Nationwide Implementation of Double Reflex Testing for Hepatitis Delta in Spain: Results From the Retrospective Phase of the Spain‐DDR Study

Key Points

• Hepatitis D virus seroprevalence was widely documented across various regions in Spain, highlighting national implementation success.
• The expansion of double reflex testing demonstrates its feasibility across the country from 2022 to 2024, with mixed regional outcomes.
• Assessment using retrospective data reveals ongoing challenges, particularly in addressing underdiagnosis in coinfected patients.
• Standardized reflex protocols and training are crucial for ensuring consistent care and improving diagnosis efforts in the population.