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  • Kamal, HabibaDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden (author)

The cascade of care for patients with chronic hepatitis delta in Southern Stockholm, Sweden for the past 30 years

  • Article/chapterEnglish2024

Publisher, publication year, extent ...

  • Wiley-Blackwell Publishing Inc.2024
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:oru-109511
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-109511URI
  • https://doi.org/10.1111/liv.15770DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:154140314URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • BACKGROUND AND AIMS: Previous studies have shown suboptimal screening for hepatitis D virus (HDV) among patients with chronic hepatitis B (CHB). This study presents the cascade of care for HDV infection in a major secondary referral centre in Southern Stockholm, Sweden.METHODS: HBsAg+ve patients attending Karolinska University Hospital (KUH) from 1992 to 2022 were identified. The prevalence of anti-HDV and/or HDV RNA positivity, interferon (IFN) therapy and maintained virological responses (MVR) after HDV treatment were assessed. Also, time to anti-HDV testing was analysed in relation to liver-related outcomes with logistic regression.RESULTS: Among 4095 HBsAg+ve persons, 3703 (90.4%) underwent an anti-HDV screening; within a median of 1.8 months (range 0.0-57.1) after CHB diagnosis. This screening rate increased over time, to 97.9% in the last decade. Overall, 310 (8.4%) were anti-HDV+ve, of which 202 (65.2%) were HDV RNA+ve. Eighty-five (42%) received IFN, and 9 (10.6%) achieved MVR at the last follow-up. The predictive factors for anti-HDV screening were Asian origin, diagnosis after the year 2012, HIV co-infection (negative factor) and HBV DNA level < 2000 IU/mL in univariable analysis, while HIV co-infection was the only remaining factor in multivariable analysis. Delayed anti-HDV test >5 years was independently associated with worsened liver-related outcomes (adjusted odds ratio = 7.6, 95% CI 1.8-31.6).CONCLUSION: Higher frequency of HDV screening than previously published data could be seen among CHB patients at KUH in a low-endemic setting. Receiving a delayed screening test seems to be associated with worse outcomes, stressing the need of a strategy for timely HDV diagnosis.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Lindahl, KarinDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden (author)
  • Ingre, MichaelDepartment of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden; Centre for Bioinformatics and Biostatistics, Karolinska Institute, Stockholm, Sweden (author)
  • Gahrton, CarolineDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden (author)
  • Karkkonen, KerstinDepartment of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden (author)
  • Nowak, PiotrDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden (author)
  • Vesterbacka, JanDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden (author)
  • Stål, PerDepartment of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden; Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden (author)
  • Wedemeyer, HeinerDepartment of Gastroenterology and Hepatology, University of Hannover, Hannover, Germany (author)
  • Duberg, Ann-Sofi,Docent,1957-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)adg (author)
  • Aleman, SooKarolinska Institutet (author)
  • Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine Huddinge, Karolinska Institute, Stockholm, SwedenDepartment of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden; Centre for Bioinformatics and Biostatistics, Karolinska Institute, Stockholm, Sweden (creator_code:org_t)

Related titles

  • In:Liver international: Wiley-Blackwell Publishing Inc.44:1, s. 228-2401478-32231478-3231

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