Improvement in the Microbiological Diagnosis of Hepatitis D on the Mediterranean Coast of Southeastern Spain: A Repeated Cross-Sectional Survey.

BACKGROUND

Hepatitis D virus (HDV) remains underdiagnosed, and universal screening of HBsAg-positive patients is recommended. We assessed changes in HDV diagnostic capacity across public hospitals in the Valencian Community, Spain.

METHODS

Repeated cross-sectional surveys were conducted in 2024 and 2025. Analyses included the 19 hospitals participating in both years and evaluated anti-HDV testing, HDV RNA detection, reflex testing, and clinician notification.

RESULTS

Anti-HDV testing increased from 84.2% to 94.7%, HDV RNA testing from 68.4% to 84.2%, reflex testing from 43.8% to 77.8% (p = 0.04), and direct clinician communication from 75.0% to 83.3%. Improvements were most marked in hospitals with fewer than 500 beds, where anti-HDV testing rose from 78.6% to 92.9% and HDV RNA testing from 57.1% to 78.6%.

CONCLUSIONS

HDV diagnostic capacity improved substantially, particularly in smaller hospitals. Further organizational measures are needed to achieve universal double-reflex testing and timely communication of positive results.