{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:30:06Z","timestamp":1787067006706,"version":"build-2736575974"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006392","name":"Centre Hospitalier Universitaire Vaudois","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006392","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004784","name":"Novartis Stiftung\u00a0f\u00fcr\u00a0Medizinisch-Biologische Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004784","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005688","name":"Gottfried und Julia Bangerter-Rhyner-Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005688","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatitis B virus (HBV) is a major global health challenge with approximately 250\u2013350 million chronically infected individuals. An improved understanding of the demographic features and outcomes of chronic HBV infection and hepatitis D virus (HDV) infection in low-endemic areas may improve prevention, early identification and management both at individual and community levels. Here, we retrospectively analyzed the demographic and clinical characteristics, treatment rates and outcomes of adult patients with chronic HBV infection with or without HDV coinfection examined at Lausanne University Hospital, Switzerland over a 10-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed the medical records of all adult patients with chronic HBV and HDV infection examined in our center between 2007 and 2016. Liver-related outcome was defined as the occurrence of cirrhosis, hepatocellular carcinoma, liver transplantation or liver-related death. Analyses were performed using logistic regression and results were reported as odds ratio (OR) and 95% confidence interval (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 672 consecutive patients, 421 (62.6%) were male, median age was 36 years (interquartile range, 28\u201346 years), and 233 (34.7%) were of African origin. The prevalence of HDV coinfection was 7.1% and the proportion of anti-HDV-positive patients with detectable HDV RNA was 70.0%. In multivariate analysis, HDV coinfection was the strongest predictor for liver-related outcome (OR 6.06, 95% CI 2.93\u201312.54, p&lt;0.001), followed by HBeAg positivity (OR 2.47, 95% CI 1.30\u20134.69, p = 0.006), age (OR per 10-year increase 2.03, 95% CI 1.63\u20132.52, p&lt;0.001) and sex (OR for female 0.39, 95% CI 0.22\u20130.71, p = 0.002). The predictive accuracy of the multivariate model was high (receiver operator characteristic area under the curve 0.81).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This retrospective study underscores the importance of migration in the epidemiology of chronic hepatitis B in low-endemic areas. HDV coinfection, HBeAg positivity and age predicted liver-related outcomes while female sex had a protective effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0250347","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T15:18:59Z","timestamp":1619536739000},"page":"e0250347","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["Demographics and outcomes of hepatitis B and D: A 10-year retrospective analysis in a Swiss tertiary referral center"],"prefix":"10.1371","volume":"16","author":[{"given":"Joana","family":"Vieira Barbosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Sahli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Aubert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziz","family":"Chaouch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darius","family":"Moradpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Fraga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,27]]},"reference":[{"key":"pone.0250347.ref001","first-page":"370","article-title":"European Association for the Study of the Liver Clinical Practice Guidelines on the management of hepatitis B virus infection","volume":"67","year":"2017","journal-title":"J Hepatol"},{"key":"pone.0250347.ref002","unstructured":"Global hepatitis report. Geneva: World Health Organization 2017."},{"key":"pone.0250347.ref003","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1056\/NEJMra1810477","article-title":"Global elimination of chronic hepatitis","volume":"380","author":"DL Thomas","year":"2019","journal-title":"N Eng J Med"},{"key":"pone.0250347.ref004","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.gtc.2020.01.001","article-title":"Global epidemiology of viral hepatitis","volume":"49","author":"H Razavi","year":"2020","journal-title":"Gastroenterol Clin North Am"},{"key":"pone.0250347.ref005","doi-asserted-by":"crossref","first-page":"18035","DOI":"10.1038\/nrdp.2018.35","article-title":"Hepatitis B virus infection","volume":"4","author":"MF Yuen","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"pone.0250347.ref006","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/liv.14367","article-title":"Optimal management of chronic hepatitis B patients receiving nucleos(t)ide analogues","volume":"40","author":"M Buti","year":"2020","journal-title":"Liver Int"},{"key":"pone.0250347.ref007","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S2468-1253(19)30119-0","article-title":"A global scientific strategy to cure hepatitis B","volume":"4","author":"PA Revill","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"pone.0250347.ref008","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1016\/S0140-6736(15)61412-X","article-title":"Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013","volume":"386","author":"A Schweitzer","year":"2015","journal-title":"Lancet"},{"key":"pone.0250347.ref009","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S2468-1253(19)30014-7","article-title":"Mass migration to Europe: an opportunity for elimination of hepatitis B virus?","volume":"4","author":"M Thijssen","year":"2019","journal-title":"Lancet 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