{"doi":"10.1093/cid/ciaf324","title":"Translating Hepatitis D Virus Screening Cost-Effectiveness into Practice: The Case for Reflex Testing in the United States","abstract":"We read with great interest the recent study by Toy et al. demonstrating the cost-effectiveness of one-time hepatitis delta virus (HDV) testing among HBsAg-positive adults in the United States.i As the authors highlight, HDV is the most aggressive form of viral hepatitis, yet only ~13% of adults with chronic hepatitis B virus (HBV) are ever tested in the US.ii We commend the authors for advocating for universal HDV screening in HBsAg-positive adults in the US, as advised by the European Association for the Study of the Liver.iii Recommending one-time HDV screening on account of its cost-effectiveness is a step in the right direction, but efforts should be made to consider how we may optimize implementation to ensure the testing is done.CDC guidance recommends a one-time HBV triple panel screen for all adults, which is an ideal opportunity to also implement reflex HDV testing.iv Reflex testing may prove to be even more impactful and cost-effective, reducing potential missed diagnoses and detecting patients earlier in their disease course.","journal":"Clinical Infectious Diseases","year":2025,"id":536273,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9504,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1421110,"name":"Anna Mageras","orcid":"0000-0002-6239-4135","position":1,"is_corresponding":false},{"id":1421111,"name":"Nina Rodriguez","orcid":"0009-0000-2996-9462","position":2,"is_corresponding":false},{"id":1302825,"name":"Frances Lee","orcid":null,"position":3,"is_corresponding":false},{"id":1421597,"name":"Lauren Alpert","orcid":null,"position":4,"is_corresponding":false},{"id":239503,"name":"Andrea D. Branch","orcid":"0000-0003-2865-3188","position":5,"is_corresponding":false},{"id":634371,"name":"Xiaotao Zhang","orcid":"0000-0002-3968-5030","position":6,"is_corresponding":false},{"id":566991,"name":"Douglas T. Dieterich","orcid":"0000-0001-7786-8594","position":7,"is_corresponding":false},{"id":439745,"name":"Tatyana Kushner","orcid":"0000-0001-6663-6253","position":8,"is_corresponding":false},{"id":1248778,"name":"Cecilia Katzenstein","orcid":"0000-0002-0082-6879","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-19T02:52:05.227140Z","pmid":"40518949","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}