{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:07:36Z","timestamp":1783836456999,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI20\/01692"],"award-info":[{"award-number":["PI20\/01692"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI23\/01065"],"award-info":[{"award-number":["PI23\/01065"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Chronic hepatitis D (CHD) is associated with rapid progression to liver cirrhosis. However, the prognostic relevance of quantitative serum HDV\u2010RNA remains incompletely defined. We aimed to evaluate whether baseline HDV\u2010RNA levels are associated with the risk of liver\u2010related events in untreated patients with CHD and to validate these findings in two independent European cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a multicentre retrospective\u2010prospective cohort study including 260 untreated adults with CHD and detectable HDV\u2010RNA. Patients were derived from a Spanish derivation cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200998) and two Italian validation cohorts (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009100 and\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200962). Baseline serum qHDV\u2010RNA was categorized in 1\u2010log increments starting from 6\u2009IU\/mL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow\u2010up of 4.1\u2009years, 74 patients (28%) experienced at least one liver\u2010related event, with a significantly higher incidence in patients with cirrhosis than in those without cirrhosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among noncirrhotic patients, increasing baseline HDV\u2010RNA levels were consistently associated with a higher proportion of liver\u2010related events across derivation and validation cohorts, whereas no events occurred at the lowest HDV\u2010RNA category. In contrast, among patients with established cirrhosis, baseline HDV\u2010RNA levels were not associated with the occurrence of liver\u2010related events, and cumulative incidence was comparable across viral load categories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline quantitative HDV\u2010RNA allows early risk stratification in untreated patients with chronic hepatitis D before the development of liver cirrhosis. Once cirrhosis is established, clinical outcomes are largely independent of viral replication, emphasising the need to prioritise timely antiviral intervention and close surveillance at earlier disease stages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70695","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:39:16Z","timestamp":1776749956000},"page":"326-333","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline\n                    <scp>HDV<\/scp>\n                    \u2010\n                    <scp>RNA<\/scp>\n                    Levels Could Stratify Clinical Risk Before, But Not After, Cirrhosis in Chronic Hepatitis D: A Multicentre European Study"],"prefix":"10.1111","volume":"64","author":[{"given":"Adriana","family":"Palom","sequence":"first","affiliation":[{"name":"Liver Unit, Hospital Univesitari Vall d'Hebron  Barcelona Spain"},{"name":"CIBERehd  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9899-4669","authenticated-orcid":false,"given":"Elisabetta","family":"Degasperi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Coco","sequence":"additional","affiliation":[{"name":"Hepatology Unit, University Hospital  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8022-8803","authenticated-orcid":false,"given":"Alessandro","family":"Loglio","sequence":"additional","affiliation":[{"name":"Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Ciancio","sequence":"additional","affiliation":[{"name":"Citta della Salute e della Scienza di Torino (City of Health and Science of Turin), School of Medicine, Department of Medical Sciences University of Turin Department of Medical Sciences, University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia Anna","family":"Niro","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Endoscopy Fondazione Casa Sollievo della Sofferenza, IRCCS  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Riveiro\u2010Barciela","sequence":"additional","affiliation":[{"name":"Liver Unit, Hospital Univesitari Vall d'Hebron  Barcelona Spain"},{"name":"CIBERehd  Madrid Spain"},{"name":"Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5424-3479","authenticated-orcid":false,"given":"Angela","family":"Carvalho\u2010Gomes","sequence":"additional","affiliation":[{"name":"CIBERehd  Madrid Spain"},{"name":"Hepatology Unit HBP Surgery and Transplant Laboratory, Instituto de Investigaci\u00f3n Sanitaria La Fe (IIS La Fe)  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Garc\u00eda\u2010Samaniego","sequence":"additional","affiliation":[{"name":"Liver Unit, Hospital Universitario La Paz, IdiPAZ, Universidad Aut\u00f3noma de Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabela","family":"Lens","sequence":"additional","affiliation":[{"name":"CIBERehd  Madrid Spain"},{"name":"Liver Unit, Hospital Clinic Barcelona, IDIBAPS, Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"Rando\u2010Segura","sequence":"additional","affiliation":[{"name":"CIBERehd  Madrid Spain"},{"name":"Microbiology Department Hospital Universitari Vall d'Hebron  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Sambarino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Cotugno","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Endoscopy Fondazione Casa Sollievo della Sofferenza, IRCCS  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2656-224X","authenticated-orcid":false,"given":"Loretta A.","family":"Kondili","sequence":"additional","affiliation":[{"name":"National Center for Global Health, Istituto Superiore di Sanit\u00e0 (Italian Institute of Health)  Italy"},{"name":"UniCamillus International Medical University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizia","family":"Brunetto","sequence":"additional","affiliation":[{"name":"Hepatology Unit, University Hospital  Pisa Italy"},{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0769-1767","authenticated-orcid":false,"given":"Mauro","family":"Vigan\u00f2","sequence":"additional","affiliation":[{"name":"Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII  Bergamo 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