Impact of hepatitis D reflex testing on the future disease burden

Chronic hepatitis D (CHD) is a severe form of viral hepatitis that leads to liver cirrhosis and hepatocellular carcinoma. CHD is underdiagnosed, and this study aimed to assess the impact of hepatitis D reflex testing in HBsAg-positive individuals in Spain over the next 8 years. Two scenarios were co...

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Detalles Bibliográficos
Autores: Buti, Maria|||0000-0002-0732-3078, Domínguez-Hernández, Raquel|||0000-0003-1083-7288, Palom, Adriana|||0000-0002-0130-1302, Esteban, Rafael|||0000-0001-5280-392X, Casado, Miguel Ángel|||0000-0002-8743-6653
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:287787
Acceso en línea:https://ddd.uab.cat/record/287787
https://dx.doi.org/urn:doi:10.1111/liv.15776
Access Level:acceso abierto
Palabra clave:Burden
Hepatitis D virus (HDV)
Reflex testing
Screening
Descripción
Sumario:Chronic hepatitis D (CHD) is a severe form of viral hepatitis that leads to liver cirrhosis and hepatocellular carcinoma. CHD is underdiagnosed, and this study aimed to assess the impact of hepatitis D reflex testing in HBsAg-positive individuals in Spain over the next 8 years. Two scenarios were compared: the current situation (7.6% of HBsAg-positive patients tested for anti-HDV) and reflex testing for all positive samples. A decision tree model was designed to simulate the CHD care cascade. Implementing reflex testing would increase anti-HDV detection to 5498 cases and HDV-RNA to 3225 cases. Additionally, 2128 more patients would receive treatment, with 213 achieving undetectable HDV-RNA levels. The cost per anti-HDV case detected would be €132. In the median time of the analysis, liver complications (decompensated cirrhosis, HCC and liver-related deaths) would be reduced by 35%-38%, implying an estimated cost savings of 36 million euros associated with the management of such complications. By 2030, implementing anti-HDV reflex testing would reduce the clinical and economic burden of CHD by 35%-38%.