Hepatitis Delta Virus (HDV) infection: frequency and outcome in Persons Living With HIV (PLWH). Data from the ICONA (Italian Cohort of Naïve for Antiretrovirals) cohort

Overall, prevalence of HDV superinfection in Italy is estimated to be around 9% of HBV chronically infected [1]. The rate of HDVAb testing in HBsAg positive persons living with HIV (PLWH) is very low and even more the rate of HDV-RNA testing. HDV causes the most severe liver disease with also a faster progression among PLWH [2]; suppressive antiviral treatment was recently available for this infection, but the burden and natural history of hepatitis delta in the HIV population have not been well examined. Moreover, a peculiar aspect for PLWH co-infected with HBV/HDV is that some of the antiretroviral drugs (boosted-protease inhibitors , efavirenz and etravirine) had an inhibitory effect on the Na+/ Taurocholate polypeptide cotransporter polypeptide (NTCP), a cellular receptor on hepatocytes serving for HBV and HDV virus entry [3].