Year 2026 / Volume 118 / Number 1
Original
Prevalence of hepatitis delta virus infection in Galicia ‒ Results of the universal implementation of double reflex testing

14-19

DOI: 10.17235/reed.2025.11393/2025

Raquel Carracedo Montero, María de los Ángeles Cañizares, Sandra Cortizo, Matilde Trigo, Noelia Calvo, María José Gude, Patricia Ordóñez, Luz Moldes, Jorge Julio Cabrera, Noelia Parajó, Sara Pereira, Luis Rodríguez Otero, Antonio Aguilera,

Abstract
Introduction: chronic hepatitis caused by the hepatitis delta virus is the most severe form of viral hepatitis and carries the greatest risk of complications. The real prevalence of this infection remains unknown. Objectives: this study sought to determine the prevalence of both the antibodies and the active infection rates of hepatitis delta in the Autonomous Region of Galicia, Spain. Materials and methods: a prospective study was conducted including all patients carrying the hepatitis B surface antigen who attended any hospital within the Galician Health Service between 2023 and 2024. These patients underwent serum testing for antibodies against the hepatitis delta virus (LIAISON® XL MUREX Anti-HDV Assay; Diasorin Saluggia, Italia); the viral load was then assessed in those that tested positive (Hepatitis Delta Real Time PCR Kit; Vircell, Granada, Spain). The samples with a positive viral load were subsequently genotyped. Results: a total of 1,962 patients were included, 85 of whom had anti-HDV antibodies, and 20 of these (23.5 %) had a detectable viral load. The prevalence obtained was 4.3 % in carriers of the hepatitis B virus surface antigen, and 0.03 per 1,000 inhabitants. The most common genotype found in active infections was 1D. Conclusions: the seroprevalence obtained in this study confirmed the low circulation of the hepatitis delta virus in our region. However, a significant proportion of affected patients have an active infection, and early diagnosis is essential to prevent disease progression and the development of complications. As expected, most of our patients are infected with strains of genotype 1D, which is predominant worldwide, including Europe. However, we also found three strains of genotype 5 in patients from West Africa.
Lay Summary
The hepatitis Delta virus (HDV) is a rarely seen virus that affects patients with hepatitis B and can cause the most severe form of viral hepatitis. Until recently, there were no effective treatments for this virus, but since 2020, the use of Bulevirtide has been approved, which is the first direct-acting antiviral specifically targeting HDV. This study, in which all hospitals in the Galician Health Service have participated, aims to determine the prevalence of hepatitis Delta in our region. To this end, during 2023 and 2024, all HBsAg carriers who visited any hospital in Galicia were tested to determine whether they were infected with HDV. Based on the data obtained, we estimate that the prevalence in our setting is 0.03 per 1,000 inhabitants, which is low. However, a significant proportion of affected patients have active infection and are at risk of serious complications in the short to medium term. It is therefore essential to diagnose them early to prevent the disease from progressing and to enable them to benefit from treatment against HDV.
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Carracedo Montero R, Cañizares M, Cortizo S, Trigo M, Calvo N, Gude M, et all. Prevalence of hepatitis delta virus infection in Galicia ‒ Results of the universal implementation of double reflex testing. 11393/2025


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Publication history

Received: 04/06/2025

Accepted: 08/07/2025

Online First: 29/09/2025

Published: 14/01/2026

Article Online First time: 117 days

Article editing time: 224 days


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