OBJECTIVES: Hepatitis delta (HDV) is a rare condition, affecting a subset of HBV+ patients. EMA have recently approved the first treatment for this condition. Prevalence of HDV in the UK is unknown. Objective of this research was to estimate prevalence of HDV in England, Scotland & Wales in preparation for local and national budget discussions with clinicians and payers.

METHODS: Using a multivariate model framework outlined previously, population data for England, Scotland and Wales by country of origin were fed into the model to estimate HDV prevalence based on prior HBV and HDV prevalence by country of origin. Data sets were sought at individual regions within England and by health board within Wales & Scotland.

RESULTS: Total HDV prevalence within England, Scotland and Wales was estimated at 12-14k, 900-1k and 200-300 patients respectively. Highest regional prevalence for HDV in England was found in London (~45% of total England prevalence), with top 5 countries of birth for HDV prevalence identified as Romania, Nigeria, India, Pakistan & Somalia, accounting for ~35% of overall HDV. The overall co-infection rate for HBV+ HDV was calculated at 7%, 6% and 5% for England, Scotland & Wales respectively. Results were highly dependent on granularity of population data by country of origin.

CONCLUSIONS: HDV prevalence is highly dependant on migration populations and background rates of HBV infection. Overall across the UK, there are an estimated 14.5k HDV+ patients, however it is unlikely that the majority of these patients will be diagnosed / aware of their condition. Due to the diverse cultural backgrounds of potential patients, careful consideration will need to be given to how these patient access care and should be supported for their infection.