Viruses (Aug 2023)

Is Slovakia Almost a Hepatitis D Free Country?

  • Pavol Kristian,
  • Ivana Hockicková,
  • Elena Hatalová,
  • Daniela Žilinčanová,
  • Marek Rác,
  • Veronika Bednárová,
  • Patrícia Denisa Lenártová,
  • Sylvia Dražilová,
  • Ľubomír Skladaný,
  • Ivan Schréter,
  • Peter Jarčuška,
  • Monika Halánová

DOI
https://doi.org/10.3390/v15081695
Journal volume & issue
Vol. 15, no. 8
p. 1695

Abstract

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Background: It is assumed that the prevalence of hepatitis D in HBsAg-positive individuals reaches 4.5–13% in the world and on average about 3% in Europe. Data from several European countries, including Slovakia, are missing or are from an older period. Methods: We analyzed all available data on hepatitis D from Slovakia, including reports from the Slovak Public Health Authority and the results of one prospective study, and three smaller surveys. The determination of anti-HDV IgG and IgM antibodies and/or HDV RNA was used to detect hepatitis D. Results: In the years 2005–2022, no confirmed case of acute or chronic HDV infection was reported in Slovakia. The presented survey includes a total of 343 patients, of which 126 were asymptomatic HBsAg carriers, 33 acute hepatitis B, and 184 chronic hepatitis B cases. In a recent prospective study of 206 HBsAg-positive patients who were completely serologically and virologically examined for hepatitis B and D, only 1 anti-HDV IgG-positive and no anti-HDV IgM or HDV RNA-positive cases were detected. In other smaller surveys, two anti-HDV IgG-positive patients were found without the possibility of HDV RNA confirmation. In total, only 3 of 329 HBsAg-positive patients (0.91%) tested positive for anti-HDV IgG antibodies, and none of 220 tested positive for HDV RNA. Conclusion: The available data show that Slovakia is one of the countries with a very low prevalence of HDV infection, reaching less than 1% in HBsAg-positive patients. Routine testing for hepatitis D is lacking in Slovakia, and therefore it is necessary to implement testing of all HBsAg-positive individuals according to international recommendations.

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