Hepatitis D in the Middle East and North Africa (MENA): Update and Challenges Ahead

Abstract

Hepatitis D virus (HDV) is a defective RNA virus and its life cycle is dependent on hepatitis B virus (HBV). Worldwide, it is estimated that 15 to 20 million individuals are HDV- infected representing approximately 5 % of the 350 million cases of HBV chronically- infected individuals. The belief that HDV is under control is far from true. Studies from Europe have clearly shown that HDV reservoirs have been maintained via import from Southern or Eastern Europe, and from endemic areas such as countries of the Middle East and North Africa (MENA region). The current review highlights the underestimated disease burden caused by HDV in the MENA region. A series of recommendations are advanced which will contribute to the control of HBV/HDV in the MENA region and consequently in neighboring Europe. The lack of conclusive evidence on the best treatment strategy of HDV, necessitates continued research on HDV infection.