{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T12:18:22Z","timestamp":1787833102423,"version":"build-2784847793"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    As little is known about the disease burden of chronic hepatitis D virus (HDV) infection, this study examined health\u2010related quality of life (HRQoL) and fatigue at different disease stages. This was a real\u2010world quantitative cross\u2010sectional survey of patients in Germany, Italy, Spain and the USA. Patients were recruited via their treating physicians. Patients who had received bulevirtide for hepatitis B or treatment licensed for HDV were excluded. Of 211 patients, 41% were noncirrhotic (\n                    <jats:italic>F0\u2013F3<\/jats:italic>\n                    ); 20% had liver cirrhosis with normal function (\n                    <jats:italic>compensated<\/jats:italic>\n                    ); 20% had liver cirrhosis (\n                    <jats:italic>F4<\/jats:italic>\n                    ) with impaired function (\n                    <jats:italic>decompensated<\/jats:italic>\n                    ); 19% had hepatocellular carcinoma (\n                    <jats:italic>HCC<\/jats:italic>\n                    ). Mean (standard deviation; SD) age was 54.5 (11.5) years, 75% were male. ANOVA showed a significant decrease (indicating poorer HRQoL) in EQ\u20105D\u20103L visual analogue scale (VAS) scores and index values with worsening disease stage and increasing severity (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). All domain scores of the Hepatitis Quality of Life Questionnaire v2 (except positive wellbeing) worsened with progressing disease and increasing symptom severity (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009\u2264\u20090.0001). Mean Fatigue Severity Scale (FSS) total scores also increased, indicating greater fatigue, with worsening of disease and increasing symptom severity (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). HDV infection significantly impacts patients' HRQoL and fatigue, particularly for patients at later disease stages. Treatments that slow disease progression, reducing the burden of HDV infection, are needed.\n                  <\/jats:p>","DOI":"10.1111\/jvh.70193","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:53:49Z","timestamp":1785560029000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Chronic Hepatitis D Virus Infection on Health\u2010Related Quality of Life and Fatigue: A Real\u2010World International Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1026-7476","authenticated-orcid":false,"given":"P.","family":"Lampertico","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Foundation IRCCS ca\u2019 Granda Ospedale Maggiore Policlinico  Milan Italy"},{"name":"CRC \u201cA. M. And A. Migliavacca\u201d Center for Liver Disease, Department of Pathophysiology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6306-3189","authenticated-orcid":false,"given":"R. G.","family":"Gish","sequence":"additional","affiliation":[{"name":"Hepatits B Foundation  Doylestown Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Reau","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Digestive Diseases and Nutrition Rush Medical College  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2906-0480","authenticated-orcid":false,"given":"H.","family":"Wedemeyer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, and Endocrinology Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Buti","sequence":"additional","affiliation":[{"name":"Liver Unit, Hospital Universitario Valle Hebron and Ciber\u2010Ehd del Instituto Carlos III  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Inc.  Foster City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Yehoshua","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Inc.  Foster City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Burk","sequence":"additional","affiliation":[{"name":"HEOR Consultant  Laguna Beach California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5176-1200","authenticated-orcid":false,"given":"L.","family":"Mirams","sequence":"additional","affiliation":[{"name":"Adelphi Real World  Bollington UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Adelphi Real World  Bollington UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Taylor\u2010Whiteley","sequence":"additional","affiliation":[{"name":"Adelphi Real World  Bollington UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rock","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Inc.  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