{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T17:39:46Z","timestamp":1788716386764,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"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","award":["IN\u2010ES\u2010980\u20107058"],"award-info":[{"award-number":["IN\u2010ES\u2010980\u20107058"]}],"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Hepatitis D virus (HDV) infection remains underdiagnosed, and real\u2010world data on screening and linkage to care are limited. We assessed the implementation of Opti\u2010Hep\u2010D, a publicly funded initiative for HDV management in the Spanish region of Catalonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective multicentre study conducted between January 2024 and April 2025, all HBsAg\u2010positive samples underwent reflex anti\u2010HDV and HDV\u2010RNA testing, with subsequent active linkage to care of individuals testing positive. Clinical data were collected in their electronic medical records. Patient characteristics, risk factors, and bulevirtide initiation wereanalysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 369\u2009581 HBsAg determinations, 6100 were positive. Anti\u2010HDV testing was completed in 5399 (89%), identifying 305 (5.6%) positive individuals. HDV\u2010RNA was assessed in 285 patients, of whom 86 (30%) were viremic. Among 2945 first\u2010time anti\u2010HDV tests, 130 (4.4%) were positive and 26 (20%) were viremic. Notably, 42% of positive patients had no documented risk factors or elevated ALT. HDV prevalence varied across settings (2.3%\u201314%) and was highest in prisons. Newly diagnosed individuals tended to be younger with milder disease. Among 86 viremic individuals, 95% were successfully linked to care and 43% initiated bulevirtide; 57% remained untreated due to patient\u2010related or reimbursement barriers. No prison inmates received bulevirtide, mainly because of complex social situations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Large\u2010scale double reflex HDV screening with active linkage to care is feasible and effective in real\u2010world practice and may serve as a model for other healthcare settings. Although care engagement is high, treatment initiation remained limited by structural and social barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70672","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:11:07Z","timestamp":1779246667000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real\u2010World Outcomes of Opti\u2010Hep\u2010D: An Innovative, Multicentre and Multidisciplinary Program Improving Hepatitis D Cascade of Care"],"prefix":"10.1111","volume":"46","author":[{"given":"Adriana","family":"Palom","sequence":"first","affiliation":[{"name":"Department of Medicine Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas  Madrid Spain"},{"name":"Microbiology Department Hospital Universitari Vall d'Hebron  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"Rando\u2010Segura","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas  Madrid Spain"},{"name":"Microbiology Department Hospital Universitari Vall d'Hebron  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Calatayud\u2010Samper","sequence":"additional","affiliation":[{"name":"Microbiology Department Hospital Universitari de Bellvitge  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema","family":"Fern\u00e1ndez\u2010Rivas","sequence":"additional","affiliation":[{"name":"Microbiology Department, Clinical Laboratory North Metropolitan Area Hospital Universitari Germans Trias I Pujol  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Sell\u00e9s\u2010Sanchez","sequence":"additional","affiliation":[{"name":"Microbiology Department Hospital Universitari Joan XXIII De Tarragona  Tarragona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saray","family":"Mormeneo\u2010Bayo","sequence":"additional","affiliation":[{"name":"Microbiology Department Hospital Universitari Arnau De Vilanova  Lleida Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00fania P\u00e9rez","family":"del Campo","sequence":"additional","affiliation":[{"name":"Microbiology Department Hospital Universitari Doctor Josep Trueta  Girona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"del Corral","sequence":"additional","affiliation":[{"name":"Microbiology Department Hospital Universitari Verge De La Cinta  Tortosa 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Quer","family":"Boniquet","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Hospital Universitari Joan XXIII De Tarragona  Tarragona Spain"},{"name":"PADEICS Catalan Institute of Health  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carles Aracil","family":"Blanch","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas  Madrid Spain"},{"name":"Gastroenterology Unit Hospital Universitari Doctor Josep Trueta  Girona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Marco","sequence":"additional","affiliation":[{"name":"Penitentiary Health Program Catalan Institute of Health  Barcelona Spain"},{"name":"Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) Centro De Investigaci\u00f3n Biom\u00e9dica En Red  Madrid 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