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Background. The influence of co-infection with hepatitis D and B viruses on the prognosis of patients with liver cirrhosis is not well established. It is generally considered that hepatic insufficiency in co-infected (HBV+HDV) patients is more severe and rapidly progressive, the evolution being aggravated by numerous complications. Aim. The aim of our study was to compare the long term evolution of patients with liver cirrhosis secondary to viral hepatitis B and D co-infection with that of cirrhotic patients with only hepatitis B virus infection. Methods. Patients were enrolled consecutively from cases admitted in our department during one year (2005) and diagnosed then for the first time with compensated cirrhosis secondary to VHB+VHD co-infection (first group) and VHB mono-infection (second group) respectively. We followed the patients from inclusion (at cirrhosis diagnosis) until death, liver transplantation or until the end of study period (31 December 2013). The occurrence of complications of cirrhosis (hepatocellular carcinoma, refractory ascites, hepatic encephalopathy, upper digestive bleeding, portal vein thrombosis, hepatorenal syndrome, spontaneous bacterial peritonitis) and the causes of death were noted. Survival curves were calculated using Kaplan Meier method and compared using the log-rank test. Results. We enrolled 75 patients with HVD+HBV cirrhosis and 75 patients with HBV cirrhosis. In HDV+HBV group 49.34% were men, with the mean age 43.86 +/-11.66 and in HBV group 66.67% were men with mean age 48.20 +/-11.82. At diagnosis mean MELD score was similar in both groups: 9.45 ± 1.99 for HDV+HBV and 8.14 ± 1.34 for HBV group. Patient mortality during follow-up was predicted (in univariate analysis) by: the presence of HBV and HDV coinfection, Child Pugh class C, MELD score and by the following complications of cirrhosis: hepatocellular carcinoma, refractory ascites, hepatic encephalopathy, upper digestive bleeding, jaundice, portal vein thrombosis, hepatorenal syndrome. Although patients with HDV+HBV related cirrhosis had a significantly lower survival compared to HBV related cirrhosis (p=0.01) in multivariate analysis the only independent predictors for patient death were: the presence of hepatocellular carcinoma, refractory ascites and presence of hepatic encephalopathy episodes. Liver transplantation was performed in 12 patients; 9 patients with HDV+HBV related cirrhosis and only 3 patients with HBV cirrhosis (p=0.13). Conclusion. The presence of HVD+HVB co-infection is not an independent risk factor for mortality [ABSTRACT FROM AUTHOR]