title: A re-assessment of the epidemiology and patient characteristics of hepatitis D virus infection in inner city London.
abstract: OBJECTIVE
  To re-assess the prevalence and patient characteristics of hepatitis D virus (HDV) infection among hepatitis B patients in inner city London.
  
  
  METHODS
  All hepatitis B patients attending clinics over a 52 months period were tested for HDV antibody. All reactive samples were also tested for anti-HDV IgM and RNA. The characteristics of HDV seronegative patients first seen in the calendar year 2008 were compared with all HDV seropositive patients in the cohort.
  
  
  RESULTS
  Of 1048 hepatitis B patients, 11 had equivocal anti-HDV serology (1%) and 22 were HDV seropositive (2.1%, 95%CI 1.39-3.16%); 12 were anti-HDV IgM positive and 15 HDV RNA positive. No patient with equivocal anti-HDV serology had detectable HDV RNA. Five HDV seropositive patients were intravenous drug users (22.7%); 17/22 were from abroad with 11/22 (50%) from sub-Saharan Africa. HDV seropositive patients had poorer laboratory parameters and were more likely to have evidence of cirrhosis. Triple infected (HIV/HBV/HDV) patients were also more likely to have cirrhosis than HIV/HBV dually infected patients.
  
  
  CONCLUSIONS
  The prevalence of HDV in hepatitis B patients in inner city London was about 2%. The role of migration from endemic countries should be recognised.
authors: Department of Infectious Diseases, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, UK. william.tong@kcl.ac.uk
authors: C Y
authors: CY
authors: William Tong
authors: Radha
authors: R
authors: Asher
authors: Martina
authors: M
authors: Toby
authors: Siew L
authors: SL
authors: Ngui
authors: Kate
authors: K
authors: Tettmar
authors: Samreen
authors: S
authors: Ijaz
authors: Richard
authors: R
authors: Tedder
authors: Ranjababu
authors: R
authors: Kulasegaram
authors: Mark
authors: M
authors: Wilkinson
authors: Terry
authors: T
authors: Wong
mesh_terms: D000328:Adult; D015331:Cohort Studies; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology; D003699:Hepatitis D / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D018709:Statistics, Nonparametric; D015819:Substance Abuse, Intravenous