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Existing research argues that a “democratic constraint” blocks the path towards fiscal integration in the eurozone: Voters in creditor countries are fundamentally opposed to debt sharing, while voters in debtor countries are unwilling to leave the euro, which constrains national politicians. However, this literature neglects that preferences are strategically interdependent across countries and dependent on the information processed by voters. Based on two linked survey experiments in Germany and Italy, conducted at a crucial moment during the COVID-19 pandemic, we show that a majority of German voters accept debt mutualization in order to stave off a break-up of the euro as a result of Italexit. In contrast, Italian voters prefer Italexit if austerity and structural reforms are required to remain in the euro. Our experimental results thus first suggest that there is no insurmountable opposition towards debt mutualization in German public opinion and second that there is a serious risk of Italian public opinion turning against the euro if further austerity is imposed. Furthermore, they help to explain why German politicians relaxed their hostility to joint debt and agreed to the introduction of the EU’s pandemic recovery fund in 2020.

HBV-DNA levels are low or even undetectable in the majority HDV-infected patients. The impact of PEG-IFNα on HBV-DNA kinetics in HDV-infected patients has not been studied in detail. We analysed data of a prospective treatment trial where 120 HDV-RNA–positive patients were randomized to receive PEG-IFNα-2a plus tenofovir-disoproxil-fumarate (PEG-IFNα/TDF, n = 59) or placebo (PEG-IFNα/PBO; n = 61) for 96 weeks. At week 96, HBV-DNA was still quantifiable in 71% of PEG-IFNα/PBO-treated patients but also in 76% of PEG-IFNα/TDF-treated patients, despite low HBV-DNA baseline values. Surprisingly, a transient HBV-DNA increase between weeks 12 and 36 was observed in 12 in PEG-IFNα/TDF-treated and 12 PEG-IFNα/PBO-treated patients. This increase was positively associated with HBsAg loss [(P = 0.049, odds ratio (OR) 5.1] and HDV-RNA suppression (P = 0.007, OR 4.1) at week 96. Biochemical markers of cell death (M30 and ALT) were higher during the HBV-DNA peak but no distinct systemic immune pattern could be observed by screening 91 soluble inflammatory markers. In conclusion, an early increase in HBV-DNA during PEG-IFNα-2a therapy occurred in more than 20% of patients, even in TDF-treated patients. This transient HBV-DNA rise may indicate PEG-IFNα–induced cell death and lead to long-term HDV-RNA suppression and HBsAg loss. © 2020 John Wiley & Sons Ltd

The role of low levels of HDV-RNA during and after interferon therapy of hepatitis D is unknown. We re-analysed HDV RNA in 372 samples collected in the HIDIT-2 trial (Wedemeyer et al, Lancet Infectious Diseases 2019) with the Robogene assay (RA; Jena Analytics). Data were compared with the previously reported in-house assay (IA). We detected HDV-RNA in one-third of samples previously classified as undetectable using the highly sensitive RA. Low HDV viraemia detectable at week 48 or week 96 was associated with a high risk for post-treatment relapse, defined as HDV RNA positivity in both assays at week 120. HDV RNA relapses occurred in 10/15 (67%) patients with detectable low HDV RNA at week 48 and in 10/13 (77%) patients with low viraemia samples at week 96. In contrast, the post-treatment relapse rate was lower in patients with undetectable HDV RNA in both assays during treatment. © 2020 The Authors. Liver International published by John Wiley & Sons Ltd

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Preventing a total European meltdown will require the German chancellor to fully abandon her cherished vision for the continent.

The COVID-19 pandemic may lead to a resurgence of the euro crisis. In this context, Italy seems particularly vulnerable: support for the euro is lower than in most other eurozone countries, and a possible exit could have serious consequences for the common currency. Based on a novel survey experiment, this paper shows that the pro-euro coalition is fragile in Italy and preferences are malleable. They are heavily dependent on the perceived costs of continued membership, as a majority of Italians would opt for Italexit rather than accepting a bailout plan requiring the implementation of austerity policies. Individuals who feel they have not benefited from the euro are most likely to support exit when faced with the prospect of austerity. This suggests that, differently from Greece, where voters were determined to remain in the euro at all costs, the pro-euro coalition may crumble if Italy is exposed to harsh conditionality. Die COVID-19-Pandemie hat das Potenzial, zu einem Wiederaufleben der Eurokrise beizutragen. Italien erscheint unter diesen Umständen besonders verwundbar: Die Unterstützung für den Euro ist geringer als in den meisten anderen Ländern der Eurozone und ein möglicher Ausstieg Italiens aus dem Euro könnte schwerwiegende Folgen für die gesamte Währungsunion haben. Anhand eines neuen Umfrageexperiments zeigt dieses Papier, dass das den Euro unterstützende gesellschaftliche Bündnis in Italien brüchig ist und die Präferenzen in der italienischen Wählerschaft in hohem Maße veränderlich sind. Individuelle Präferenzen zum Euro hängen stark von den wahrgenommenen Kosten einer fortwährenden Mitgliedschaft im Euro ab. Eine Mehrheit der Italienerinnen und Italiener würde eher für einen Italexit stimmen, als ein Rettungspaket zu akzeptieren, welches die Umsetzung von Austeritätspolitik erfordern würde. Sind die Befragten mit der Aussicht auf Austeritätspolitik konfrontiert, stimmen insbesondere diejenigen für einen Ausstieg Italiens aus dem Euro, die glauben, dass der Euro ihnen nicht genutzt habe. Im Gegensatz zu Griechenland, wo Wählerinnen und Wähler entschlossen waren, zu jedem Preis im Euro zu verbleiben, zeigt dieser Befund, dass das Pro-Euro-Bündnis in Italien auseinanderfallen könnte, sollte Italien mit einer harten Austeritätspolitik konfrontiert sein. Contents 1 Introduction 2 Individual-level preferences for eurozone membership and exit 3 Framing effects on support for the euro 4 Data and methods Experiment design and dependent variable Independent variables Empirical strategy 5 Results The social support base of eurozone membership and exit Multivariate analysis of support for the euro Results from the survey experiment Heterogeneous framing effects 6 Conclusion References