{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T20:05:26Z","timestamp":1791144326010,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Hepatitis B virus (HBV)\u2013hepatitis delta virus (HDV) coinfection is the most severe form of chronic viral hepatitis, but the factors that determine disease progression and severity are incompletely characterised. This long\u2010term follow\u2010up study aims to identify risk factors for severe liver\u2010related outcomes. In this multicentre national cohort study, data from admission until the last visit between 2001 and 2023 was retrospectively collected from 162 HBV\u2010HDV coinfected patients. The inclusion criteria were HBsAg or HBV DNA positivity, anti\u2010HDV or HDV RNA positivity, and at least one follow\u2010up visit. The median follow\u2010up was 6.2\u2009years (IQR 3.3\u201310.2). At baseline, 68\/152 (44.7%) patients were diagnosed with advanced liver fibrosis. Forty patients (24.7%) had at least one severe liver\u2010related outcome during follow\u2010up. HDV viremia was detectable in 92 patients (64.3%) at last evaluation and was more frequently detectable in patients of European origin (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). HDV RNA\u2010positive patients had a 4.7\u2010fold higher risk for severe liver\u2010related outcomes (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and were more frequently diagnosed with advanced fibrosis at baseline (<jats:italic>p<\/jats:italic>\u2009=\u20090.007) compared to HDV RNA\u2010negative patients. Multivariate analyses identified HDV RNA positivity, as well as several markers for liver disease severity, such as INR, platelet count, and advanced fibrosis at baseline, and age at admission as independent risk factors for severe liver\u2010related outcomes. In conclusion, almost one in four HBV\u2010HDV coinfected patients developed a severe liver\u2010related outcome during follow\u2010up. Several markers for liver disease severity and HDV RNA positivity were the strongest predictors for outcomes.<\/jats:p>","DOI":"10.1111\/jvh.14060","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T12:50:11Z","timestamp":1737636611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Severe Liver\u2010Related Outcomes in Patients With Hepatitis Delta: Results From a Multi\u2010Ethnic Multicenter Long\u2010Term Follow\u2010Up Study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8658-4742","authenticated-orcid":false,"given":"Arno","family":"Furquim d\u2019Almeida","sequence":"first","affiliation":[{"name":"Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Pediatrics University of Antwerp Antwerp Belgium"},{"name":"Department of Gastroenterology and Hepatology Antwerp University Hospital Antwerp 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