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World J Hepatol. Oct 27, 2026; 18(10): 124709
Published online Oct 27, 2026. doi: 10.4254/wjh.124709
Published online Oct 27, 2026. doi: 10.4254/wjh.124709
Impact of hepatitis delta virus infection on waiting list outcomes: A competing-risks analysis
Angela Peltec, Diana Buga, Discipline of Gastroenterology, Department of Internal Medicine, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau 2019, Moldova
Adrian Hotineanu, Surgery Department No. 2, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau 2019, Moldova
Heiner Wedemeyer, Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover 30625, Germany
Author contributions: Peltec A designed and conducted the study and wrote the paper; Buga D contributed to the analysis and wrote the paper; Hotineanu A provided clinical advice; Wedemeyer H supervised the study.
AI contribution statement: Certain sections of this manuscript were revised with the assistance of AI tools exclusively for language improvement. All AI-generated suggestions were thoroughly checked and validated by the authors, who assume full responsibility for the scientific content of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Research Ethics Committee of the Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova (approval No. 40).
Informed consent statement: Written informed consent was obtained from all participants included in the prospective phase of the study. For the retrospective phase, anonymized clinical data from the National Transplant Registry were used in accordance with institutional review board approval.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The statistical code and de-identified dataset supporting the findings of this study are available from the corresponding author upon reasonable request, subject to compliance with national data protection regulations.
Corresponding author: Angela Peltec, PhD, Associate Professor, Discipline of Gastroentero
Received: June 23, 2026
Revised: July 27, 2026
Accepted: September 23, 2026
Published online: October 27, 2026
Processing time: 120 Days and 10.3 Hours
Revised: July 27, 2026
Accepted: September 23, 2026
Published online: October 27, 2026
Processing time: 120 Days and 10.3 Hours
Core Tip
Core Tip: This national competing-risks study shows that hepatitis D virus infection approximately doubled the cause-specific hazards of both waiting-list death and liver transplantation. However, the cumulative incidence of waiting-list death was not increased because patients with hepatitis D underwent transplantation more frequently. This divergence between cause-specific and subdistribution effects highlights how transplantation modifies the observed mortality risk. Hepatitis D status may therefore improve clinical risk stratification in endemic settings, although the current evidence does not support a formal model for end-stage liver disease exception.