Hepatitis delta virus (also named hepatitis D virus, HDV), the satellite virus of hepatitis B virus (HBV), exacerbates the disease burden associated with HBV infection. An early study, based on data published in the 1980s and 1990s, estimated that there were 15 million HDV infections globally, which would have represented 5% of all chronic HBV carriers at the time [1]. In 2018, a study reported approximately 62-72 million HDV infections worldwide, and this number was subsequently adjusted to an even higher estimate of 74 million [2,3]. However, this estimate was challenged and arguments were brought forward that this number constituted an over-estimation [4,5]. To clarify this controversy, we have recently re-estimated the global prevalence as 48-60 million HDV infections, corresponding to 0.8% of the general population, or 13% of all HBV carriers [6]. Very recently, an estimate of approximately 50 million HDV infections or a global prevalence of 0.7% in the general population was proposed [7,8]. Nevertheless, the dynamics of HDV epidemiology over the past decades remains largely obscure.
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