Evidence map›Paper›PMID 25962883›Full record

ArticleJournal of hepatology2015

Delta hepatitis within the Veterans Affairs medical system in the United States: Prevalence, risk factors, and outcomes.

Tatyana Kushner, Marina Serper, David E Kaplan

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hepatology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 5 pooled it
6.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 5 syntheses or guidelines pooled it, 159 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Pooled it
  6. Trial
  7. Article
  8. Article
  9. Review
  10. Review
  11. Analysis of a PCORnetCommunications medicine · 2026
    Article
  12. Article
  13. Article
  14. Low coverage of hepatitis D virus testing in individuals with hepatitis B virus and HIV, the Netherlands, 2000 to 2022.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025
    Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. [Current status of diagnosis and treatment and progress in drug research and development for hepatitis D].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024
    Review

12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Tatyana KushnerDivision of Gastroenterology, University of Pennsylvania, Philadelphia, PA, United States.
Marina SerperDivision of Gastroenterology, University of Pennsylvania, Philadelphia, PA, United States; Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States.
David E KaplanDivision of Gastroenterology, University of Pennsylvania, Philadelphia, PA, United States; Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States. Electronic address: dakaplan@mail.med.upenn.edu.
University of Pennsylvania · US

Funding

CLINICAL EPIDEMIOLOGY TRAINING IN GASTROENTEROLOGYT32DK007740 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI James D Lewis · 1997 to 2026
$9.2M
Intramural VA VA999999NIAID NIH HHS L30 AI133795NIDDK NIH HHS T32 DK007740NIDDK NIH HHS T32 DK007740-18
6 · The paper itself

Abstract

BACKGROUND &

aimsLow hepatitis delta prevalence estimates in the United States are likely biased due to low testing rates. The objectives of this study were to quantify the prevalence of testing and identify factors associated with hepatitis D positive status among chronic hepatitis B patients in the Veterans Health Administration.

methodsWe performed a nationwide retrospective study of all veterans who tested positive for HBsAg from October 1999 to December 2013. Hepatitis D antibody testing results were used to stratify patients into three groups: HDV-positive, HDV-negative, and HDV-not tested. Demographics, comorbidities, additional laboratory data and clinical outcomes were compared across these groups of patients using standard statistical approaches.

resultsAmong 25,603 patients with a positive hepatitis B surface antigen, 2175 (8.5%) were tested for HDV; 73 (3.4%) patients tested positive. Receiving HDV testing was associated with receipt of testing for HBV, HIV, and HCV. Predictors of positive HDV results included substance abuse and cirrhosis. Fitting a predefined high-risk profile (abnormal ALT with suppressed HBV DNA titers) was strongly associated with testing positive for HDV (OR 3.2, 95%CI 1.4-7.5). Most (59%) of HDV-positive patients were HCV co-infected. HDV-positive subjects had higher risks of all-cause mortality. Incidence rates of HCC were 2.9 fold higher in HDV-positive relative to HDV-negative individuals (p=0.002). In adjusted analyses, HDV was independently associated with HCC (OR 2.1, 95%CI 1.1-3.9).

conclusionsTesting rates for hepatitis delta in chronic hepatitis B patients in the United States are inappropriately low. Approaches to increase testing for HDV particularly in high-risk subsets should be explored.

Indexed as

VeteransAdultAgedCoinfectionFemaleHepatitis AntibodiesHepatitis B Surface AntigensHepatitis DHepatitis Delta VirusHumansMaleMiddle AgedPrevalenceRetrospective StudiesRisk FactorsUnited StatesHepatitis AntibodiesHepatitis B Surface AntigensDatabaseHepatitis BHepatitis DHepatocellular carcinoma

Identifiers

PMID25962883
PMCPMC4574953
OpenAlexW1810525385

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.