{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:52:31Z","timestamp":1786117951205,"version":"build-2736575974"},"reference-count":200,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"institutional infrastructure of the Hospital Universitario Marqu\u00e9s de Valdecilla and IDIVAL"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV), together with HIV and bacterial sexually transmitted infections (STIs), account for a rising toll of more than one million deaths annually and overlap within shared behavioral and social networks, yet are still diagnosed through separate, pathogen-specific pathways. This narrative review synthesizes contemporary evidence on the convergence between viral hepatitis, HIV, and high-risk STI groups\u2014men who have sex with men, pre-exposure prophylaxis (PrEP) users, people practicing chemsex, people who inject drugs, incarcerated populations, and migrants from endemic regions\u2014and characterizes the diagnostic technologies and linkage-to-care models available to address it. Despite effective antivirals, the diagnostic cascade remains the principal bottleneck: most people with chronic HCV are undiagnosed, and HDV\u2014with a pooled anti-HDV seroprevalence of approximately 4.5% among HBsAg-positive individuals\u2014is its clearest expression, as most carriers are never tested. Reflex algorithms, multiplex panels, point-of-care assays, dried blood spots, and electronic health record alerts are validated but unevenly implemented. We argue that, alongside persistent resource, political, and equity-related constraints, a substantial share of the remaining barriers is operational rather than purely technological, and propose a practical, STI-clinic-centered framework integrating reflex testing, population-specific periodicity, and explicit linkage pathways toward the WHO 2030 elimination targets.<\/jats:p>","DOI":"10.3390\/v18080861","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T14:45:47Z","timestamp":1786027547000},"page":"861","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated Diagnosis of Hepatitis B, C, and D Viruses and HIV in Populations Evaluated for Sexually Transmitted Infections: A Narrative Review and Operational Framework"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0012-484X","authenticated-orcid":false,"given":"Joaqu\u00edn","family":"Cabezas","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Department, Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"},{"name":"Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3321-0683","authenticated-orcid":false,"given":"Ezequiel","family":"Ridruejo","sequence":"additional","affiliation":[{"name":"Hepatology Section, Department of Medicine, Centro de Educaci\u00f3n M\u00e9dica e Investigaciones Cl\u00ednicas Norberto Quirno (CEMIC), Ciudad Aut\u00f3noma de Buenos Aires C1425ASG, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6568-7048","authenticated-orcid":false,"given":"Jos\u00e9 Antonio","family":"Velarde-Ruiz Velasco","sequence":"additional","affiliation":[{"name":"Servicio de Gastroenterolog\u00eda, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara 44280, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7511-5396","authenticated-orcid":false,"given":"Graciela","family":"Castro-Narro","sequence":"additional","affiliation":[{"name":"Unidad de Hepatolog\u00eda y Trasplante, Hospital M\u00e9dica Sur, Ciudad de M\u00e9xico 14050, Mexico"},{"name":"Departamento de Gastroenterolog\u00eda, Hepatolog\u00eda y Trasplante, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Ciudad de M\u00e9xico 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Cay\u00f3n-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Cheinquer","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Interna, Facultade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre 90040-060, Brazil"},{"name":"Hepatology Department, Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre 90035-903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Contreras","sequence":"additional","affiliation":[{"name":"Centro de Gastroenterolog\u00eda Avanzada de Santo Domingo, Santo Domingo 10148, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelia","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Gastroenterology Academic Unit, Hospital de Cl\u00ednicas, Faculty of Medicine, Universidad de la Rep\u00fablica (UdelaR), Montevideo 11200, Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie","family":"Perell\u00f3","sequence":"additional","affiliation":[{"name":"Unidad de Hepatolog\u00eda, Centro de Estudios Digestivos, Hospital Metropolitano Santiago (HOMS), Santiago de los Caballeros 51000, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Calleja","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro, Universidad Aut\u00f3noma de Madrid, 28222 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8248-0172","authenticated-orcid":false,"given":"Javier","family":"Crespo","sequence":"additional","affiliation":[{"name":"Valdecilla Research Institute (IDIVAL), Universidad de Cantabria, 39008 Santander, Spain"},{"name":"MedicineAI Association, 28027 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref_1","unstructured":"Polaris Observatory HCV Collaborators (2022). 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