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. 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.