Title: Investigating HDV screening rates and associated demographic characteristics among first-time HBV positive patients in Alberta from 2018-2022

Background: Hepatitis D virus (HDV) occurs exclusively in Hepatitis B virus (HBV) carriers and increases risk of severe liver disease. However, the proportion of HBV carriers screened for HDV in Alberta remains unclear.

Purpose: We aimed to identify the proportion and demographic characteristics of first-time HBV carriers in Alberta screened for HDV.

Methods: HBV data was extracted from public health laboratory records between January 01, 2018-December 31, 2022 and linked to HDV testing data within 6 months of HBV diagnosis using patient PHN. Demographic characteristics were compared between individuals screened and not screened for HDV using Chi-Square tests. Geographic region and income quintile were analyzed using Alberta 2016 census estimates.

Results: From 3643 unique first-time HBV carriers, 264 (7.25%) were screened for HDV. Individuals aged 21-40 (48.5%, p<0.001), males (64.6%, p<0.001), and those living in metropolitan regions (86.6%, p=0.020) were most likely to receive HDV screening. HBV/HCV coinfected individuals were not more likely to receive screening compared to those with HBV monoinfection (p=0.215). All other demographics were statistically insignificant.

Conclusions: Overall, HDV screening was low in HBV carriers. A higher number of females were positive for HBV compared to males, yet the proportion screened for HDV was lower. More efforts should focus on HDV screening among HBV carriers who are older, females, those residing in rural regions, and those with HCV coinfection.