{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:53:13Z","timestamp":1791330793668,"version":"4.3.1"},"reference-count":26,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal-of-hepatology.eu","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hepatology"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jhep.2026.10.003","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:38:59Z","timestamp":1791329939000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Can Hepatitis D Remain Hidden? Revisiting HDV Persistence and Mechanisms of Reactivation"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2906-0480","authenticated-orcid":false,"given":"Heiner","family":"Wedemeyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jhep.2026.10.003_bib1","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1136\/gutjnl-2020-323888","article-title":"Hepatitis D virus in 2021: virology, immunology and new treatment approaches for a difficult-to-treat disease","volume":"70","author":"Urban","year":"2021","journal-title":"Gut"},{"key":"10.1016\/j.jhep.2026.10.003_bib2","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.jhep.2021.04.051","article-title":"Ubiquitous expression of HBsAg from integrated HBV DNA in patients with low viral load","volume":"75","author":"Meier","year":"2021","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2026.10.003_bib3","article-title":"Hepatitis B virus enhancer 1 activates preS1 and preS2 promoters of integrated HBV DNA impairing HBsAg secretion","volume":"6","author":"Gu","year":"2024","journal-title":"JHEP Rep"},{"key":"10.1016\/j.jhep.2026.10.003_bib4","doi-asserted-by":"crossref","first-page":"5742","DOI":"10.1128\/JVI.00430-14","article-title":"Envelope proteins derived from naturally integrated hepatitis B virus DNA support assembly and release of infectious hepatitis delta virus particles","volume":"88","author":"Freitas","year":"2014","journal-title":"J Virol"},{"key":"10.1016\/j.jhep.2026.10.003_bib5","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1136\/gutjnl-2023-330577","article-title":"Spatial transcriptomics reveals a low extent of transcriptionally active hepatitis B virus integration in patients with HBsAg loss","volume":"73","author":"Yu","year":"2024","journal-title":"Gut"},{"key":"10.1016\/j.jhep.2026.10.003_bib6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1002\/hep.27102","article-title":"Late HDV RNA relapse after peginterferon alpha-based therapy of chronic hepatitis delta","volume":"60","author":"Heidrich","year":"2014","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2026.10.003_bib7","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1111\/jvh.13366","article-title":"Ten-year follow-up of a randomized controlled clinical trial in chronic hepatitis delta","volume":"27","author":"Wranke","year":"2020","journal-title":"J Viral Hepat"},{"key":"10.1016\/j.jhep.2026.10.003_bib8","doi-asserted-by":"crossref","DOI":"10.1002\/ueg2.70153","article-title":"Ten-Year Follow-Up After 96 Weeks Treatment With Peginterferon Plus Tenofovir in Hepatitis D (HIDIT-II): Improved Clinical Outcome After Combination Therapy","volume":"14","author":"Yurdaydin","year":"2026","journal-title":"United European Gastroenterol J"},{"key":"10.1016\/j.jhep.2026.10.003_bib9","first-page":"1","article-title":"EASL Clinical Practice Guidelines on the management of hepatitis B virus infection","author":"Cornberg","year":"2025","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2026.10.003_bib10","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jhep.2023.05.001","article-title":"EASL Clinical Practice Guidelines on hepatitis delta virus","volume":"79","year":"2023","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2026.10.003_bib11","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jhep.2011.06.016","article-title":"Rapid early HDV RNA decline in the peripheral blood but prolonged intrahepatic hepatitis delta antigen persistence after liver transplantation","volume":"56","author":"Mederacke","year":"2012","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2026.10.003_bib12","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1111\/j.1365-2893.2009.01144.x","article-title":"Virological and clinical characteristics of delta hepatitis in Central Europe","volume":"16","author":"Heidrich","year":"2009","journal-title":"J Viral Hepat"},{"key":"10.1016\/j.jhep.2026.10.003_bib13","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1002\/hep.31214","article-title":"Long-Term Study of Hepatitis Delta Virus Infection at Secondary Care Centers: The Impact of Viremia on Liver-Related Outcomes","volume":"72","author":"Kamal","year":"2020","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2026.10.003_bib14","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jhep.2020.04.008","article-title":"The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis","volume":"73","author":"Stockdale","year":"2020","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2026.10.003_bib15","doi-asserted-by":"crossref","DOI":"10.1111\/liv.70799","article-title":"High Rates of Advanced Chronic Liver Disease in Patients With Chronic Hepatitis D Virus Infection in Uzbekistan","volume":"46","author":"Khodjaeva","year":"2026","journal-title":"Liver Int"},{"key":"10.1016\/j.jhep.2026.10.003_bib16","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2025.103708","article-title":"Double reflex testing for anti-HDV antibody following an HBsAg-positive test result and HDV RNA in those anti-HDV positive: a global systematic review and meta-analysis","volume":"91","author":"Li","year":"2026","journal-title":"EClinicalMedicine"},{"key":"10.1016\/j.jhep.2026.10.003_bib17","doi-asserted-by":"crossref","DOI":"10.1097\/HEP.0000000000001786","article-title":"Diabetes, male sex, low levels of HBsAg, HDV RNA, and ALT predict spontaneous HDV suppression in chronic hepatitis D","author":"Kamal","year":"2026","journal-title":"Hepatology"},{"key":"10.1016\/j.jhep.2026.10.003_bib18","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.jhep.2026.03.046","article-title":"144 Weeks of bulevirtide monotherapy for chronic hepatitis D: Final and post-treatment results from a phase III randomized trial","volume":"85","author":"Wedemeyer","year":"2026","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2026.10.003_bib19","unstructured":"the Hamburg Group for the study of HBV and, H. D. V., Pfl\u00fcger LS, Giersch K et al. Silent but persistent: Failure of continuous tenofovir based ART to prevent HBV and HDV reactivation under chemotherapy in an HBsAg-negative patient living with HIV. J Hepatol."},{"key":"10.1016\/j.jhep.2026.10.003_bib20","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1016\/j.jhep.2023.11.019","article-title":"Increase in HDV replication during steroid therapy - potential implications for testing and treatment strategies","volume":"81","author":"Patmore","year":"2024","journal-title":"J Hepatol"},{"issue":"Suppl 1","key":"10.1016\/j.jhep.2026.10.003_bib21","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/liv.15424","article-title":"Immunology of hepatitis D virus infection: General concepts and present evidence","volume":"43","author":"Hoblos","year":"2023","journal-title":"Liver Int"},{"key":"10.1016\/j.jhep.2026.10.003_bib22","unstructured":"Case Report S G, Di Marco L, De Maria N et al. Post-Transplant Hepatitis D Breakthrough Driven by Integrant-Derived HBsAg from an Extrahepatic HCC Metastasis. J Hepatol."},{"key":"10.1016\/j.jhep.2026.10.003_bib23","first-page":"S0168","article-title":"Serum HBsAg cannot distinguish cccDNA activity from integrated HBV DNA expression in chronic hepatitis B virus infection","author":"Suslov","year":"2026","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2026.10.003_bib24","doi-asserted-by":"crossref","DOI":"10.1111\/liv.70189","article-title":"Hepatitis D Virus Infection: Pathophysiology, Epidemiology and Treatment. Report From the Third Delta Cure Meeting 2024","volume":"45","author":"Degasperi","year":"2025","journal-title":"Liver Int"},{"key":"10.1016\/j.jhep.2026.10.003_bib25","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/j.jhep.2024.12.044","article-title":"Real-world effectiveness and safety of bulevirtide monotherapy for up to 96 weeks in patients with HDV-related cirrhosis","volume":"82","author":"Degasperi","year":"2025","journal-title":"J Hepatol"},{"key":"10.1016\/j.jhep.2026.10.003_bib26","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.jhep.2024.01.035","article-title":"Blocking viral entry with bulevirtide reduces the number of HDV-infected hepatocytes in human liver biopsies","volume":"80","author":"Allweiss","year":"2024","journal-title":"J Hepatol"}],"container-title":["Journal of Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0168827826029223?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0168827826029223?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:39:02Z","timestamp":1791329942000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0168827826029223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":26,"alternative-id":["S0168827826029223"],"URL":"https:\/\/doi.org\/10.1016\/j.jhep.2026.10.003","relation":{},"ISSN":["0168-8278"],"issn-type":[{"value":"0168-8278","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Can Hepatitis D Remain Hidden? Revisiting HDV Persistence and Mechanisms of Reactivation","name":"articletitle","label":"Article Title"},{"value":"Journal of Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jhep.2026.10.003","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"https:\/\/doi.org\/10.1016\/j.jhep.2026.08.010","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"https:\/\/doi.org\/10.1016\/j.jhep.2026.08.029","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"simple-article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver.","name":"copyright","label":"Copyright"}]}}