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Kristian P, Hockicková I, Hatalová E, Žilinčanová D, Rác M, Bednárová V, Lenártová PD, Dražilová S, Skladaný Ľ, Schréter I, Jarčuška P, Halánová M. Is Slovakia Almost a Hepatitis D Free Country? Viruses 2023; 15:1695. [PMID: 37632037 PMCID: PMC10459979 DOI: 10.3390/v15081695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
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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Affiliation(s)
- Pavol Kristian
- Department of Infectology and Travel Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Safarik University, 041 90 Kosice, Slovakia; (P.K.); (P.D.L.); (I.S.)
| | - Ivana Hockicková
- Department of Infectology and Travel Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Safarik University, 041 90 Kosice, Slovakia; (P.K.); (P.D.L.); (I.S.)
| | - Elena Hatalová
- Department of Epidemiology, Faculty of Medicine, Pavol Jozes Safarik University, 040 11 Kosice, Slovakia; (E.H.); (V.B.); (M.H.)
| | - Daniela Žilinčanová
- II. Department of Internal Medicine, HEGITO Division Hepatology, Gastroenterology and Liver Transplantation, F. D. Roosevelt University Hospital, Slovak Medical University, 974 01 Banska Bystrica, Slovakia; (D.Ž.); (Ľ.S.)
| | - Marek Rác
- Department of Internal Medicine, Faculty Hospital, 949 01 Nitra, Slovakia;
| | - Veronika Bednárová
- Department of Epidemiology, Faculty of Medicine, Pavol Jozes Safarik University, 040 11 Kosice, Slovakia; (E.H.); (V.B.); (M.H.)
| | - Patrícia Denisa Lenártová
- Department of Infectology and Travel Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Safarik University, 041 90 Kosice, Slovakia; (P.K.); (P.D.L.); (I.S.)
| | - Sylvia Dražilová
- 2nd Department of Internal Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Safarik University, 041 90 Kosice, Slovakia; (S.D.); (P.J.)
| | - Ľubomír Skladaný
- II. Department of Internal Medicine, HEGITO Division Hepatology, Gastroenterology and Liver Transplantation, F. D. Roosevelt University Hospital, Slovak Medical University, 974 01 Banska Bystrica, Slovakia; (D.Ž.); (Ľ.S.)
| | - Ivan Schréter
- Department of Infectology and Travel Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Safarik University, 041 90 Kosice, Slovakia; (P.K.); (P.D.L.); (I.S.)
| | - Peter Jarčuška
- 2nd Department of Internal Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Safarik University, 041 90 Kosice, Slovakia; (S.D.); (P.J.)
| | - Monika Halánová
- Department of Epidemiology, Faculty of Medicine, Pavol Jozes Safarik University, 040 11 Kosice, Slovakia; (E.H.); (V.B.); (M.H.)
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