Z Gastroenterol 2021; 59(08): e353
DOI: 10.1055/s-0041-1734294
POSTER
Hepatologie

Update on the Austrian epidemiology of Hepatitis D Virus (HDV)

M Jachs
1   Medical University of Vienna, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Vienna, Austria
,
T Binter
1   Medical University of Vienna, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Vienna, Austria
,
C Schmidbauer
2   Klinik Ottakring, Division of Gastroenterology, Department of Medicine II, Vienna, Austria
,
M Strasser
3   Paracelsus Medical University, First Department of Medicine, Salzburg, Austria
,
H Laferl
4   Klinik Favoriten, Department of Infectious Diseases and Tropical Medicine, Vienna, Austria
,
S Hametner-Schreil
5   Internal Medicine IV, Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
,
A Lindorfer
5   Internal Medicine IV, Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
,
K Dax
6   Kepler Universitätsklinikum, Department of Internal Medicine and Gastroenterology and Hepatology, Linz, Austria
,
R Stauber
7   Medical University of Graz, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Graz, Austria
,
H Kessler
8   Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Granz, Austria
,
S Bernhofer
9   Department of Internal Medicine II, University Hospital St. Pölten, St. Pölten, Austria
,
L Loacker
10   Central Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Innsbruck, Innsbruck, Austria
,
S Bota
11   Hepatology, Endocrinology, Rheumatology and Nephrology, Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology, Klagenfurt, Austria
,
I Santonja
12   Center for Virology, Medical University of Vienna, Vienna, Austria
,
P Munda
1   Medical University of Vienna, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Vienna, Austria
,
M Gschwantler
2   Klinik Ottakring, Division of Gastroenterology, Department of Medicine II, Vienna, Austria
,
M Peck-Radosavljevic
11   Hepatology, Endocrinology, Rheumatology and Nephrology, Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology, Klagenfurt, Austria
,
H Holzmann
12   Center for Virology, Medical University of Vienna, Vienna, Austria
,
H Zoller
13   Medical University of Innsbruck, Department of Internal Medicine I, Innsbruck, Austria
,
P Ferenci
1   Medical University of Vienna, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Vienna, Austria
,
T Reiberger
1   Medical University of Vienna, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Vienna, Austria
› Author Affiliations
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    Background and Aims Hepatitis D virus (HDV) coinfection promotes progression to cirrhosis, decompensation and hepatocellular carcinoma in hepatitis B (HBV) patients. The prevalence of viremic HDV infection in Austria is unknown. With new treatment options emerging, updated epidemiological data on HDV are urgently needed.

    Method Ten Austrian hepatitis treatment centers contributed patients who tested positive for anti-HDV antibodies between 2010 and 2020. We evaluated the rate of HDV viremia and the disease severity among viremic patients with at least one visit after January 2019 (‘active’ HDV cohort). We (i) evaluated the prevalence of HDV-infection in Austria, and (ii) characterized the ‘active’ HDV-patient cohort in Austria.

    Results 347 patients with positive anti-HDV antibodies were identified. HDV-RNA-PCR testing was performed in 202 (58.2 %) patients, and 126 (62.4 %) had confirmed HDV viremia. Hepatocellular carcinoma was diagnosed in 7 (5.6 %) patients, and 11 (8.7 %) patients died of liver-related causes, while 7 (5.6 %) patients underwent liver transplantation. The ‘active’ Austrian HDV cohort included 74 patients (52.7 % male), and the median age was 46 (IQR 37-59) years. Evidence for advanced chronic liver disease (ACLD, defined by histological F3/F4 fibrosis, liver stiffness measurement[LSM] ≥10kPa, presence of varices, or hepatic venous pressure gradient[HVPG] ≥6 mmHg) was detected in 38 (51.4 %) patients, two of which (5.4 %) showed decompensated ACLD.Thirty-seven (50.0 %) patients of the ‘active’ HDV cohort were previously/currently treated with interferon (IFN). Treatment with the novel sodium-taurocholate cotransporting polypeptide (NTCP) inhibitor bulevirtide was initiated in 20 (27.0 %) patients.

    Conclusion The total number of 126 confirmed HDV viremic cases in Austria is low but likely underestimated. Since half of the ‘active’ patients had ACLD, improved testing and workup strategies should be implemented in order to improve access to emerging new therapies.


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    Publication History

    Article published online:
    01 September 2021

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