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  • Hepatitis Delta: Flying Under the Radar in the U.S.

    … S. C., Morse, L. J., Ukena, T., et al. (1987). Outbreak of severe hepatitis due to delta and hepatitis B viruses in parenteral drug abusers and their contacts. N Engl J Med, 317(20), 1256-1262. 4. The City of New York. (2016). Hepatitis D and E and other suspected infectious viral hepatitides reporting. Retrieved from http://rules.cityofnewyork.us/tags/reportable-diseases. 5. Martins, E and Glenn, J. Prevalence of Hepatitis Delta Virus (HDV) Infection in the United States: Results from an ICD-10 Review. Poster Sa1486 DDW May 2017. 6. Lauren M. Kucirka, Homayoon Farzadegan, Jordan J. Feld, Shruti H. Mehta, Mark Winters, Jeffrey S. Glenn, Gregory D. Kirk, Dorry L. Segev, Kenrad E. Nelson, Morgan Marks, Theo Heller, Elizabeth T. Golub, Prevalence, Correlates, and Viral Dynamics of Hepatitis Delta among Injection Drug Users, The Journal of Infectious Diseases, Volume 202, Issue 6, 15 September 2010, Pages 845–852. 7. Kushner, T., Serper, M., & Kaplan, D. E. (2015). Delta hepatitis within the veterans affairs medical system in the United States: Prevalence, risk factors, and outcomes. 8. Gish, Robert & Yi, Debbie & Kane, Steve & Clark, Margaret & Mangahas, Michael & Baqai, Sumbella & A Winters, Mark & Proudfoot, James & Glenn, Jeffrey. (2013). Coinfection with Hepatitis B and D: Epidemiology, Prevalence and Disease in Patients in Northern California. Journal of gastroenterology and hepatology. 28. 10.1111/jgh.12217

    http://www.hepb.org/blog/hepatitis-delta-flying-radar-u-s/
  • Where Can I Order Hepatitis Delta Testing?

    By Sierra Pellechio, BS, CHES, Hepatitis Delta Connect Program Manager Historically, testing for hepatitis delta has been difficult to access and often not commercially available. With the rise in awareness about hepatitis B and delta coinfection, more tests are beginning to be offered by multiple labs for clinicians in the United States looking to test their patients. Because hepatitis delta can only infect people who also have hepatitis B, the Hepatitis B Foundation’s medical director and leading hepatologist Dr. Robert Gish recommends testing all hepatitis B patients for hepatitis delta. “Screening all hepatitis B patients will allow a better understanding of hepatitis delta prevalence and its impact on outcomes and will identify patients who can be offered treatment within or outside clinical trials.” The first step in diagnosing an infection is the HDV antibody total (anti-HDV) test. Patients who have recovered from or are currently infected will be positive for the anti-HDV and will present high titers in later stages of acute infection and persist in cases of chronic infection. If the HDV antibody total test is positive, it should be followed by the HDV RNA (PCR) test to confirm an active infection. If this test is negative, a current infection is unlikely. Testing hepatitis B patients for hepatitis delta is important because when people with hepatitis B are exposed to the hepatitis delta virus, 90% will develop a chronic infection1. Coinfection will alter treatment and management plans, because antivirals effective on hepatitis B do not control hepatitis delta2. While the standard treatment of interferon is less than 30% effective in controlling coinfection, there are new drugs in development. With two of these drugs set to enter phase 3 clinical trials in 2019, it is more important than ever to identify coinfected patients and connect patients into clinical trials. Until recently, only the anti-HDV test was widely available in the United States. In

    https://www.hepb.org/blog/can-order-hepatitis-d-testing/
  • Nearly 1 in 4 Romanians with Hepatitis B also Infected with Hepatitis D

      By Sierra Pellechio, Hepatitis Delta Connect Coordinator Since the 1990’s most of Eastern Europe has seen a decline in the prevalence of hepatitis D, a dangerous coinfection of hepatitis B, attributed to successful vaccination programs and government prioritization. Romania, which has the highest hepatitis B prevalence in the EU, has not seen such declines of hepatitis D, which affects 23% of its hepatitis B patients. Hepatitis D coinfection is considered hyperendemic to the country, and has some of the highest rates of coinfection globally1. Seventy percent of these 200,000 patients will progress to cirrhosis, often within only 10  years2, and face barriers to receiving effective treatment and management. Although the country enacted a national hepatitis B vaccination program for all newborns in 1995 and a catch-up program for school-age children in 1999, older populations already infected with hepatitis B and inadequately immunized young people represent susceptible groups for coinfection with hepatitis B and disease.1,3. Additionally; lack of hepatitis B vaccination recommendations for high risk groups, low implementation of hepatitis B screening during pregnancy, supply shortages and vaccine hesitancy, have created opportunities for hepatitis B and D transmission. Exposure to infected blood or sexual fluids through blood transfusions or surgeries (before the 1990’s), tattoos, piercings, injection drug use, or sexual contact with an infected person, can expose people already living with hepatitis B to hepatitis D, or expose those who have not received the full hepatitis B vaccine series to both viruses. Control of hepatitis B and D coinfection has also been hindered by the lack of a national registry and surveillance system thus preventing an understanding of the accurate prevalence and public health burden1. With health expenditure and life expectancy the lowest in the EU, Romania is battling large system-wide failures that have fostered the

    http://www.hepb.org/blog/nearly-1-4-romanians-hepatitis-b-also-infected-hepatitis-d/
  • Where is Hepatitis D? High Prevalence of Hepatitis B/D Coinfection in Central Africa

    By Sierra Pellechio, Hepatitis Delta Connect Coordinator While hepatitis B is known to be highly endemic to sub-Saharan Africa and is estimated to affect 5-20% of the general population, the burden of hepatitis D, a dangerous coinfection of hepatitis B, has largely been left undescribed. Since the virus’s discovery 40 years ago, Africa has faced structural barriers that have contributed to the ongoing prevalence of the virus in this region. Widespread instability, under-resourced health systems, and poor surveillance have contributed to inadequate research and a lack of understanding about the health burden of hepatitis D on hepatitis B patients, particularly in Central Africa. New data, however, reveals pockets of hepatitis B/D coinfection in this region, particularly in countries such as Cameroon, Central African Republic and Gabon. In a recently published study of nearly 2,000 hepatitis B infected blood samples from 2010-2016 in Cameroon, 46.7% tested positive for hepatitis D antibodies, a marker of past or current hepatitis D coinfection. Another study of 233 chronic hepatitis B carriers from 2008-2009 found a 17.6% positivity for hepatitis D antibodies. Other small studies from the Central African Republic have revealed 68.2% prevalence in hepatitis B patients, 50% coinfection in liver cancer patients and an 18.8% coinfection in hepatitis B infected pregnant women. Not only are new studies revealing evidence that there are groups at higher risk for hepatitis D, but a 2008 study on 124 community members in Gabon found 66% of them had markers for hepatitis D, proving this virus can also be circulating in the general population. Globally, hepatitis D is thought to affect about 5-10% of hepatitis B patients, making Central Africa an area of extremely high prevalence. A diagnosis with hepatitis B and D can increase the risk for cirrhosis and liver cancer by nearly three times, and with only one available treatment, the future for coinfected patients if often

    http://www.hepb.org/blog/hepatitis-d-high-prevalence-hepatitis-bd-coinfection-central-africa/
  • Hepatitis Delta: Coinfection vs. Superinfection

    By Sierra Pellechio, Hepatitis Delta Connect Coordinator Hepatitis delta is an aggressive form of hepatitis that can only exist alongside hepatitis B. This means that all hepatitis B patients are at risk for hepatitis delta, but so are people who have not received the hepatitis B vaccination series. If contracted, 70-90% of people with chronic hepatitis B will go on to also develop a chronic hepatitis delta infection – called a “superinfection”. Approximately 70% of these cases will progress to cirrhosis (liver scarring), compared to 15-30% of those infected only with the hepatitis B virus. Due to the likelihood of liver complications, hepatitis B patients should be aware of potential exposures to hepatitis delta. The virus is spread the same way as hepatitis B, through direct blood-to-blood contact and unprotected sex with an infected person. It is important to be aware that blood contact could also occur by exposure to unsafe blood transfusions, unsterile medical or dental equipment, and the sharing of razors or toothbrushes with an infected person due to the possibility of infected blood entering the body. People who are not infected with hepatitis B may be at risk for “coinfection”, when someone contracts hepatitis B and delta simultaneously during one exposure. In these cases, greater than 90% of adults will clear both infections and develop protective antibodies. While a co-infection generally resolves spontaneously after about 6 months, it can sometimes result in a life-threatening or fatal liver failure. The good news is that the hepatitis B vaccine series can prevent both viruses in people who are not already infected. Once completed, the vaccine can provide a lifetime of protection! For more information about hepatitis B/delta coinfection, please visit www.hepdconnect.org or email us at connect@hepdconnect.org.

    https://www.hepb.org/blog/hepatitis-d-coinfection-vs-superinfection/
  • Podcasts

    Listen to our podcasts to learn more about all things hepatitis delta! Bright and Evangeline sit down with Dan to talk about his experience with hepatitis Delta. We talk about his initial feelings surrounding the diagnosis, his treatment, how he got involved with the Hepatitis B Foundation, and his hope for the future of all people living with hepatitis B and Delta. Listen here today!  Join us for a podcast in which researchers from the Hepatitis B Foundation in the United States and the University of New South Wales in Australia come together to discuss the profound impacts stigma can have on the lives of people living with hepatitis B. Click here to listen! Listen to the latest episode of B Heppy, the Hepatitis B Foundation's monthly podcast, all about hepatitis delta! B Heppy host Evangeline chats with Dr. Robert Gish to discuss what hepatitis delta is, how it is related to hepatitis B, how to manage it, and what future treatment options look like. Listen here today!

    https://www.hepb.org/research-and-programs/hepdeltaconnect/resources/podcasts/
  • German scientist, inventor of new, first-in-class treatment for hepatitis D, to receive the 2023 Baruch S. Blumberg Prize

    Prof. Stephan Urban led development of the first treatment for hepatitis D, an often-fatal infection for millions of people worldwide. Doylestown, Pa., Nov. 14, 2022 – The Hepatitis B Foundation, a global nonprofit organization, today announced that Stephan Urban, PhD, distinguished professor and globally recognized virologist, has been chosen to receive its 2023 Baruch S. Blumberg Prize. Prof. Urban developed bulevirtide (brand name Hepcludex), a new and effective first-in-class drug approved in Europe treat hepatitis D, which is a serious coinfection that only exists in combination with hepatitis B. Developed by Prof. Urban and his team at Heidelberg University Hospital, bulevirtide blocks the entry of the hepatitis B and hepatitis D viruses into the liver cell. Hepcludex, the first commercial formulation of bulevirtide, was approved by the European Commission in July 2020. Studies have estimated that 12 to 74 million people carrying the hepatitis B virus have been coinfected with hepatitis D virus (HDV) worldwide. Chronic HDV infection results in often fatal complications and a higher risk of liver cancer. “Prof. Urban’s innovative research has helped us understand key components of hepatitis B and D virology, and he is a pioneer in the development of new therapeutics for hepatitis B and D,” Hepatitis B Foundation President Chari A. Cohen, DrPH, MPH, said. “The hepatitis B and D communities owe him a debt of gratitude.” The Baruch S. Blumberg Prize is the Hepatitis B Foundation’s highest honor. It is named for Baruch S. Blumberg, MD, DPhil, who received the Nobel Prize in Medicine and Physiology in 1976 for discovering the hepatitis B virus. He was a faculty member at the Fox Chase Cancer Center in Philadelphia at the time. Dr. Blumberg was instrumental in the creation of the Foundation, served on our Scientific and Medical Advisory Board and was the Foundation’s Distinguished Scholar from 1992 until his death in 2011. The Foundation’s research arm was renamed the Baruch S. Blumberg Institute in his honor. A committee of former Blumberg Prize recipients annually selects a new honoree. Past recipients include Dr. Harvey Alter, who was among the winners of the 2020 Nobel Prize in Medicine and Physiology; Dr. Anna Lok, assistant dean for clinical research, University of Michigan Medical School; and Dr. John Taylor, professor emeritus, Fox Chase Cancer Center. The Blumberg Prize will be presented to Prof. Urban at the 2023 Hepatitis B Foundation Gala, which will be held on March 10 at the Warrington in Warrington, Pa. Timothy M. Block, PhD, co-founder of the Hepatitis B Foundation and a virologist who is one of the world’s leading experts on hepatitis B, said: “Prof. Urban is one of the world’s most innovative and creative scientists, taking an idea for a drug from concept all the way to practice, where it’s now being used to treat people. Honoring this kind of accomplishment is exactly what we intended for the Blumberg Prize.” Prof. Urban is head of Translational Virology in the Department of Infectious Diseases, Molecular Virology, at Heidelberg University Hospital. He also is Project Coordinator for the DZIF (German Center for Infection research) TTU Hepatitis Program. Prof. Urban was awarded with the DZIF Research Award in 2014, received the Pettenkofer Prize in 2011, the distinguished award in Hepatitis B Virus research in 2021 and the Wolfgang Gerok prize in 2022. Prof. Urban’s research interests include molecular mechanisms of hepatitis B and hepatitis D virus/host interactions with a focus on the early and late events of viral infection; identification of hepadnaviral receptors and structural analyses of virus receptor interactions; development of novel cell culture systems for HBV and HDV; clinical development of entry inhibitors for HBV and HDV infection; and analyses of innate immune responses upon HBV and HDV infection. Prof. Urban completed his Diploma in Biochemistry at the University of Tübingen in 1991 and was awarded a doctorate in 1995 under Prof. P.H. Hofschneider at the Max-Planck-Institut für Biochemie, Martinsried. He conducted postdoctoral research at the Centre for Molecular Biology, Heidelberg University, with Prof. H. Schaller and became an independent group leader in the department of molecular virology headed by Prof. Ralf Bartenschlager.

    https://www.hepb.org/news-and-events/news-2/german-scientist-inventor-of-worlds-first-treatment-for-hepatitis-d-to-receive-the-2023-baruch-s-blumberg-prize/
  • Hepatitis B Foundation creates two Global Community Advisory Boards

    People living with and affected by hepatitis B and hepatitis delta will provide input to industry, government and nonprofits working on drug development. Doylestown, Pa., July 18, 2022 – To further its work as the world’s leading nonprofit dedicated to hepatitis B and liver cancer, the Hepatitis B Foundation has formed two new Global Community Advisory Boards. At the Foundation’s invitation, 81 people worldwide, primarily people living with hepatitis B and delta infections, applied to serve on the advisory boards. One board, which has 14 members, is dedicated to hepatitis B and the other, with nine members, is devoted to hepatitis delta, or hepatitis D. Members represent Albania, Australia, Canada, Cameroon, Ghana, India, Israel, Mongolia, Nigeria, Philippines, Romania, Senegal, Taiwan, Tanzania, Uganda, the U.K. and the U.S. The Foundation will work to share the board members’ perspectives, experience and expertise with those engaged in drug development and clinical research in hepatitis B and D. A primary goal is to ensure that the voices of those living with HBV and HDV are central to decision-making by industry, government and nonprofits, and to drive progress toward cures for hepatitis B and D. “The Hepatitis B Foundation always has placed a high value on the voices of people with hepatitis B and D, and their loved ones,” Chari A. Cohen, DrPH, MPH, president of the Foundation, said. “We believe that no major strides can be made without understanding the lived experience of those affected by these diseases. We are extremely grateful that so many people agreed to serve on the advisory boards and contribute their time, energy and ideas.” Chari A. Cohen, DrPH, MPH, president, Hepatitis B Foundation   Advisory board members will participate in discussions with drug and clinical trial developers, represent the advisory boards at public events and conferences, and contribute to outreach and education in their home communities. The boards’ meetings, to be held quarterly, will be online due their worldwide membership. About Hepatitis B: Hepatitis B is the most common serious liver infection in the world. It is caused by the hepatitis B virus that attacks and injures the liver. Each year up to 1 million people die from hepatitis B worldwide, even though it is preventable and treatable. Hepatitis B is a “silent epidemic” because most people do not have symptoms when they are newly or chronically infected. Thus, they can unknowingly infect others and continue the spread of hepatitis B. For people who are chronically infected and asymptomatic, liver damage can still occur silently and can develop into more serious liver disease, such as cirrhosis or liver cancer. About Hepatitis Delta: Hepatitis delta, also known as hepatitis D or HDV, is a liver infection caused by the hepatitis delta virus that results in the most severe form of viral hepatitis known to humans. Only those already infected with hepatitis B can acquire hepatitis delta, as it is dependent on the hepatitis B virus to reproduce. Of the more than 296 million people living with hepatitis B, an estimated 15-20 million are also infected with hepatitis delta. Coinfections lead to more serious liver disease than hepatitis B infection alone. They are associated with faster progression to liver fibrosis, increased risk of liver cancer, and early decompensated cirrhosis and liver failure.  

    https://www.hepb.org/news-and-events/news-2/hepatitis-b-foundation-creates-two-global-community-advisory-boards/
  • Hepatitis Delta Trials

    Click here for more information on clinical trials for hepatitis delta.

    https://www.hepb.org/treatment-and-management/clinical-trials/hepatitis-d-trials-2/
  • Welcome to Hepatitis Delta Connect!

    A dedicated program of the Hepatitis B Foundation to increase awareness about hepatitis delta - a serious virus that coinfects hepatitis B patients - and to promote screening and testing, and provide information and support for those affected.      Clinical Trial Finder - Find A Clinical Trial Near You!                                                                                                         Check Out Our Latest Podcast! Bright and Evangeline sit down with Dan to talk about his experience with hepatitis Delta. We talk about his initial feelings surrounding the diagnosis, his treatment, how he got involved with the Hepatitis B Foundation, and his hope for the future of all people living with hepatitis B and Delta. Listen here today! Join us for our next hepatitis delta webinar in June! This will be a two-part series. Part 1, happening on June 8th, 2023 at 10am Eastern Time, will feature a panel discussion about hepatitis delta in the European context, the status of approvals of Hepcludex (bulevirtide) around the continent, and how the medication is changing the HDV landscape. We will be joined by panelists from the UK, Spain, Romania, France, and Italy. Part 2, taking place on June 15th, 2023 at 10am Eastern Time, will explore the epidemiology of hepatitis delta in areas of the world in which bulevirtide has not yet been approved, as well as challenges with diagnostics and management of the virus in different contexts. We will be joined by panelists in North America, Africa, Asia, and Australia. Hope to see you there! Please click here to register for part 1 and click here to register for part 2! We would love to hear from you! Complete the survey to sign up! Please note: This survey link is specifically for those living with hepatitis delta, or those who are caretakers of people living with hepatitis delta. Take our brief survey & sign up to receive updates on clinical trials, info about hepatitis delta monitoring, management & care + more! Sign up today! Please note: This survey link is specifically for healthcare providers caring for people living with hepatitis delta. We've educated 13,000 people in 111 countries!   News & Updates March 2023 Blog Post: Why Is Hepatitis Delta So Hard to Eliminate? December 2022 Blog Post: What You Need to Know About the 2022 Liver Meeting and How it Relates to Hepatitis Delta September 2022 Blog Post: What's the Difference? Herbal Remedies and Supplements vs. Western Medicine July 2022 Blog Post: Results from Hepatitis Delta Clinical Trials Announced at 2022 International Liver Congress View our webinar, "The Lived Experience of Hepatitis Delta" recording here. 05/17/2023: The Many Functions Of The Hepatitis D Antigen Proteins 05/16/2023: Hundreds of NHS patients in England and Wales offered access to first treatment conditionally licensed for the most aggressive form of viral hepatitis 05/15/2023: With NICE nod, Gilead clears another regulatory hurdle in Europe for Hepcludex 05/10/2023: RNA Gymnastics: How Does Hepatitis Delta Virus Replicate? 05/05/2023: After FDA rejection, Gilead's Hepcludex looks set for full EU nod 04/06/2023: Molecular and Clinical Features of Hepatocellular Carcinoma in Patients with HBV-HDV Infection 04/06/2023: Hepatitis D double reflex testing of all hepatitis B carriers in low HBV and high HBV/high HDV prevalence countries 03/20/2023: Real-world studies show efficacy, safety of BLV monotherapy in patients with HDV-related compensated cirrhosis 03/17/2023: Hepatitis Delta, Aisf and Simit specialists present joint and updated document 03/14/2023: Scottish Medicines Consortium accepts treatment for chronic hepatitis delta virus 03/2023: Improved hepatitis delta virus genome characterization by single molecule full-length genome sequencing combined with VIRiONT pipeline 01/21/2023: Bulevirtide in the Treatment of Hepatitis Delta: Drug Discovery, Clinical Development and Place in Therapy 01/11/2023: Identifying and Screening At-Risk Patients for Hepatitis Delta Virus: A Case Report 01/03/2023: A 3-Year Course Of Bulevirtide Monotherapy May Cure HDV Infection In Cirrhotics 01/2023: Effect of variants in LGP2 on MDA5-mediated activation of interferon response and suppression of hepatitis D virus replication 01/2023: D is for Diagnosis, Whom to Screen for hepatitis Delta virus Get Connected   

    https://www.hepb.org/research-and-programs/hepdeltaconnect/