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Differences in delta virus hepatitis diagnosis methods and its effect on the hepatitis D prevalence
  1. Dan-Ting Shen1,
  2. Hemant Goyal2,
  3. Hua-Guo Xu1
  1. 1 Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
  2. 2 Department of Internal Medicine, Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA
  1. Correspondence to Dr Hua-Guo Xu, Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; huaguoxu{at}

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We thank H Wedemeyer and F Negro for their critical commentary about our article.1 The authors acknowledge that the global disease burden of hepatitis D virus (HDV) is higher than previously estimated. However, they emphasised limitation of this systematic review and meta-analysis that about one-third of anti-HDV-positive patients can have undetectable HDV RNA levels and the global disease burden estimated by only anti-HDV-positivity rate might not reflect the true prevalence of HDV.2 We agree with the authors that synchronous detection of anti-HDV antibodies and HDV RNA is necessary to diagnose the …

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  • Contributors H-GX and D-TS designed the study. All the authors contributed to the generation, collection, assembly, analysis and/or interpretation of data. D-TS and H-GX wrote the manuscript. H-GX and HG revised the manuscript. All the authors have read the manuscript and approved the final manuscript.

  • Funding This work was supported by the National Natural Science Foundation of China (81302531), the Natural Science Foundation of Jiangsu Province of China (BK20181492), the Talents Planning of Six Summit Fields of Jiangsu Province (2013-WSN-037), the Postgraduate Research & Practice Innovation Program of Jiangsu Province (KYCX17_1287 and SJCX18_0435), the National Key Clinical Department of Laboratory Medicine of China in Nanjing, the Key Laboratory for Laboratory Medicine of Jiangsu Province (ZDXKB2016005) and the Priority Academic Program Development of Jiangsu Higher Education Institutions.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.