Hepatitis D Very Prevalent in Injection Drug Users Living With HIV

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“We should test everybody,” said Charles Béguelin, noting that the vast majority of hepatitis D infections go undetected.

In his preconference session at the 30th Conference on Retroviruses and Opportunistic Infections (CROI 2023), Charles Béguelin of the University of Bern discussed coinfection of hepatitis B, hepatitis D, and HIV among persons who inject drugs.

“Sometimes you have a topic that you don’t know why, but you find it really interesting,” said Béguelin.

During a case-based liver workshop, Béguelin gave a presentation entitled “Hepatitis Delta Infection Among Persons With HIV.”

Approximately 15% of persons living with HIV were coinfected with hepatitis D, Béguelin said, “but really that high prevalence comes from people who inject drugs.”

Among injection drug users living with HIV, hepatitis D prevalence was about 50%. This research was vital, Béguelin explained, because the individuals with replicating hepatitis D had mortality rates 2-3 times higher than those with hepatitis B.

“We had the chance to go more in detail and realize that it’s not all persons living with HIV who have such a high prevalence of hepatitis delta, it’s really this group of persons who were infected by intravenous drug use,” said Béguelin.

Although the 50% hepatitis D prevalence in injection drug users living with HIV is very high, Béguelin and his team were relieved to see not all persons living with HIV had such a high rate of hepatitis D coinfection.

Béguelin is confident that measures such as syringe service programs will make hepatitis D less prevalent in this cohort. However, there are still challenges hindering our understanding of hepatitis D coinfection.

Béguelin noted guidelines stating all individuals with hepatitis B should be tested for hepatitis D. “Even if you don’t really have a risk factor for it, you can have hepatitis D,” he explained. “Most studies show that only 10% of persons get tested.”

Béguelin’s preconference session, “Hepatitis Delta Infection Among Persons With HIV,” was given Sunday, February 19, at the 30th Conference on Retroviruses and Opportunistic Infections (CROI 2023).

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