{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T20:50:17Z","timestamp":1788814217287,"version":"build-2803163510"},"reference-count":22,"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\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005062","name":"Fujirebio Europe","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Chronic hepatitis D virus (HDV) infection can cause severe liver disease. With new treatment options available, it is important to identify patients at risk for liver\u2010related complications. We aimed to investigate kinetics and predictive values of novel virological and immunological markers in the natural course of chronic HDV infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HBcrAg, HBV RNA and quantitative anti\u2010HBc were analysed in samples from HDV\u2010infected patients at three consecutive time points. Results were linked to clinical outcome by univariable and multivariable analyses. Primary endpoint was the composite endpoint of any liver\u2010related event.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Samples from 190 individual patients were analysed with a median clinical follow\u2010up time of 2.69 (IQR 1.13\u20136.51) years. The majority of patients had cirrhosis (98\/190, 52%), and the primary endpoint occurred in 33% (62\/190). In univariable analysis, age, cirrhosis, lower quantitative anti\u2010HBc, higher ratio of HBcrAg\/anti\u2010HBc and detectable HDV RNA were associated with the primary endpoint. In multivariable analysis, only the presence of liver cirrhosis (HR 7.74, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and age (1.06, p\u2009&lt;\u20090.001) remained independently associated with the primary endpoint. Kinetics of virological parameters during follow\u2010up were similar between the groups. Quantitative anti\u2010HBc was significantly lower in patients with liver cirrhosis (687 (IQR 188\u20133388) IU\/ml vs. 309 (IQR 82\u2013924) IU\/ml, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0004), and lower levels were independently associated with the development of the primary endpoint (HR 1.0, <jats:italic>p<\/jats:italic>\u2009=\u20090.014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In chronic HDV infection, neither baseline values nor kinetics of HBV RNA, HBcrAg and anti\u2010HBc were independently associated with clinical outcome, while stage of liver disease and age were predictors of liver\u2010related events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.70003","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T13:51:15Z","timestamp":1737640275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Value and Kinetics of Virological Markers in the Natural Course of Chronic Hepatitis D Virus Infection"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4425-2640","authenticated-orcid":false,"given":"Lisa","family":"Sandmann","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"},{"name":"D\u2010SOLVE Consortium, an EU Horizon Europe Funded Project  partner site Hannover Germany"},{"name":"Cluster of Excellence RESIST (EXC 2155) Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2358-0100","authenticated-orcid":false,"given":"Valerie","family":"Ohlendorf","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alena","family":"Ehrenbauer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Bremer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9666-0753","authenticated-orcid":false,"given":"Anke R. M.","family":"Kraft","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"},{"name":"Cluster of Excellence RESIST (EXC 2155) Hannover Medical School  Hannover Germany"},{"name":"German Center for Infection Research (DZIF)  Hannover\/Braunschweig Germany"},{"name":"Centre for Individualised Infection Medicine (CiiM), a Joint Venture Between Helmholtz\u2010Centre for Infection Research and Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9141-8001","authenticated-orcid":false,"given":"Markus","family":"Cornberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"},{"name":"D\u2010SOLVE Consortium, an EU Horizon Europe Funded Project  partner site Hannover Germany"},{"name":"Cluster of Excellence RESIST (EXC 2155) Hannover Medical School  Hannover Germany"},{"name":"German Center for Infection Research (DZIF)  Hannover\/Braunschweig Germany"},{"name":"Centre for Individualised Infection Medicine (CiiM), a Joint Venture Between Helmholtz\u2010Centre for Infection Research and Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Deterding","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2906-0480","authenticated-orcid":false,"given":"Heiner","family":"Wedemeyer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"},{"name":"D\u2010SOLVE Consortium, an EU Horizon Europe Funded Project  partner site Hannover Germany"},{"name":"Cluster of Excellence RESIST (EXC 2155) Hannover Medical School  Hannover Germany"},{"name":"German Center for Infection Research (DZIF)  Hannover\/Braunschweig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3250-3177","authenticated-orcid":false,"given":"Benjamin","family":"Maasoumy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology Hannover Medical School  Hanover Germany"},{"name":"German Center for Infection Research (DZIF)  Hannover\/Braunschweig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.05.001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000642"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0101002"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31026"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15433"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32018"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31616"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.02.010"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13804"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1821"},{"key":"e_1_2_11_12_1","unstructured":"R Core Team \u201cR: A Language and Environment for Statistical Computing. 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