{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T11:43:05Z","timestamp":1792669385813,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"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":[[2026,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Hepatitis delta virus (HDV) infection causes the most severe form of viral hepatitis, with highly heterogeneous outcomes ranging from viral control to persistent viraemia and progressive liver disease. The Human Leukocyte Antigen (HLA) system plays a central role in antiviral immunity, yet its contribution to HDV disease remains poorly defined. We aimed to identify HLA genetic polymorphisms associated with virological control and disease severity.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n High\u2010resolution genotyping of classical (A, B, C, DPB1, DQB1, DRB1) and non\u2010classical (E, G) HLA was performed in 72 anti\u2010HDV\u2010positive patients. A group of healthy donors (\n N<\/jats:italic>\n \u2009=\u2009150) was used as a reference. Patients were stratified by longitudinal HDV RNA status into viraemic (persistent viraemia,\n N<\/jats:italic>\n \u2009=\u200936) and non\u2010viraemic (undetectable viraemia,\n N<\/jats:italic>\n \u2009=\u200936) groups. Clinical data, including liver fibrosis stage, were collected. T cell receptor (TCR) \u03b2\u2010chain sequencing was performed in isolated CD3\n +<\/jats:sup>\n T cells from viraemic patients and compared to a group of healthy donors (HD;\n N<\/jats:italic>\n \u2009=\u200944).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The\n HLA\u2010A*11:01<\/jats:italic>\n allele was exclusively observed in viraemic patients (\n p<\/jats:italic>\n \u2010value <\u20090.001, FDR\u2009=\u20090.02; allele frequency\u2009=\u20090.15). Multivariate analysis confirmed its independent association with persistent viraemia and advanced fibrosis. Notably, its frequency did not differ between our cohort and the overall reference population. Furthermore, viraemic\n HLA\u2010A*11:01<\/jats:italic>\n carriers exhibited significantly higher TCR\u03b2 chain clonality, consistent with a restricted and potentially ineffective antiviral T\u2010cell response.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n HLA\u2010A*11:01<\/jats:italic>\n identifies a subgroup of HDV patients at high risk of persistent viral replication and advanced fibrosis. The integration of HLA genotyping into risk stratification algorithms may help to early identify patients requiring intensified monitoring and timely therapeutic intervention.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apt.70961","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:11:37Z","timestamp":1789099897000},"page":"1432-1447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["HLA<\/scp>\n \u2010A*11:01 Identifies Patients at Risk for Persistent Viraemia and Advanced Fibrosis in\n HDV<\/scp>\n Infection"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4318-532X","authenticated-orcid":false,"given":"Maria Francesca","family":"Cortese","sequence":"first","affiliation":[{"name":"Liver Unit, Group of Microbiology Vall d'Hebron Institut de Recerca (VHIR), Instituto de Investigaci\u00f3n Sanitaria Hospital Universitari Vall d'Hebron (IIS IR\u2010HUVH) Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0130-1302","authenticated-orcid":false,"given":"Adriana","family":"Palom","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"},{"name":"Liver Diseases Research Group Vall d'Hebron Research Institute, Instituto de Investigaci\u00f3n Sanitaria Hospital Universitari Vall d'Hebron (IIS IR\u2010HUVH) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna Rando","family":"Segura","sequence":"additional","affiliation":[{"name":"Liver Unit, Group of Microbiology Vall d'Hebron Institut de Recerca (VHIR), Instituto de Investigaci\u00f3n Sanitaria Hospital Universitari Vall d'Hebron (IIS IR\u2010HUVH) Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3099-067X","authenticated-orcid":false,"given":"Francesc","family":"Rudilla","sequence":"additional","affiliation":[{"name":"Transfusional Medicine Group Vall d'Hebron Research Institute, Universitat Aut\u00f2noma de Barcelona (VHIR\u2010UAB) Barcelona Spain"},{"name":"Immunogenetics and Histocompatibility Laboratory Banc de Sang i Teixits (Blood and Tissue Bank, BST) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma Enrich","family":"Rande","sequence":"additional","affiliation":[{"name":"Transfusional Medicine Group Vall d'Hebron Research Institute, Universitat Aut\u00f2noma de Barcelona (VHIR\u2010UAB) Barcelona Spain"},{"name":"Immunogenetics and Histocompatibility Laboratory Banc de Sang i Teixits (Blood and Tissue Bank, BST) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0043-7028","authenticated-orcid":false,"given":"Arnau Puig","family":"Lopez","sequence":"additional","affiliation":[{"name":"Liver Unit, Group of Microbiology Vall d'Hebron Institut de Recerca (VHIR), Instituto de Investigaci\u00f3n Sanitaria Hospital Universitari Vall d'Hebron (IIS IR\u2010HUVH) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1146-4084","authenticated-orcid":false,"given":"David Tabernero","family":"Caellas","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"},{"name":"Liver Diseases Research Group Vall d'Hebron Research Institute, Instituto de Investigaci\u00f3n Sanitaria Hospital Universitari Vall d'Hebron (IIS IR\u2010HUVH) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3531-9990","authenticated-orcid":false,"given":"Judit Vico","family":"Romero","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"},{"name":"Liver Unit Vall d'Hebron University Hospital Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2239-4939","authenticated-orcid":false,"given":"Juan Carlos","family":"Ruiz\u2010Cobo","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"},{"name":"Liver Unit Vall d'Hebron University Hospital Barcelona Spain"},{"name":"Universitat Autonoma de Barcelona (UAB) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9309-2052","authenticated-orcid":false,"given":"Mar","family":"Riveiro\u2010Barciela","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"},{"name":"Liver Unit Vall d'Hebron University Hospital Barcelona Spain"},{"name":"Universitat Autonoma de Barcelona (UAB) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6917-1276","authenticated-orcid":false,"given":"Maria Jos\u00e9","family":"Herrero","sequence":"additional","affiliation":[{"name":"Transfusional Medicine Group Vall d'Hebron Research Institute, Universitat Aut\u00f2noma de Barcelona (VHIR\u2010UAB) Barcelona Spain"},{"name":"Immunogenetics and 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