Impact of hepatitis D reflex testing on the future disease burden: A modelling analysis.

Abstract

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%.

• Authors: Maria Buti, Raquel Domínguez-Hernández, Adriana Palom, Rafael Esteban, Miguel Ángel Casado
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 43 Issue 12 Pg. 2611-2614 (Dec 2023) ISSN: 1478-3231 [Electronic] United States
• PMID: 37916574 (Publication Type: Journal Article)
• Copyright: © 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Hepatitis B Surface Antigens
• Hepatitis Antibodies
• RNA

Topics

• Humans
• Carcinoma, Hepatocellular (diagnosis, epidemiology, complications)
• Hepatitis Delta Virus (genetics)
• Hepatitis B Surface Antigens
• Liver Neoplasms (diagnosis, complications)
• Hepatitis D (complications)
• Hepatitis Antibodies
• Reflex
• RNA
• Hepatitis B virus (genetics)