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. 2025 Nov 7.
doi: 10.1007/s15010-025-02683-w. Online ahead of print.

Hepatitis D virus infection prevalence in persons with human immunodeficiency virus and hepatitis B virus coinfection in Germany

Fauzi Elamouri  1   2 , Thomas Lutz  3 , Gabi Knecht  3 , Christoph Wyen  4   5 , Philip Posdzich  4 , Malte Monin  6   7 , Michael Sabranski  6 , Christian Hoffmann  6 , Alexander Killer  8 , Björn Erik-Ole Jensen  8 , Jakob J Malin  5 , Stefan Esser  9 , Stefan Mauss  10 , Roger Vogelmann  11 , Christoph Boesecke  1 , Daniel Beer  12 , Stephan Grunwald  13 , Annette Haberl  14 , Florian Voit  15 , Nazifa Qurishi  16 , Sebastian Noe  17 , Pavel Khaykin  16 , Stephan M Schneeweiß  18 , Stefan Christensen  19   20 , Carolynne Schwarze-Zander  21 , Arne Jessen  22 , Anders Boyd  23 , Jürgen K Rockstroh  24   25 , Kathrin van Bremen  26
Affiliations

Hepatitis D virus infection prevalence in persons with human immunodeficiency virus and hepatitis B virus coinfection in Germany

Fauzi Elamouri et al. Infection. .

Abstract

Purpose: People with HIV (PWH) who have chronic hepatitis B virus (HBV) coinfection are at increased risk of also having hepatitis D virus (HDV) infection given the shared transmission pathways. The current prevalence of HDV in Germany among people with HIV/HBV, however, is unknown. The aim of this study was to determine the percent with HDV screening as well as the current HDV prevalence among German PWH with HBV coinfection and underlying risk factors for HDV infection.

Methods: 21 German HIV treatment centers (6 university clinics, 15 private practices) recruited all people with a confirmed HIV diagnosis and a positive hepatitis B surface antigen for more than 6 months, aged ≥ 18 years, and actively in care on December 31, 2023. We assessed the percent with anti-HDV antibody testing in the total cohort. In addition, we calculated the prevalence of individuals who ever had an anti-HDV positive serology (i.e., past/current infection) and the prevalence of individuals whose last HDV RNA result was positive (i.e., active infection).

Results: Overall, 458 PWH with HBV coinfection were included in the analysis. 17% of the participants were female and 83% male. Median age was 55 years (IQR 48-61). 99% of participants were receiving antiviral dual active therapy with 84% having undetectable HIV viral load and 90.8% having undetectable HBV-DNA. Anti-HDV antibody results were available in 370 (81%). Of these, 27 (7.3%) had a previous/current HDV infection. HDV RNA testing was performed in 24/27 participants with HDV-positive serology, of whom 14/24 (58%) were positive.

Conclusion: In Germany, 7% of PWH with HBV coinfection who underwent HDV screening had HDV antibodies with only half showing signs of active HDV replication.

Keywords: HBV. hepatitis delta; HIV; Screening.

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Conflict of interest statement

Declarations. Competing interests: x☐ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Fauzi Elamouri, Arne Jessen, Philip Posdzich. ☐x The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Thomas Lutz: TLs institution has received research grants from Gilead, GSK, MSD, Moderna, Heidelberger Immuno, Deutsche Leberhilfe, AbbVie. Gaby Knecht: GKs institution has received research grants from Gilead, GSK, MSD, Moderna, Heidelberger Immuno, Deutsche Leberhilfe, AbbVie. Christoph Wyen: CW has received honoraria for consulting or speaking at educational events from Abbvie, Gilead, MSD, Janssen, and ViiV. Malte Benedikt Monin: MBM has received honoraria for consulting or speaking at educational events from AbbVie, AstraZeneca, Gilead Sciences, Janssen, Novavax, Pfizer, Takeda, and ViiV Healthcare. Michael Sabranski: MS has received honoraria for consulting or speaking at educational events from Abbvie, Gilead, MSD, Janssen, and ViiV. Christian Hoffmann: CH has received honoraria for consulting or speaking at educational events from Astra Zeneca, Gilead, MSD, Janssen, Recordati and ViiV. CHs institution has received research grants from Gilead, MSD, Recordati, and ViiV. Alexander Killer: AK has received honoraria for consulting or speaking from AbbVie and Gilead, and travel support from Gilead and Ipsen. AKs institution has received a research grant from Gilead. Björn-Erik Ole Jensen: BEOJ has received honoraria for consulting or speaking at educational events from Gilead, MSD, Janssen, Astra Zeneca, Pfizer, GSK and ViiiV as well as travel support from Gilead. Jakob J. Malin: J. J. M. received consulting honoraria and/or speaker’s fees from Astra Zeneca, Gilead Sciences, Merck Sharp & Dohme and Janssen Cilag. Stefan Esser: SE has received honoraria for consulting or speaking at educational events from Abbvie, Gilead, MSD, Janssen, and ViiV. SEs institution has received a research grant from Gilead and ViiV. Stefan Mauss: SM has received honoraria for consulting or speaking from AbbVie and ViiV and travel support from Gilead and AbbVie. Roger Vogelmann: RV has received honoraria for consulting or speaking at educational events from Gilead, MSD, ViiV, Tillots Pharma and Lilly and travel support from Gilead. Christoph Boesecke: CB has received honoraria for consulting or speaking at educational events from Abbvie, Astra Zeneca, Bavarian Nordic, Gilead, MSD, Janssen, and ViiV. CBs institution has received a research grant from Gilead. Daniel Beer: DB has received honoraria for consulting or speaking at educational events from Abbvie, Amgen, Gilead, MSD, Janssen, and ViiV. Stephan Grunwald: SG has received honoraria for consulting or speaking at educational events from ViiV and MSD. SG has served as an investigator in clinical trials sponsored by Gilead, GSK, MSD, Abbvie, Janssen, AstraZeneca, Pfizer and Madrigal. Annette Haberl: AH has received lecture fees from Gilead Sciences and ViiV Healthcare and support for congress participation from Gilead Sciences. Florian Voit: FV reports personal fees, non-financial support from Gilead Sciences, ViiV Healthcare and Pfizer, and grants from MSD and B. Braun Melsungen AG outside the submitted work. Nazifa Qurishi: NQ has received honoraria for consulting or speaking at educational events from AbbVie, MSD, Gilead, Camurus, Janssen, ViiV and IndiviorSebastian Noe has received honoraria for consulting or speaking at educational events from Gilead, MSD, and ViiV Healthcare. SN has obtained support for medical education from AMGEN, Gilead, MSD, and ViiV Healthcare. Pavel Khaykin: has received honoraria for consulting or speaking at educational events from Abbvie, Gilead, Sanofi, Camurus, Janssen, and ViiV. Stephan M. Schneeweiss: SMS has received honoraria for consulting or speaking at educational events from Gilead, MSD and ViiV. SMS’s institution has received honoraria from conducting studies from Gilead, GSK and ViiV. Stefan Christensen: SC has received honoraria for consulting or speaking from AbbVie, Gilead, Indivior and ViiV and travel support from Gilead and AbbVie. Anders Boyd: AB has received honoraria for speaking at educational events from Gilead,. Jürgen Rockstroh: JKR has received honoraria for consulting or speaking at educational events from Abbvie, Abbott, Berlin Cure, Gilead, MSD, Janssen, and ViiiV. JKRs institution has received a research grant from Gilead. Kathrin van Bremen KvB has received honoraria for consulting or speaking from AbbVie, Gilead, MSD and ViiV and travel support from Gilead.….

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