Epidemiology and Intrafamilial Transmission of Hepatitis D: Current Trends and Challenges

Abstract

Hepatitis D virus (HDV) remains a significant global public health concern, particularly in regions where hepatitis B virus (HBV) infection is endemic. As a defective virus that requires HBV co-infection, HDV contributes to the rapid progression of liver disease, often resulting in cirrhosis and hepatocellular carcinoma at a younger age compared to HBV monoinfection. Despite global efforts to eliminate viral hepatitis, HDV remains underdiagnosed and underreported, especially in developing countries. This review summarizes current knowledge on the epidemiology of hepatitis D, highlighting regional variations, risk factors, and population groups at elevated risk. Special emphasis is placed on the mechanisms and prevalence of intrafamilial transmission, an aspect that has received limited attention despite its critical role in maintaining viral circulation. Challenges in diagnosis, the lack of standardized testing, and limited antiviral treatment options are discussed. Recent advances in HDV therapeutics and prevention strategies are also explored, with a focus on public health implications.