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Hepatitis delta infection
among persons living with HIV in Europe
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Jan 2023


DISCUSSION: In this large European cohort study of >1500 participants with HIV and HBV coinfection, close to 50% of PWID had anti-HDV antibodies, of whom 65% had active replication. Among other participants, the prevalence of HDV infection was close to estimates reported in populations without HIV, with the highest estimates observed in southern Europe. Over a median of 10.8 years, HDV-infected individuals were 1.6 times more likely to die, this excess mortality being driven by liver-related deaths in individuals with active HDV replication. HDV-infected individuals were also six times more likely to develop HCC compared to HDV-negative ones. Our results underline the importance of the systematic assessment of HDV infection among HBsAg-positive individuals and highlight the urgent need for improving treatment strategies to reduce the risk for HDV-related complications.
The overall prevalence of anti-HDV positivity was 15.2% (237/1556, 95% CI 13.5%–17.1%) and was similar in the SHCS (15%) and EuroSIDA (15.5%).

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