{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:17:58Z","timestamp":1792099078172,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:00:00Z","timestamp":1723075200000},"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":["Liver International"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Chronic hepatitis D infection is the most severe form of viral hepatitis and can rapidly progress to cirrhosis or hepatocellular carcinoma. Despite recommendations for systematic screening of hepatitis B surface antigen (HBsAg)\u2010positive individuals, data from real\u2010world studies have reported a low frequency of hepatitis D (or delta) virus (HDV) screening. Our cross\u2010sectional analysis evaluated the diagnostic cascade for hepatitis D infection in tertiary centres and described the characteristics of HDV\u2010positive patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 6772 individuals who tested HBsAg positive for the first time between 2018 and 2022 were retrospectively included. Demographic, clinical and laboratory data were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5748 HBsAg\u2010positive individuals (84.9%) were screened for HDV infection. The screening rate varied from 63% to 97% according to the screening strategy used in the centres including or not HDV reflex testing. The prevalence of HDV infection was 6.3%. HDV RNA levels were determined in 285 of the 364 (78.3%) HDV antibody screening\u2010positive patients, and 167 (58.6%) had active HDV infection. 66.8% were males, with a mean age of 44.9\u2009years. A total of 97.5% were born abroad, and 92.9% were HBeAg negative. At the time of diagnosis, HDV RNA levels were 6.0 Log UI\/mL; 60.1% had alanine aminotransferase &gt;40\u2009U\/L, and 56.3% had significant fibrosis (\u2265F2), including 41.6% with cirrhosis. The most common genotype was HDV\u20101 (75.4%). Coinfections were not uncommon: 7.4% were HIV positive, and 15.0% were HCV antibody positive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study highlights the need for increased screening and monitoring of HDV infection. Reflex testing helps to identify HDV\u2010infected individuals.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.16031","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T11:40:10Z","timestamp":1723117210000},"page":"2858-2865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The diagnostic cascade for patients with hepatitis delta infection in France, 2018\u20132022: A cross\u2010sectional study"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7336-7730","authenticated-orcid":false,"given":"S\u00e9gol\u00e8ne","family":"Brichler","sequence":"first","affiliation":[{"name":"French National Reference Center for Hepatitis B, C and D Viruses, Laboratoire de Microbiologie Clinique, H\u00f4pital Avicenne  Bobigny France"},{"name":"\u201cTeam Viruses, Hepatology, Cancer\u201d Institut de Recherche Biom\u00e9dicale INSERM U955  Cr\u00e9teil 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