Hepatitis B and Delta Virus Infections: Epidemiological Aspects, Natural History, and Management Strategies

Chronic infection with the hepatitis B virus (HBV), either alone or in combination with the hepatitis delta virus (HDV), is a major public health issue in France and worldwide, due to its prevalence, its often asymptomatic nature, and the risk of long-term liver complications.Its natural history is characterized by variable progression, which can lead to the development of fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Initial evaluation combines biochemical markers, viral load, and noninvasive assessment of fibrosis. Follow-up is tailored to serological status, viral replication level, laboratory abnormalities, the severity of fibrosis, and the presence of comorbidities. Coinfection with HCV is associated with faster progression of liver disease and increases the risk of cirrhosis, HCC, and liver-related death, warranting systematic screening and enhanced follow-up.Despite effective viral suppression, the risk of complications persists, particularly in patients with advanced fibrosis and/or comorbidities, underscoring the importance of prolonged monitoring and comprehensive, very long-term care.

Author(s): Parlati Lucia, Fontaine Hélène, Bourlière Marc

Publishing year: 2026

Pages: 444-451

Weekly Epidemiological Bulletin, 2026, n° 19-20, p. 444-451

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