Hepatitis D can be transmitted through blood, sexual contact, and percutaneous incjection (IV drug users, hemopheliacs). Perinatal infection is rare. HDV is seen worldwide, with more than 10 million people infected. Epidemics have been observed in the Amazon Basin, the Mediterranean Basin and Central Africa, and HDV spread by close contact is endemic to many Mediterranean countries, while in the US it is for the most part confined to persons exposed to contaminated blood.

A CDC map of HDV prevalence across the globe 0

From: Centers for Disease Control and Prevention (CDC), Atlanta, USA.

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