亚洲地区不同人群丁型肝炎病毒感染的流行情况

胡泽法·艾哈迈德; 里达·阿尤布; 乌萨马·艾哈迈德; 比拉勒·艾哈迈德; 阿菲娅·阿尤布; 阿迪勒·马苏德; 埃鲁姆·汗; 赛义德·哈米德

doi:10.12449/JCH260201

亚洲地区不同人群丁型肝炎病毒感染的流行情况

DOI: 10.12449/JCH260201

1.
阿迦汗大学病理学与检验医学系，卡拉奇巴基斯坦 74200
2.
阿迦汗大学眼科与视觉科学系，卡拉奇巴基斯坦 74200
3.
信德省人民初级卫生保健项目总部医务官地区办公室KHI-Ⅱ，卡拉奇巴基斯坦 75950
4.
齐亚丁医院内科与联合健康科学系，卡拉奇巴基斯坦 75600
5.
阿迦汗大学临床试验中心，卡拉奇巴基斯坦 74200

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：胡泽法·艾哈迈德负责研究构思，数据分析，撰写文章；里达·阿尤布、乌萨马·艾哈迈德参与数据分析和文章撰写工作；乌萨马·艾哈迈德参与文章初审；比拉勒·艾哈迈德参与数据提取和文章准备；阿菲娅·阿尤布、阿迪勒·马苏德参与文章撰写与修订；埃鲁姆·汗负责方法学指导及文章审阅；赛义德·哈米德负责全面指导、终审和定稿。

详细信息

通信作者:
赛义德·萨迪克·哈米德， saeed.hamid@aku.edu （ORCID： 0000-0001-7218-6885）

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出版历程
- 收稿日期: 2026-02-10
- 录用日期: 2026-02-25
- 出版日期: 2026-02-25

Subgroup stratified burden of hepatitis D virus in Asia

1.
Aga Khan University，Department of Pathology & Laboratory Medicine，Stadium Road，Karachi，Pakistan 74200
2.
Aga Khan University，Department of Ophthalmology and Visual Sciences，Stadium Road，Karachi，Pakistan 74200
3.
People’s Primary Healthcare Initiative （PPHI） Sindh，Medical Officer Head Quarters，District Office-KHI Ⅱ，Karachi，Pakistan 75950
4.
Dr Ziauddin Hospital，Clifton，The Department of Medicine and Allied Health Sciences，Karachi，Pakistan 75600
5.
Aga Khan University，Clinical Trials Unit，Stadium Road，Karachi，Pakistan 74200

More Information

Corresponding author: Saeed S. Hamid，saeed.hamid@aku.edu（ORCID：0000-0001-7218-6885）

摘要

摘要: 丁型肝炎病毒（HDV）感染是病毒性肝炎中最严重的类型，但因筛查策略不一致及监测有限，在亚洲地区长期被忽视。本文系统综述了1970—2025年亚洲地区的社区/普通人群、肝病门诊/医院队列及高危人群3个亚组分层的HDV流行率，其中，巴基斯坦、哈萨克斯坦及吉尔吉斯斯坦的社区/普通人群HDV流行率高；蒙古国、乌兹别克斯坦的肝病门诊/医院队列呈高地方性流行；中国香港、中国台湾及越南、阿曼苏丹国的高危人群中存在传播集中现象。此外，许多国家尚缺乏可查的亚组数据。HDV流行分布不均且因人群特征而异的疾病负担凸显。HDV感染是进展期肝病的重要驱动因素，加强常规HDV筛查及RNA检测，对于明确疾病负担和推进实现世界卫生组织提出的“2030年消除病毒性肝炎公共卫生危害”这一目标至关重要。
- δ肝炎病毒 /
- 流行病学 /
- 亚洲
Abstract: Hepatitis D virus （HDV） infection， the most severe form of viral hepatitis， remains underrecognized in the Asia due to inconsistent screening and limited surveillance. This systematic review （1970—2025） stratified HDV prevalence by population subgroups： community， hospital-based， and high-risk.Community studies showed high prevalence in Pakistan， Kazakhstan， and Kyrgyzstan； hospital cohorts revealed hyperendemicity in Mongolia and Uzbekistan； high-risk populations showed concentrated transmission in ［Hong Kong， China］，［Taiwan， China］， Vietnam， and Sultanate of Oman. Many countries and regions lacked subgroup-specific data.The uneven， population-dependent burden underscores HDV as a major driver of advanced liver disease in Central and South Asia. Routine HDV screening and RNA-based diagnostics are essential to define burden and advance WHO 2030 elimination targets.¹
- Hepatitis Delta Virus /
- Epidemiology /
- Asia

HTML全文

图 1 基于社区/普通人群研究的亚洲地区丁型肝炎病毒感染风险分布图

Figure 1. Bar charts representing risk distribution of hepatitis D virus infection in Asia regions based on community/ general population based studies

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图 2 基于肝病门诊/医院研究的亚洲地区丁型肝炎病毒感染风险分布图

Figure 2. Bar charts representing risk distribution of hepatitis D virus infection in Asia regions based on liver clinic/ hospital based studies

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图 3 基于高风险人群的亚洲地区丁型肝炎病毒感染风险分布图

Figure 3. Bar charts representing risk distribution of hepatitis D virus infection in Asia regions based on high-risk population

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图 4 乙型肝炎病毒阳性患者中丁型肝炎病毒阳性率的森林图

Figure 4. Forest plot demonstrating hepatitis D virus seropositivity in hepatitis B virus-positive patients

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图 5 乙型肝炎病毒阳性患者中丁型肝炎病毒RNA检出率的森林图

Figure 5. Forest plot demonstrating hepatitis D virus RNA prevalence in hepatitis B virus-positive patients

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参考文献(80)

[1]	DEGASPERI E, SANDMANN L, WEDEMEYER H, et al. Hepatitis D virus infection: Pathophysiology, epidemiology and treatment. report from the third delta cure meeting 2024[J]. Liver Int, 2025, 45( 7): e70189. DOI: 10.1111/liv.70189.
[2]	MIAO ZJ, ZHANG SS, OU XM, et al. Estimating the global prevalence, disease progression, and clinical outcome of hepatitis delta virus infection[J]. J Infect Dis, 2020, 221( 10): 1677- 1687. DOI: 10.1093/infdis/jiz633.
[3]	STOCKDALE AJ, KREUELS B, HENRION MYR, et al. The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis[J]. J Hepatol, 2020, 73( 3): 523- 532. DOI: 10.1016/j.jhep.2020.04.008.
[4]	ÖRMECI N, ERDEM H. Changing trends in the epidemiology of delta virus infection[J]. Vhd, 2023, 29( 1): 1- 9. DOI: 10.4274/vhd.galenos.2023.2023-3-1.
[5]	RAZAVI-SHEARER D, CHILD H, RAZAVI-SHEARER K, et al. Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories[J]. J Hepatol, 2024, 80( 2): 232- 242. DOI: 10.1016/j.jhep.2023.10.043.
[6]	GIDAAGAYA S, ROKUHARA A, SUGIYAMA M, et al. Prevalence, characteristics, and virologic correlations of hepatitis delta(D) among patients with hepatitis B surface antigen in Mongolia[J]. Glob Health Med, 2024, 6( 2): 101- 107. DOI: 10.35772/ghm.2023.01080.
[7]	CHEN XH, OIDOVSAMBUU O, LIU P, et al. A novel quantitative microarray antibody capture assay identifies an extremely high hepatitis delta virus prevalence among hepatitis B virus-infected mongolians[J]. Hepatology, 2017, 66( 6): 1739- 1749. DOI: 10.1002/hep.28957.
[8]	KHODJAEVA M, IBADULLAEVA N, KHIKMATULLAEVA A, et al. Hepatitis D virus in Uzbekistan[J]. Lancet Gastroenterol Hepatol, 2020, 5( 3): 238- 240. DOI: 10.1016/S2468-1253(19)30350-4.
[9]	TOY M, GÜLER B, SOMAY K, et al. Hepatitis delta virus infection in Turkey: A meta-analysis of prevalence[J]. IJID Reg, 2024, 10: 228- 234. DOI: 10.1016/j.ijregi.2024.02.003.
[10]	MUMTAZ K, HAMID SS, ADIL S, et al. Epidemiology and clinical pattern of hepatitis delta virus infection in Pakistan[J]. J Gastroenterol Hepatol, 2005, 20( 10): 1503- 1507. DOI: 10.1111/j.1440-1746.2005.03857.x.
[11]	LIANG X, CHEN Q, TANG H, et al. Prevalence of hepatitis D virus antibody in Chinese patients with chronic hepatitis B[J]. J Clin Transl Hepatol, 2025, 13( 4): 278- 283. DOI: 10.14218/JCTH.2024.00313.
[12]	WANG Y, SHEN GZ, LU RC, et al. The prevalence of HDV among HBsAg-positive populations with and without HIV-1 in China[J]. Int J Infect Dis, 2024, 140: 70- 77. DOI: 10.1016/j.ijid.2023.12.014.
[13]	ROGGENBACH I, CHI XM, LEMPP FA, et al. HDV seroprevalence in HBsAg-positive patients in China occurs in hotspots and is not associated with HCV mono-infection[J]. Viruses, 2021, 13( 9): 1799. DOI: 10.3390/v13091799.
[14]	LNU M. Viral hepatitis in Indonesia: Past, present, and future[J]. Eurasian J Hepato Gastroenterol, 2016, 6( 1): 65- 69. DOI: 10.5005/jp-journals-10018-1171.
[15]	ABBAS M, ABBAS Z, SHARIF MY. Community-based double reflex screening reveals widespread hepatitis D viremia among hepatitis B surface antigen carriers in Pakistan[J]. Cureus, 2025, 17( 6): e85200. DOI: 10.7759/cureus.85200.
[16]	JAHAN S, FATIMA G. HBV-HDV co-infection: Alarming prevalence at a tertiary care Hospital, Karachi, Pakistan[J]. Int J Infect Dis, 2020, 101: 523. DOI: 10.1016/j.ijid.2020.09.1355.
[17]	JAMIL AR. Prevalence of hepatitis delta virus in Sindh and Punjab(Pakistan) epidemiological survey[J]. Int J Infect Dis, 2016, 45: 228. DOI: 10.1016/j.ijid.2016.02.514.
[18]	BATHIJA SK, TUNIO S, BANO S, et al. Seroprevalence of hepatitis delta virus(HDV) in Hyderabad, Sindh[J]. J Microbiol Sci, 2023, 2( 1): 11- 13. DOI: 10.38211/jms.2023.01.49.
[19]	ZAIDI G, IDREES M, MALIK FA, et al. Prevalence of hepatitis delta virus infection among hepatitis B virus surface antigen positive patients circulating in the largest province of Pakistan[J]. Virol J, 2010, 7: 283. DOI: 10.1186/1743-422x-7-283.
[20]	BAZ M, SANA U, HASINA J, et al. Revalence of HDV infection among HBsAg positive patients in district Nasirabad Balochistan[J]. Pak Euro J Med Life Sci, 2023, 6( 4): 589- 596. DOI: 10.31580/pjmls.v6i4.2567.
[21]	KHAN AU, WAQAR M, AKRAM M, et al. True prevalence of twin HDV-HBV infection in Pakistan: A molecular approach[J]. Virol J, 2011, 8( 1): 420. DOI: 10.1186/1743-422X-8-420.
[22]	SONKAR A, BISHWAL SC, SHARMA RK, et al. Prevalence of Hepatitis D virus antibodies in Hepatitis B patients treated at tertiary care unit at Jabalpur Central India[J]. Indian J Med Microbiol, 2022, 40( 1): 132- 134. DOI: 10.1016/j.ijmmb.2021.11.003.
[23]	JAT SL, GUPTA N, KUMAR T, et al. Prevalence of hepatitis D virus infection among hepatitis B virus-infected individuals in India[J]. Indian J Gastroenterol, 2015, 34( 2): 164- 168. DOI: 10.1007/s12664-015-0555-6.
[24]	SHAH L, MULLAN S. Prevalence of hepatitis D virus in South Gujarat[J]. Natl J Med Res, 2012, 2( 2): 177- 120.
[25]	CHAKRABORTY C, GHOSH K, CHAKRABORTY S. Prevalence of hepatitis D among hepatitis B cases in eastern India[J]. Indian J Basic Appl Med Res, 2015, 4( 4): 195- 199.
[26]	SARAVANAN S, VELU V, KUMARASAMY N, et al. Seroprevalence of hepatitis delta virus infection among subjects with underlying hepatic diseases in Chennai, southern India[J]. Trans R Soc Trop Med Hyg, 2008, 102( 8): 793- 796. DOI: 10.1016/j.trstmh.2008.05.001.
[27]	CHAKRABORTY P, KAILASH U, JAIN A, et al. Seroprevalence of hepatitis D virus in HBV-related liver disease[J]. Indian J Med Res, 2005, 122( 3): 254- 257.
[28]	ZAKI H, DARMSTADT GL, BATEN A, et al. Seroepidemiology of hepatitis B and delta virus infections in Bangladesh[J]. J Trop Pediatr, 2003, 49( 6): 371- 374. DOI: 10.1093/tropej/49.6.371.
[29]	ARAKAWA Y, MORIYAMA M, TAIRA M, et al. Molecular analysis of hepatitis D virus infection in Miyako Island, a small Japanese island[J]. J Viral Hepat, 2000, 7( 5): 375- 381. DOI: 10.1046/j.1365-2893.2000.00244.x.
[30]	SASAKI T, SUDA G, OHARA M, et al. Recent prevalence and characteristics of patients with hepatitis delta virus in Hokkaido, Japan[J]. Hepatol Res, 2023, 53( 10): 960- 967. DOI: 10.1111/hepr.13936.
[31]	NAKASONE H, SAKUGAWA H, SHOKITA H, et al. Prevalence and clinical features of hepatitis delta virus infection in the Miyako Islands, Okinawa, Japan[J]. J Gastroenterol, 1998, 33( 6): 850- 854. DOI: 10.1007/s005350050186.
[32]	SY NE, MACALAGAY PS, PAULINO GP, et al. Serologic classification of acute viral hepatitis at San Lazaro Hospital, Manila, Philippines[J]. Southeast Asian J Trop Med Public Health, 1990, 21( 1): 69- 75.
[33]	BINH MT, HOAN NX, VAN TONG H, et al. HDV infection rates in northern Vietnam[J]. Sci Rep, 2018, 8: 8047. DOI: 10.1038/s41598-018-26446-w.
[34]	NGUYEN HM, SY BT, TRUNG NT, et al. Prevalence and genotype distribution of hepatitis delta virus among chronic hepatitis B carriers in Central Vietnam[J]. PLoS One, 2017, 12( 4): e0175304. DOI: 10.1371/journal.pone.0175304.
[35]	HALL N, THUY LN, DO THI D, et al. High prevalence of hepatitis delta virus among persons who inject drugs, Vietnam[J]. Emerg Infect Dis, 2015, 21( 3): 540- 543. DOI: 10.3201/eid2103.141147.
[36]	SY BT, RATSCH BA, TOAN NL, et al. High prevalence and significance of hepatitis D virus infection among treatment-Naïve HBsAg-positive patients in northern Vietnam[J]. PLoS One, 2013, 8( 10): e78094. DOI: 10.1371/journal.pone.0078094.
[37]	KHOSROJERDI A, JAVANMARD D, PAGHEH AS, et al. Investigation of seroprevalence and risk factors of hepatitis D in provinces with common borders of Iran and Afghanistan[J]. Hepat Mon, 2025, 25( 1): e149232. DOI: 10.5812/hepatmon-149232.
[38]	AZAD AR, ZARGAR MR, ZOLFAGHARI MR, et al. The prevalence of hepatitis B and D viruses and evaluating YMDD mutation in HBV-suspected patients in Qom province, Iran[J]. Jundishapur J Microbiol, 2020, 13( 2): e100038. DOI: 10.5812/jjm.100038.
[39]	POURI AA, GHOJAZADEH M, BAIAZ B, et al. Prevalence of hepatitis D virus among HBsAg-positive individuals,2015-2016: Azar cohort study[J]. Health Promot Perspect, 2020, 10( 1): 38- 42. DOI: 10.15171/hpp.2020.07.
[40]	TAHAEI SM, MOHEBBI SR, AZIMZADEH P, et al. Prevalence of hepatitis D virus in hepatitis B virus infected patients referred to Taleghani hospital, Tehran, Iran[J]. Gastroenterol Hepatol Bed Bench, 2014, 7( 3): 144- 150.
[41]	GHADIR MR, BELBASI M, HEIDARI A, et al. Prevalence of hepatitis D virus infection among hepatitis B virus infected patients in Qom province, center of Iran[J]. Hepat Mon, 2012, 12( 3): 205- 208. DOI: 10.5812/hepatmon.5121.
[42]	ZIAEE M, AZARKAR G. Prevalence of hepatitis D virus infection among patients with chronic hepatitis B attending birjand hepatitis clinic(east of Iran) in 2012[J]. Hepat Mon, 2013, 13( 8): e11168. DOI: 10.5812/hepatmon.11168.
[43]	DULGER AC, SUVAK B, GONULLU H, et al. High prevalence of chronic hepatitis D virus infection in Eastern Turkey: Urbanization of the disease[J]. Arch Med Sci, 2016, 12( 2): 415- 420. DOI: 10.5114/aoms.2015.52030.
[44]	ANANCHUENSOOK P, SUKSAWATAMNUAY S, THAIMAI P, et al. Prevalence of hepatitis D virus infection among patients with chronic hepatitis B infection in a tertiary care centre in Thailand[J]. Sci Rep, 2023, 13: 22633. DOI: 10.1038/s41598-023-49819-2.
[45]	HONGJAISEE S, KHAMDUANG W, SRIPAN P, et al. Prevalence and factors associated with hepatitis B and D virus infections among migrant sex workers in Chiangmai, Thailand: A cross-sectional study in 2019[J]. Int J Infect Dis, 2020, 100: 247- 254. DOI: 10.1016/j.ijid.2020.09.004.
[46]	CHO Y, PARK S, PARK S, et al. Real-world epidemiology, treatment patterns, and disease burden of chronic hepatitis B and HDV co-infection in South Korea[J]. Infect Dis Ther, 2023, 12( 10): 2387- 2403. DOI: 10.1007/s40121-023-00860-8.
[47]	KIM HS, KIM SJ, PARK HW, et al. Prevalence and clinical significance of hepatitis D virus co-infection in patients with chronic hepatitis B in Korea[J]. J Med Virol, 2011, 83( 7): 1172- 1177. DOI: 10.1002/jmv.22095.
[48]	JEONG SH, KIM JM, AHN HJ, et al. The prevalence and clinical characteristics of hepatitis delta infection in Korea[J]. Korean J Hepatol, 2005, 11( 1): 43- 50.
[49]	HAMA SA, SIRWAN R, ABUBAKR M, et al. Clinical prevalence of hepatitis D virus among hepatitis B patients in sulaymaniyah governorate, northern Iraq[J]. J Viral Hepat, 2024, 31( 11): 670- 676. DOI: 10.1111/jvh.13987.
[50]	HUSSEIN NR, RASHEED ZA, TAHA AA, et al. The prevalence of hepatitis D virus infection amongst patients with chronic active hepatitis B virus infection in Duhok Governorate[J]. Int J Pure Appl Sci Technol, 2015, 28( 1): 1- 7.
[51]	HUSSEINI A ALI, SAEED KMI, YURDCU E, et al. Epidemiology of blood-borne viral infections in Afghanistan[J]. Arch Virol, 2019, 164( 8): 2083- 2090. DOI: 10.1007/s00705-019-04285-y.
[52]	HUSSEINI A ALI, ROSTAMZADEH M. Phylogenetic analysis and prevalence of Delta hepatitis among HBsAg carriers in Afghanistan[J]. Mol Biol Res Commun, 2022, 11( 4): 183- 186. DOI: 10.22099/mbrc.2022.44692.1780.
[53]	GUNEID AM EL, GUNAID AA, O’NEILL AM, et al. Prevalence of hepatitis B, C, and D virus markers in Yemeni patients with chronic liver disease[J]. J Med Virol, 1993, 40( 4): 330- 333. DOI: 10.1002/jmv.1890400413.
[54]	HUDU SA, NIAZLIN MT, NORDIN SA, et al. Genetic diversity of hepatitis B co-infection with hepatitis C, D and E viruses among Malaysian chronic hepatitis B patients[J]. Afr H Sci, 2018, 18( 4): 1117. DOI: 10.4314/ahs.v18i4.33.
[55]	TAN DS, DIMITRAKAKIS M, MANGALAM S, et al. Prevalence of hepatitis delta virus infection in Malaysia[J]. Singapore Med J, 1989, 30( 1): 34- 37.
[56]	JAMJOOM GA, EL-DALY MM, AZHAR EI, et al. Prevalence and molecular characterization of hepatitis D virus in Saudi Arabia: A single-center study[J]. Saudi J Gastroenterol, 2017, 23( 3): 176- 182. DOI: 10.4103/sjg.SJG_515_16.
[57]	Abstracts[J]. Saudi J Gastroenterol, 2024, 30( Suppl 2): S43- S58. DOI: 10.4103/sjg.sjg_439_24.
[58]	Abstracts[J]. Saudi J Gastroenterol, 2023, 29( Suppl 2): S37- S50. DOI: 10.4103/sjg.sjg_413_23.
[59]	REGMI K, SHRESTHA JK, SUDHAMSHU KC, et al. Prevalence of hepatitis D among patients with hepatitis B viral infection attending a tertiary care centre of Nepal[J]. J Nepal Med Assoc, 2017, 56( 208): 417- 420. DOI: 10.31729/jnma.3378.
[60]	JUMABAYEVA A, NERSESOV A, KULZHANOV M, et al. Prevalence of viral hepatitis B, C, and D in Kazakhstan[J]. Sci World J, 2022, 2022: 9102565. DOI: 10.1155/2022/9102565.
[61]	ILYASSOVA BS, ABZHAPAROVA B, SMAILOVA DS, et al. Prevalence and genotypes distribution of virus hepatitis B and hepatitis delta virus in chronic liver diseases in Kazakhstan[J]. BMC Infect Dis, 2023, 23: 533. DOI: 10.1186/s12879-023-08524-1.
[62]	TOUKAN AU, ABU-EL-RUB OA, ABU-LABAN SA, et al. The epidemiology and clinical outcome of hepatitis D virus(delta) infection in Jordan[J]. Hepatology, 1987, 7( 6): 1340- 1345. DOI: 10.1002/hep.1840070627.
[63]	KHETSURIANI N, TISHKOVA F, JABIROV S, et al. Substantial decline in hepatitis B virus infections following vaccine introduction in Tajikistan[J]. Vaccine, 2015, 33( 32): 4019- 4024. DOI: 10.1016/j.vaccine.2015.05.092.
[64]	DUSTOV A, KHAKIMOVA Z. Hepatitis B, D, C, and HCC viruses in Tajikistan[J]. Gastroint Hepatol Dig Dis, 2018, 1( 1): 1- 4. DOI: 10.33425/2639-9334.1004.
[65]	AGHAYEVA G. Epidemiological and clinical problems of hepatitis delta in Azerbaijan. 2020[EB/OL]. https://www.academia.edu/41961235/Epidemiological_and_clinical_problems_of_Hepatitis_Delta_in_Azerbaijan. https://www.academia.edu/41961235/Epidemiological_and_clinical_problems_of_Hepatitis_Delta_in_Azerbaijan
[66]	YARDENI D, CIVIDALLI O, ITKOWITZ B, et al. Impact of universal screening forHDVinHBV-infected patients on Chronic HDV Detection rate in Israel[J]. J Viral Hepat, 2025, 32( 7): e70046. DOI: 10.1111/jvh.70046.
[67]	SHIRAZI R, RAM D, RAKOVSKY A, et al. Characterization of hepatitis B and delta coinfection in Israel[J]. BMC Infect Dis, 2018, 18( 1): 97. DOI: 10.1186/s12879-018-3008-x.
[68]	EILAT-TSANANI S, ZOUBI A, HAZZAN R. Detection of hepatitis D virus: Performance in the community[J]. Isr Med Assoc J, 2022, 24( 8): 529- 532.
[69]	VIRACHITH S, PHAKHOUNTHONG K, KHOUNVISITH V, et al. Hepatitis B virus exposure, seroprotection status, and susceptibility in health care workers from Lao people’s democratic republic: Cross-sectional study[J]. JMIR Public Health Surveill, 2024, 10: e65093. DOI: 10.2196/65093.
[70]	AKMATOV MK, BEISHEEVA NJ, NURMATOV AZ, et al. The changing epidemiology of viral hepatitis in a post-soviet country: The case of Kyrgyzstan[J]. Pathogens, 2023, 12( 8): 989. DOI: 10.3390/pathogens12080989.
[71]	RAMIA S, EL-ZAATARI M, SHARARA AI, et al. Current prevalence of hepatitis delta virus(HDV) infection and the range of HDV genotypes in Lebanon[J]. Epidemiol Infect, 2007, 135( 6): 959- 962. DOI: 10.1017/s0950268806007643.
[72]	AGHANASHINIKAR PN, AL-DHAHRY SH, AL-MARHUBY HA, et al. Prevalence of hepatitis B and delta in Omani patients[J]. Transplant Proc, 1992, 24( 5): 1913- 1914. DOI: 10.1097/00007890-199210000-00046.
[73]	AL-KANDARI S, NORDENFELT E, AL-NAKIB B, et al. Hepatitis delta virus infection in acute hepatitis in Kuwait[J]. Scand J Infect Dis, 1988, 20( 1): 15- 19. DOI: 10.3109/00365548809117212.
[74]	KASRADZE A, SHADAKER S, KUCHULORIA T, et al. The burden and epidemiology of hepatitis B and hepatitis D in Georgia: Findings from the national seroprevalence survey[J]. Public Health, 2020, 185: 341- 347. DOI: 10.1016/j.puhe.2020.06.024.
[75]	ABDALLAH T, IBRAHIM T, HAJMUSA M, et al. Seroprevalence and clinical outcome of hepatitis D infection in Qatar[J]. East Mediterr Health J, 2022, 28( 11): 840- 846. DOI: 10.26719/emhj.22.081.
[76]	DEMIRCHYAN A, DUDAREVA S, SAHAKYAN S, et al. Prevalence of hepatitis B virus infection among general population of Armenia in 2021 and factors associated with it: A cross-sectional study[J]. BMJ Open, 2024, 14( 2): e080281. DOI: 10.1136/bmjopen-2023-080281.
[77]	LEE WC, CHEN TK, HAN HF, et al. Investigating the prevalence and clinical effects of hepatitis delta viral infection in Taiwan, China[J]. J Microbiol Immunol Infect, 2021, 54( 5): 901- 908. DOI: 10.1016/j.jmii.2021.03.014.
[78]	LIN HH, LEE SS, YU ML, et al. Epidemiology of hepatitis delta virus infection in HIV-infected individuals in Taiwan, China[J]. Retrovirology, 2012, 9( 1): P49. DOI: 10.1186/1742-4690-9-S1-P49.
[79]	LIU KSH, SETO WK, LAU EHY, et al. A territorywide prevalence study on blood-borne and enteric viral hepatitis in Hong Kong, China[J]. J Infect Dis, 2019, 219( 12): 1924- 1933. DOI: 10.1093/infdis/jiz038.
[80]	LOK AS, WONG A, SPORTON S, et al. Hepatitis D virus superinfection in Hong Kong, China[J]. J Hepatol, 1992, 14( 2-3): 332- 334. DOI: 10.1016/0168-8278(92)90179-s.