2198. Increased Global Incidence and Altered Demographic Profile of Hepatitis Delta Virus (HDV)

BACKGROUND: A significant increase in the yearly incidence of hepatitis delta virus (HDV) diagnosis in hepatitis B virus (HBV) patient populations has been identified through analysis of global infectious disease datasets. Currently, HDV is classified as a non-notifiable infectious disease in many countries around the world. Kuschner et al. reported over 90% of HBV-positive patients are not being tested for HDV (2015). Together, the non-notifiable status of HDV and the noncompliance in testing potential HDV carriers presents a significant barrier in active surveillance of changes in the incidence of HDV. Therefore, a study was designed to evaluate the global incidence of HDV using datamining approaches. METHODS: Datasets containing yearly HDV and HBV incidence were utilized in this study including the National Health and Nutritional Examination Survey (NHANES) datasets and 14 additional datasets obtained through data-mining of global infectious disease datasets. These global datasets of reported yearly HDV and HBV diagnoses and demographic data ranging between 1999 and 2016 were analyzed. RESULTS: Epidemiological analysis of infectious disease datasets from 15 countries identified a significant increase in the incidence of HDV relative to HBV-positive patients starting in 2011. Within the United States, analysis of NHANES datasets identified an increase in the incidence of HDV diagnosis among HBV-positive individuals from 5% in 1999–2010 to 58% in 2016. Comparative analysis of the yearly reported incidence of HDV and HBV in 14 additional countries identified a significant increase in the incidence of HDV in the same time period. Modeling of the collective spatiotemporal profile of the increase in HDV incidence is suggestive of a shared common intermittent exposure pattern of infection. The fastest growing demographic in the HDV-positive populations is in patients greater than 65 years of age. CONCLUSION: Our analysis identified a significant increase in the incidence of HDV diagnoses spanning three continents starting in 2011 and may be suggestive of an alteration in HDV transmission pattern. Active surveillance of HDV in the United States and worldwide is warranted to further define these observed changes in HDV incidence. DISCLOSURES: All authors: No reported disclosures.