S. paucimobilis can cause infections in healthy as well as immunocompromised individuals. Although it is an organism of low clinical virulence, infection caused by S. paucimobilis can lead to septic shock. Further clinical research is required to characterize this infection.

The emergence of hepatitis D virus (HDV) infection in the era of widespread HBV vaccination has not been described before. We aimed to investigate the changing epidemiology of HDV infection among high-and low-risk populations after an outbreak of human immunodeficiency virus (HIV) infection among injection drug users (IDUs) in Taiwan. A prospective, multicenter, cohort study of 2,562 hepatitis B surface antigen (HBsAg)-positive individuals was conducted to determine the prevalence, genotype, and risk factors of HDV infection from 2001 through 2012. The prevalence rates of HDV infection were 74.9%, 43.9%, 11.4%, 11.1%, and 4.4% among HIV-infected IDUs, HIV-uninfected IDUs, HIV-infected men who have sex with men, HIV-infected heterosexuals, and the general population of HBsAg-positive subjects, respectively. A significant increase in the trend of HDV prevalence from 38.5% to 89.8% was observed in HIV-infected IDUs (odds ratio 5 3.06; 95% confidence interval: 1.68-5.56; P 5 0.0002). In multivariate analysis, injection drug use, hepatitis C virus infection, HIV infection, serum HBsAg level м250 IU/mL, duration of drug use, and older age were significant factors associated with HDV infection. HDV genotype IV (72.2%) was the prevalent genotype circulating among IDUs, whereas genotype II was predominant in the non-IDU populations (73.3%). In the HIV cohort born after 1987 who were HBsAg negative, over half (52.9%) had antibody to hepatitis B surface antigen antibody levels of <10 mIU/mL and there was a significantly higher HBsAg seroprevalence in the HIV cohort, compared to the control group (8.1% vs. 0.0%; P 5 0.02). Conclusion: In the era of HBV vaccination, IDUs and HIV-infected individuals have emerged as high-risk groups and a reservoir for HDV infection. Effective strategies are needed to curb the reemerging epidemic of HDV infection in these high-risk groups. (HEPATOLOGY 2015;61:1870-1879 H epatitis D virus (HDV) is a defective, singlestranded RNA virus that requires hepatitis B surface antigen (HBsAg) envelope for assembly and transmission.1,2 Studies show that most patients with hepatitis B virus (HBV) and HDV dual infections have more severe liver disease, more rapid progression to cirrhosis, and increased frequency of hepatic decompensation and hepatocellular carcinoma

Our study demonstrated a high prevalence of HCV infection among HIV-infected IDUs in Taiwan, with a predominance of infection due to genotypes 1a, 6a, and 3a, as a result of the impact of IDUs' behavior and their drug trafficking route. Our study revealed that HCV infection in IDUs originated from a geographically large transmission network that was mainly distinct from that associated with other HCV-infected individuals; this transmission network has also been documented in association with HIV infection in IDUs.