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Abstract

Background

Since 2009, European guidelines recommend individuals with hepatitis B virus (HBV) and HIV be tested for hepatitis D virus (HDV).

Aim

To analyse HDV testing in individuals with HBV/HIV during routine practice in the Netherlands.

Methods

We assessed data from the ATHENA cohort of people with HIV who were ever HBV surface antigen-positive, aged ≥ 18 years and attended one of 24 HIV treatment centres in the Netherlands during 2000–22. Using longitudinal analysis, we estimated the percentage of individuals ever tested for HDV (antibody or RNA test) over time. In cross-sectional analysis, determinants for ever being tested by end of follow-up were assessed using relative risk regression.

Results

We identified 1,715 individuals with HBV/HIV; 1,460 (85.1%) and 255 (14.9%) were male and female at birth, respectively (median age: 52 years; IQR: 42–59). Only 249 (14.5%) had an HDV test. The percentage tested increased from 5.0% (95% CI: 3.4–7.3) in 2000 to 17.0% (95% CI: 14.9–19.3) in 2022. In 2022, 16.2% (95% CI: 13.7–19.1) of men who have sex with men, 25.0% (95% CI: 9.7–50.9) of persons who inject(ed) drugs and 18.1% (95% CI: 14.6–22.3) of heterosexual/others were tested. In multivariable analysis, ever having an HDV test was associated with detectable HBV DNA viral load (p < 0.001), ever presenting with elevated alanine aminotransferase (ALT) levels (p = 0.023), advanced fibrosis/cirrhosis (p = 0.001) and being overweight/obese (p = 0.043).

Conclusions

HDV testing coverage in the Netherlands is low for individuals with HBV/HIV. Although testing was more common in those with advanced liver disease, a considerable proportion at risk of HDV still need testing.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2025-02-26
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Low coverage of hepatitis D virus testing in individuals with hepatitis B virus and HIV, the Netherlands, 2000 to 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Anders+Boyd&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Boyd Anders</a>, <a href="/search?value1=Colette+Smit&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Smit Colette</a>, <a href="/search?value1=Annemiek+A+van+der+Eijk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van der Eijk Annemiek A</a>, <a href="/search?value1=Hans+Zaaijer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zaaijer Hans</a>, <a href="/search?value1=Bart+JA+Rijnders&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rijnders Bart JA</a>, <a href="/search?value1=Berend+van+Welzen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Welzen Berend</a>, <a href="/search?value1=Mark+AA+Claassen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Claassen Mark AA</a>, <a href="/search?value1=Katalin+Pog%C3%A1ny&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pogány Katalin</a>, <a href="/search?value1=Theodora+EMS+de+Vries-Sluijs&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Vries-Sluijs Theodora EMS</a>, <a href="/search?value1=Eline+Op+de+Coul&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Coul Eline Op</a>, <a href="/search?value1=Marc+van+der+Valk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van der Valk Marc</a>, <a href="/search?value1=on+behalf+of+the+ATHENA+observational+cohort&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the ATHENA observational cohort</a></span>. Low coverage of hepatitis D virus testing in individuals with hepatitis B virus and HIV, the Netherlands, 2000 to 2022. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(7):pii=2400344. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.7.2400344" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.7.2400344</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 31 May 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 28 Nov 2024 </span> </p>
/content/10.2807/1560-7917.ES.2025.30.7.2400344
/content/10.2807/1560-7917.ES.2025.30.7.2400344
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