3 Key Takeaways
Plain English Summary- 01Core Finding
The Expert Practice Opinion (EXPO) document was developed by subject matter experts and commissioned by the AASLD Practice Guidelines Committee to provide timely guidance on the screening, diagnosis, and management of HDV infection.
- 02Study Evidence
Tested in a expert consensus / perspective at the guideline and clinical review stage.
- 03Practical Meaning
Expert perspective or consensus guidance synthesizing existing studies rather than reporting new randomized trial data.
What This Means for You
All HBsAg positive individuals should be screened for HDV. All adults with chronic HDV and compensated liver disease are candidates for HDV therapy. Recent advances in HDV treatment offer hope for meaningful improvement in clinical outcomes.
The Discovery
HDV infection represents a rare co-infection or super-infection among persons with HBV infection and is associated with significant morbidity and mortality due to an increased risk of liver events such as hepatic decompensation and HCC. The Expert Practice Opinion (EXPO) document was developed by subject matter experts and commissioned by the AASLD Practice Guidelines Committee to provide timely guidance on the screening, diagnosis, and management of HDV infection. Writing group members performed a targeted literature review and generated EXPO statements which were agreed upon by group consensus. All individuals who are HBsAg positive should be tested at least once for HDV infection with HDV antibody. HDV antibody positive individuals should undergo HDV RNA testing to confirm active infection. All individuals with chronic HDV should undergo further evaluation including non-invasive fibrosis (tissue scarring) testing, preferably with elastography. Lab monitoring and HCC surveillance imaging is suggested every 6 months. All adults with chronic HDV viremia and compensated liver disease should be considered candidates for HDV therapy with bulevirtide for chronic virologic suppression, or alternatively bulevirtide plus peg-IFN alfa-2a for individuals without contraindications to peg-IFN and who desire a finite duration regimen. Considerations for patient selection, treatment regimen, monitoring, assessment of response, and care of patients in special populations are summarized in the document.
How It Works, Simply
This gastroenterology research focuses on antibodies. Researchers evaluated it using an expert consensus / Perspective at the guideline and clinical review stage of medical research.
3 Key Takeaways
Clinical Takeaways- 01Core Finding
The Expert Practice Opinion (EXPO) document was developed by subject matter experts and commissioned by the AASLD Practice Guidelines Committee to provide timely guidance on the screening, diagnosis, and management of HDV infection.
- 02Study Evidence
Tested in a expert consensus / perspective at the guideline and clinical review stage.
- 03Practical Meaning
Expert perspective or consensus guidance synthesizing existing studies rather than reporting new randomized trial data.
Biological Mechanism & Study Design
Study Design & Cohort
Expert consensus / Perspective
Expert consensus / Perspective · Guideline / Opinion
Biological Pathway & Modality
Antibodies
Intervention: AASLD EXPO: Diagnosis and management of hepatitis delta virus (HDV) infection
Experimental Findings & Endpoints
HDV infection represents a rare co-infection or super-infection among persons with HBV infection and is associated with significant morbidity and mortality due to an increased risk of liver events such as hepatic decompensation and HCC.
The Expert Practice Opinion (EXPO) document was developed by subject matter experts and commissioned by the AASLD Practice Guidelines Committee to provide timely guidance on the screening, diagnosis, and management of HDV infection. Writing group members performed a targeted literature review and generated EXPO statements which were agreed upon by group consensus.
All individuals who are HBsAg positive should be tested at least once for HDV infection with HDV antibody. HDV antibody positive individuals should undergo HDV RNA testing to confirm active infection.
All individuals with chronic HDV should undergo further evaluation including non-invasive fibrosis testing, preferably with elastography. Lab monitoring and HCC surveillance imaging is suggested every 6 months.
All adults with chronic HDV viremia and compensated liver disease should be considered candidates for HDV therapy with bulevirtide for chronic virologic suppression, or alternatively bulevirtide plus peg-IFN alfa-2a for individuals without contraindications to peg-IFN and who desire a finite duration regimen. Considerations for patient selection, treatment regimen, monitoring, assessment of response, and care of patients in special populations are summarized in the document.
Clinical Translation & Practice Context
All HBsAg positive individuals should be screened for HDV.
All adults with chronic HDV and compensated liver disease are candidates for HDV therapy. Recent advances in HDV treatment offer hope for meaningful improvement in clinical outcomes.
The Bottom Line · Clinical Pearl
“All HBsAg positive individuals should be screened for HDV.”
Published in Hepatology (baltimore, Md.) · Current Stage: Guideline / Opinion
