We sincerely appreciate Stockdale and colleagues1 for their critical consideration of our article. Herein, we tried to answer their concerns about the methodology of our meta-analysis.2 We used hepatitis D virus (HDV) antibody (both IgM and IgG) seropositivity as a measure of overall burden of HDV seroprevalence. Although anti-HDV IgM Ab assays may fail to detect low titres of antibodies and underestimate HDV seroprevalence,3 patients with a negative anti-HDV IgM results are less likely to progress into clinical disease.4 Majority of the included studies in our article used anti-HDV antibody assays and only two mentioned the use of RNA assays for the prevalence of HDV. Therefore, considering the wide application of the anti-HDV antibody assay as a measure of HDV seroprevalence,5 we used the similar method in our meta-analysis. We do not think it would be correct to extrapolate the prevalence of HBsAg based on our estimates of HDV seroprevalence among general population and mixed population (HBsAg carriers without risk factors such as intravenous drug use and high-risk sexual behaviours). This is because the general population and the mixed …

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丁型肝炎：不再是一种罕见疾病：2017-2018 年全球更新

我们衷心感谢 Stockdale 及其同事 1 对我们文章的批判性考虑。在此，我们试图回答他们对我们的荟萃分析方法的担忧。2 我们使用丁型肝炎病毒 (HDV) 抗体（IgM 和 IgG）血清阳性作为衡量 HDV 血清阳性率总体负担的指标。尽管抗 HDV IgM Ab 检测可能无法检测到低滴度抗体并低估 HDV 血清阳性率3，但抗 HDV IgM 结果为阴性的患者不太可能进展为临床疾病。4 我们文章中纳入的大多数研究使用抗-HDV 抗体检测，只有两个提到使用 RNA 检测检测 HDV 的流行。因此，考虑到抗 HDV 抗体检测作为 HDV 血清阳性率测量的广泛应用，5 我们在荟萃分析中使用了类似的方法。我们认为根据我们对普通人群和混合人群（没有静脉吸毒和高危性行为等危险因素的 HBsAg 携带者）中 HDV 血清阳性率的估计来推断 HBsAg 的流行率是不正确的。这是因为一般人群和混合...