{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:30:26Z","timestamp":1792114226257,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["IN\u2010IT\u2010980\u20106382"],"award-info":[{"award-number":["IN\u2010IT\u2010980\u20106382"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Ongoing migratory flows are reconstituting the hepatitis D virus (HDV) reservoir in Italy. We aimed to characterise the current clinical and virologic features of HDV infection in both native Italians and migrants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 515 hepatitis B surface antigen (HBsAg)\u2010positive patients with detectable anti\u2010HDV antibodies from 32 Italian centres between August 2022 and July 2024; all patients underwent centralised virologic assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 432 out of 515 (83.9%) patients were HDV\u2010RNA\u2010positive (4.39, 1.30\u20135.82 Log IU\/mL; 99.0% HDV genotype\u20101). HDV\u2010RNA levels correlated with ALT (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090575, 0.514\u20130.630) and hepatitis B core\u2010related antigen (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u2009=\u20090.521, 0.455\u20130.581). Native Italians (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009317; 61.6%) were older than migrants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009198; 38.4%) (median age: 60, 55\u201365 vs. 46, 39\u201354\u2009years;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and were more frequently male (68.1% vs. 49.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with a higher prevalence of liver cirrhosis (70.3% vs. 50.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and hepatocellular carcinoma (14.8% vs. 0.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among Italians, 223 (70.3%) had liver cirrhosis, 46 (14.5%) had chronic hepatitis D (CHD) without cirrhosis and 48 (15.1%) exhibited inactive\/minimal disease with low viremia (\u2264\u20093 Log IU\/mL). Among migrants, 100 (50.5%) had liver cirrhosis, 58 (29.3%) had CHD and 40 (20.2%) showed inactive\/minimal disease with low viremia (\u2264\u20093 Log IU\/mL).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The current clinical landscape of chronic HDV infections in Italy is heterogeneous, changing the perspective of CHD as uniformly severe; although cirrhosis remains common, a substantial proportion of both native Italians and migrants present with milder forms of disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70242","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T17:09:12Z","timestamp":1753808952000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Medical Impact of Hepatitis D Virus Infection in Natives and Immigrants: The Italian Paradigm"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0529-9481","authenticated-orcid":false,"given":"Gian Paolo","family":"Caviglia","sequence":"first","affiliation":[{"name":"Department of Medical Sciences University of Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4970-7762","authenticated-orcid":false,"given":"Eleonora","family":"Dileo","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0327-3875","authenticated-orcid":false,"given":"Antonella","family":"Olivero","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0431-8369","authenticated-orcid":false,"given":"Giulio","family":"Mengozzi","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Ciancio","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8022-8803","authenticated-orcid":false,"given":"Alessandro","family":"Loglio","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Hepatology and Transplantation, ASST Papa Giovanni XXIII  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Vigan\u00f2","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Hepatology and Transplantation, ASST Papa Giovanni XXIII  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8308-0701","authenticated-orcid":false,"given":"Stefano","family":"Fagiuoli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Hepatology and Transplantation, ASST Papa Giovanni XXIII  Bergamo Italy"},{"name":"Department of Medicine, Gastroenterology University of Milan Bicocca  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Colombatto","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Hepatology and Liver Physiopathology Laboratory and Internal Medicine Unit University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Coco","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Hepatology and Liver Physiopathology Laboratory and Internal Medicine Unit University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizia Rossana","family":"Brunetto","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Hepatology and Liver Physiopathology Laboratory and Internal Medicine Unit University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora","family":"Angrisani","sequence":"additional","affiliation":[{"name":"Hepatology Unit, AORN A. 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