Prospective study of hepatitis B and D epidemiology and risk factors in Romania: A 10-year update

Table 1 Demographic and clinical data for patients with hepatitis B virus monoinfection or hepatitis B virus/hepatitis D virus coinfection, %

Variable	HBV monoinfection (n = 644)	HBV/HDV coinfection (n = 319)	P value
Sex
Female	41.5	51.7	0.002a
Male	58.5	48.3	0.002a
Age, mean ± SD, yr
Total	51.6 ± 13.6	53.5 ± 11.7	0.03a
Female	51.2 ± 13.4	55.5 ± 11.4	0.002a
Male	51.8 ± 13.6	51.3 ± 11.7	0.67
Time since HBV diagnosis, mean ± SD, months	86.2 ± 3.4	112.8 ± 7.1	0.36
Stage of disease at diagnosis			< 0.0001a
Chronic hepatitis	87.9	73.1
Compensated liver cirrhosis	9.9	19.4
Decompensated liver cirrhosis	2.2	7.5
Hepatocellular carcinoma at diagnosis	2.6	4.1	0.22
HBeAg-positive	5.1	3.3	0.19
Liver stiffness measurement at therapy initiation, mean ± SD, kPa	8.7 ± 3.3	10.9 ± 5.7	0.003a
HBV DNA serum level at diagnosis, mean ± SD, IU/mL	2994542.8 ± 3014.7	610025.3 ± 158.9	< 0.0001a
Past or current pegylated interferon-α therapy	14.6	42.5	< 0.0001a
Current nucleos(t)ide analogue therapy	70.3	36.4	< 0.0001a
Previous documented COVID-19	40.8	34	0.0003a
Associated diabetes mellitus	11.2	7.5	0.07

^aP < 0.05, statistically significant P values.

COVID-19: Coronavirus disease 2019; HBeAg: Hepatitis B e antigen; HBV: Hepatitis B virus; HDV: Hepatitis D virus.

Table 2 Risk factors for hepatitis D virus infection based on the patient questionnaire data

Variable, %	HBV monoinfection (n = 644)	HBV/HDV coinfection (n = 319)	P value
Urban area	59.0	51.5	0.06
Education level			0.0006a
No or elementary school (0 to 8 yr)	17.6	24.3
High school (12 yr)	48.7	55.7
College/university	33.7	20
Vaccination against HBV (any dose)	15.6	12.5	0.25
Life partner vaccinated against HBV (any dose)	26.5	30.3	0.41
Known family members positive for HBV/HCV/HDV (monoinfection or coinfection)	18.4	20.5	0.48
Sexual contact with a partner positive for HBV/HCV/HDV (monoinfection or coinfection)	4.6	12.5	0.0001a
Occupation with risk of exposure to blood products	3.9	6.2	0.17
Blood transfusion	18.4	30	0.0004a
Haemodialysis in antecedents (long-term or incidental owing to a complication in ICU)	2.5	15.9	< 0.0001a
Any surgery before diagnosis (excluding dental surgery)	58.1	52.7	0.16
At least one hospitalization before diagnosis	82.3	65	< 0.0001a
Any dental surgery before diagnosis	83	67	< 0.0001a
Serious accidents (work, traffic, domestic)	8.4	21.3	< 0.0001a
Accidents with blood-contaminated objects	5.5	19	< 0.0001a
Injections at home/outpatient unit	4.8	16.7	< 0.0001a
Imprisonment (current or previous)	0.2	15.5	< 0.0001a
Tattoos/any body piercing	15	29.5	< 0.0001a
Injecting drug use	0.5	10.5	< 0.0001a
Multiple sexual partners in the past 3 years	15.9	25.6	0.001a
Previous sexually transmitted diseases	2.3	8.9	< 0.0001a
Abortions (improper conditions)1	3.3	5.9	0.14

^aP < 0.05, statistically significant P values.

¹Abortion was restricted between 1966 and 1989 in Romania.

HBV: Hepatitis B virus; HCV: Hepatitis C virus; HDV: Hepatitis D virus; ICU: Intensive care unit.