vienna General Hospital are co-infected with the hepatitis D virus. The rate of hepatitis D co-infection among hepatitis B patients being cared for in the special outpatient clinics of the Division of Gastroenterology and Hepatology was almost 10 percent. Some of the patients did not have any of the established risk factors for hepatitis D and would therefore have remained undetected even if they had been fully tested using established criteria. The gap-free testing of all people infected with hepatitis B therefore made a significant contribution to increasing the detection rate. "Many of the patients already had advanced liver disease. Well-tolerated and highly effective therapies can prevent the progression of the disease and thus the occurrence of serious complications in these patients," says Mathias Jachs, pleased with the positive result of the ’reflex testing’ strategy investigated in the study.
Reflex testing as a model
Automated reflex testing for the hepatitis D virus in the processing laboratory for patients with chronic hepatitis B presenting at the center for the first time is associated with low personnel and cost expenditure due to the rarity of both diseases. "As a comparatively simple measure, reflex testing should therefore be carried out as widely as possible throughout Austria. This procedure is now well established at University Hospital Vienna and underlines our high quality standards in the care of patients with chronic viral hepatitis infections," says Thomas Reiberger, head of the outpatient clinic for Viral Hepatitis at University Hospital Vienna. "We very much hope that our approach will also be adopted at other clinics in Austria and thus contribute to improving the diagnosis and treatment of hepatitis D virus infection, which is rare in Austria," said the study authors in unison.
Publication: Scientific Reports
Reflex testing for anti-HDV in HBsAg-positive patients offers high diagnostic yield in a large Central European tertiary care center.
Bernhard J, Schwarz M, Balcar L, Hofer B, Dominik N, Strassl R, Aberle S, Munda P, Mandorfer M, Trauner M, Reiberger T, Jachs M. DOI: 10.1038/s41598’024 -77737-4.
