{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:52:32Z","timestamp":1791215552013,"version":"4.1.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005258","name":"National Center for HIV, Viral Hepatitis, STD, and TB Prevention","doi-asserted-by":"publisher","award":["NU38PS004651"],"award-info":[{"award-number":["NU38PS004651"]}],"id":[{"id":"10.13039\/100005258","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic hepatitis D virus (HDV) infection increases the risk of liver-related deaths in adults with chronic hepatitis B (CHB). In the United States (US), only an estimated 12.9% of adults with CHB have received an HDV antibody test. The aim of this study is to calculate the cost-effectiveness of one-time universal HDV testing of hepatitis B surface antigen (HBsAg)\u2013positive adults living in the US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Markov model was used to calculate the costs, health impact, and cost-effectiveness of universal testing of HBsAg-positive adults with an HDV antibody test and, when positive, an HDV RNA test for chronic HDV infection. We assumed that 50% of the HDV RNA\u2013positive patients would receive the current recommended treatment with pegylated interferon (PEG-IFN) for 48 weeks with a 30% response rate. We also modeled the potential impact of hypothetical indefinite HDV antiviral therapy with a higher response rate to assess the annual cost threshold to be considered cost-effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Universal HDV testing of adults with CHB could avert 100 HDV-related deaths and an additional 30 cases of cirrhosis and 50 cases of hepatocellular carcinoma, and potentially result in a gain of 1500 quality-adjusted life-years (QALYs) per 100 000 HBsAg-positive individuals screened. At a willingness-to-pay threshold of $50 000 per QALY, the annual drug costs for a hypothetical indefinite therapy with a 50% or 70% treatment response rate would need to cost \u2264$13 027 and \u2264$14 104, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>One-time HDV testing for all HBsAg-positive adults and treatment of chronic HDV infection with PEG-IFN is potentially cost-effective in the US.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf181","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T17:33:30Z","timestamp":1744047210000},"page":"e211-e217","source":"Crossref","is-referenced-by-count":9,"title":["Cost-Effectiveness of One-time Universal Testing for Hepatitis D Among Adults With Chronic Hepatitis B in the United States"],"prefix":"10.1093","volume":"81","author":[{"given":"Mehlika","family":"Toy","sequence":"first","affiliation":[{"name":"Erasmus School of Health Policy and Management, Erasmus University , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9677-1632","authenticated-orcid":false,"given":"David","family":"Hutton","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyasu","family":"Teshale","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8293-9641","authenticated-orcid":false,"given":"William W","family":"Thompson","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Pham","sequence":"additional","affiliation":[{"name":"Asian Liver Center, Department of Surgery, Stanford University School of Medicine , Stanford, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3929-5515","authenticated-orcid":false,"given":"Joshua A","family":"Salomon","sequence":"additional","affiliation":[{"name":"Department of Health Policy, Stanford University School of Medicine , Stanford, California ,","place":["USA"]},{"name":"Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford University , Stanford, California 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