Author information

• ¹Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States.
• ²Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States.
• ³Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA, United States.
• ⁴School of Medicine and University of North Carolina Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
• ⁵Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, United States.
• ⁶Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, United States.
• ⁷Department of Medicine, University of Miami Health System, Miami, FL, United States.
• ⁸Division of Neurology, Cook County Health, Chicago, IL, United States.
• ⁹Cook County Health, Hektoen Institute of Medicine, Chicago, IL, United States.
• ¹⁰Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, United States.
• ¹¹Department of Medicine, University of California, San Francisco, San Francisco, CA, United States.
• ¹²Division of Infectious Diseases, University of Alabama-Birmingham Heersink School of Medicine, Birmingham, AL, United States.
• ¹³Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, United States.
• ¹⁴Grady Health System, Infectious Diseases Program, Atlanta, GA, United States.
• ¹⁵Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
• ¹⁶Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, United States.

Abstract

Hepatitis D virus (HDV) requires co-infection with hepatitis B virus (HBV). Human immunodeficiency virus (HIV) shares transmission routes with these viruses. Among 4,932 US women infected with or at-risk for HIV during 1994-2015, HBV surface antigen (HBsAg) positivity was more common in women with HIV (2.8% vs. 1.2%; p = 0.001); HDV was more common among participants enrolled during 2013-2015 (p = 0.0004) and those with resolved rather than active hepatitis C (1.9% vs. 0.5%; p = 0.02). Among HBsAg-positive women (n = 117), HDV antibody prevalence was 22% and did not vary by HIV status; HDV infection was associated with the presence of advanced fibrosis/cirrhosis at enrollment (adjusted odds ratio, 5.70; 95% confidence interval, 1.46-22.29). Our results demonstrate the importance of HDV testing in HBV-infected US women.