Clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis B patients: a population-based study

Abstract Background Evaluation of liver fibrosis appears to be easily overlooked in the clinic for the chronic Hepatitis D. Herein, we determine the Clinical Impact of liver fibrosis among HBsAg-positive/Anti-HDV positive US general adults. Methods Data were obtained from the National Health and Nut...

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Main Authors: Sisi Yang, Qiaofeng Ye, Yida Yang, Zhenxuan Ma
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Virology Journal
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Online Access:https://doi.org/10.1186/s12985-025-02908-2
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author Sisi Yang
Qiaofeng Ye
Yida Yang
Zhenxuan Ma
author_facet Sisi Yang
Qiaofeng Ye
Yida Yang
Zhenxuan Ma
author_sort Sisi Yang
collection DOAJ
description Abstract Background Evaluation of liver fibrosis appears to be easily overlooked in the clinic for the chronic Hepatitis D. Herein, we determine the Clinical Impact of liver fibrosis among HBsAg-positive/Anti-HDV positive US general adults. Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999–2020. Liver fibrosis was assessed by the Fibrosis-4 (FIB-4) and aspartate aminotransferase to platelet ratio index (APRI) score. To minimize confounding, propensity score matching (PSM) was applied to compare HBV/HDV-coinfected and HBV-monoinfected individuals. Results Out of 107,622 NHANES adults, 54,550 were tested for HBsAg and Anti-HDV, of whom 214 were identified as HBsAg-positive only, 50 were identified as HBsAg-positive/Anti-HDV-positive with available data for FIB-4/APRI. Mean APRI scores were 0.26 for the Non-Viral Hepatitis (NVH) group, 0.37 for the HBV group, and 0.42 for the HBV + HDV group. Corresponding mean FIB-4 scores were 1.07, 1.34, and 1.58, respectively. After PSM, HDV-infected individuals exhibited significantly higher fibrosis scores compared to HBV-positive individuals. Conclusion Hepatitis D is more severe than hepatitis B, with a higher propensity to progress to liver fibrosis. These findings highlight the importance of routine fibrosis screening in HBsAg-positive/anti-HDV-positive individuals to prevent advanced liver disease.
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spelling doaj-art-cb9f5e9d121b4c71a7298dca1e615a8b2025-08-20T03:45:45ZengBMCVirology Journal1743-422X2025-08-012211910.1186/s12985-025-02908-2Clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis B patients: a population-based studySisi Yang0Qiaofeng Ye1Yida Yang2Zhenxuan Ma3Department of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang UniversityDepartment of Biobehavioral Health, Pennsylvania State UniversityDepartment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang UniversityDepartment of Epidemiology and Biostatistics, Indiana University BloomingtonAbstract Background Evaluation of liver fibrosis appears to be easily overlooked in the clinic for the chronic Hepatitis D. Herein, we determine the Clinical Impact of liver fibrosis among HBsAg-positive/Anti-HDV positive US general adults. Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999–2020. Liver fibrosis was assessed by the Fibrosis-4 (FIB-4) and aspartate aminotransferase to platelet ratio index (APRI) score. To minimize confounding, propensity score matching (PSM) was applied to compare HBV/HDV-coinfected and HBV-monoinfected individuals. Results Out of 107,622 NHANES adults, 54,550 were tested for HBsAg and Anti-HDV, of whom 214 were identified as HBsAg-positive only, 50 were identified as HBsAg-positive/Anti-HDV-positive with available data for FIB-4/APRI. Mean APRI scores were 0.26 for the Non-Viral Hepatitis (NVH) group, 0.37 for the HBV group, and 0.42 for the HBV + HDV group. Corresponding mean FIB-4 scores were 1.07, 1.34, and 1.58, respectively. After PSM, HDV-infected individuals exhibited significantly higher fibrosis scores compared to HBV-positive individuals. Conclusion Hepatitis D is more severe than hepatitis B, with a higher propensity to progress to liver fibrosis. These findings highlight the importance of routine fibrosis screening in HBsAg-positive/anti-HDV-positive individuals to prevent advanced liver disease.https://doi.org/10.1186/s12985-025-02908-2Hepatitis b virusHepatitis d virusLiver fibrosisNational health and nutrition examination surveyPropensity score matchingAPRI
spellingShingle Sisi Yang
Qiaofeng Ye
Yida Yang
Zhenxuan Ma
Clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis B patients: a population-based study
Virology Journal
Hepatitis b virus
Hepatitis d virus
Liver fibrosis
National health and nutrition examination survey
Propensity score matching
APRI
title Clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis B patients: a population-based study
title_full Clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis B patients: a population-based study
title_fullStr Clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis B patients: a population-based study
title_full_unstemmed Clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis B patients: a population-based study
title_short Clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis B patients: a population-based study
title_sort clinical impact of hepatitis delta virus coinfection on liver fibrosis in hepatitis b patients a population based study
topic Hepatitis b virus
Hepatitis d virus
Liver fibrosis
National health and nutrition examination survey
Propensity score matching
APRI
url https://doi.org/10.1186/s12985-025-02908-2
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