Subgroup stratified burden of hepatitis D virus in Asia

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