Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 27, 2024; 16(3): 300-303
Published online Mar 27, 2024. doi: 10.4254/wjh.v16.i3.300
Is there a need for universal double reflex testing of HBsAg-positive individuals for hepatitis D infection?
Zaigham Abbas, Minaam Abbas
Zaigham Abbas, Department of Hepatogastroenterology and Liver Transplantation, Dr. Ziauddin University Hospital, Karachi 75600, Sindh, Pakistan
Minaam Abbas, Department of Medicine, University of Cambridge, Cambridge CB2 0SP, United Kingdom
Author contributions: Abbas Z conceived the theme; A review of the literature was done by Abbas Z and Abbas M; Both authors approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zaigham Abbas, AGAF, FACG, FACP, FCPS, FRCP, FRCPE, Professor, Department of Hepatogastroenterology and Liver Transplantation, Dr. Ziauddin University Hospital, Clifton, Karachi 75600, Sindh, Pakistan. drzabbas@gmail.com
Received: December 3, 2023
Peer-review started: December 3, 2023
First decision: January 15, 2024
Revised: January 16, 2024
Accepted: February 22, 2024
Article in press: February 22, 2024
Published online: March 27, 2024
Core Tip

Core Tip: Most countries lack high-quality hepatitis D virus (HDV) prevalence data, and published data are often biased by the collection techniques employed. Currently, HDV diagnosis practice is stepwise. It relies on physician’s discretion and requires numerous visits. Generally, only HBsAg-positive patients highly at risk for HDV are screened. Double reflex testing involves anti-HDV testing of all HBsAg-positive individuals, followed by HDV RNA testing for those who test positive for anti-HDV. This test approach is gaining attention because of the severe implications of HDV coinfection, and emerging as an effective strategy for identifying undiagnosed cases.