{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:42:44Z","timestamp":1760150564488,"version":"build-2065373602"},"reference-count":87,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006472","name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy of Iasi, Romania","doi-asserted-by":"publisher","award":["1715\/2017"],"award-info":[{"award-number":["1715\/2017"]}],"id":[{"id":"10.13039\/501100006472","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Approximately 62\u201372 million people are infected worldwide with HDV. Patients with chronic hepatitis D (CHD) have a higher risk of developing cirrhosis or hepatocellular carcinoma (HCC) and an increased mortality rate compared to those with chronic hepatitis B (CHB). The stage of liver fibrosis or the risk of developing HCC can also be estimated by non-invasive scores, which are cost effective, easier to apply, and reproducible. In this study, we aimed to evaluate the predictive value of four non-invasive scores (FIB-4, APRI, AST\/ALT ratio, and aMAP) in assessing severe fibrosis\/cirrhosis and the presence of HCC in patients with HBV\/HDV superinfection, as compared with HBV mono-infection. Our 8-year retrospective analysis revealed that HDV-infected patients had a 2\u20133 times higher risk of developing cirrhosis and HCC than HBV-mono-infected subjects. High AST and ALT baseline levels qualified as independent predictors for cirrhosis development in both groups. The following fibrosis scores, FIB-4, APRI score, and AAR, were significantly increased when cirrhosis was present at baseline and showed a good prediction for developing cirrhosis in the CHD group. The aMAP score, a risk predictor for HCC, showed significantly higher values in patients with HCC in both groups. Nonetheless, non-invasive scores should always be considered for monitoring patients with CHB and CHD, but only when associated with other diagnosis methods.<\/jats:p>","DOI":"10.3390\/microorganisms11122895","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T07:44:42Z","timestamp":1701330282000},"page":"2895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Non-Invasive Prediction Scores for Hepatitis B Virus- and Hepatitis D Virus-Infected Patients\u2014A Cohort from the North-Eastern Part of Romania"],"prefix":"10.3390","volume":"11","author":[{"given":"Laura Iulia","family":"Grecu","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine and Interdisciplinarity, Microbiology Discipline, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Emerging Viral Diseases, \u201cStefan S. Nicolau\u201d Institute of Virology, 030304 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5954-3312","authenticated-orcid":false,"given":"Camelia","family":"Sultana","sequence":"additional","affiliation":[{"name":"Department of Emerging Viral Diseases, \u201cStefan S. Nicolau\u201d Institute of Virology, 030304 Bucharest, Romania"},{"name":"Virology Discipline, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-5993","authenticated-orcid":false,"given":"Mariana","family":"Pavel-Tanasa","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2492-6073","authenticated-orcid":false,"given":"Simona Maria","family":"Ruta","sequence":"additional","affiliation":[{"name":"Department of Emerging Viral Diseases, \u201cStefan S. Nicolau\u201d Institute of Virology, 030304 Bucharest, Romania"},{"name":"Virology Discipline, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7512-4700","authenticated-orcid":false,"given":"Mihaela","family":"Chivu-Economescu","sequence":"additional","affiliation":[{"name":"Department of Cellular and Molecular Pathology, \u201cStefan S. Nicolau\u201d Institute of Virology, 030304 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4479-655X","authenticated-orcid":false,"given":"Lilia","family":"Matei","sequence":"additional","affiliation":[{"name":"Department of Cellular and Molecular Pathology, \u201cStefan S. Nicolau\u201d Institute of Virology, 030304 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1811-7923","authenticated-orcid":false,"given":"Ramona Gabriela","family":"Ursu","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Interdisciplinarity, Microbiology Discipline, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Iftimi","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2592-3982","authenticated-orcid":false,"given":"Luminita Smaranda","family":"Iancu","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Interdisciplinarity, Microbiology Discipline, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1136\/gut.18.12.997","article-title":"Immunofluorescence Detection of New Antigen-Antibody System (\u03b4\/Anti-\u03b4) Associated to Hepatitis B Virus in Liver and in Serum of HBsAg Carriers","volume":"18","author":"Rizzetto","year":"1977","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1136\/gutjnl-2018-316601","article-title":"Prevalence and Burden of Hepatitis D Virus Infection in the Global Population: A Systematic Review and Meta-Analysis","volume":"68","author":"Chen","year":"2019","journal-title":"Gut"},{"key":"ref_3","unstructured":"WHO (2023, October 16). Hepatitis B. 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