Consensus document on the diagnosis, management, and treatment of chronic hepatitis B virus and hepatitis D virus infection in Spain

Chronic infection by hepatitis B virus (HBV) and hepatitis D virus (HDV) continues to pose a major public health challenge in Spain due to its high morbidity and mortality and the risk of progression to cirrhosis and hepatocellular carcinoma. Although effective tools exist for the control of hepatitis B and recent therapeutic advances have been made for hepatitis D, significant inequalities persist in early diagnosis, access to treatment, and appropriate patient follow-up. This consensus document has been jointly developed by the Spanish Association for the Study of the Liver (AEEH), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC)-through its Viral Hepatitis Study Group (GEHEP)-the Spanish Society of Digestive Pathology (SEPD), the Spanish Society of Family and Community Medicine (semFYC), the Spanish Society of Hospital Pharmacy (SEFH), the Alliance for the Elimination of Viral Hepatitis in Spain (AEHVE), and the Spanish Society of Paediatric Gastroenterology, Hepatology and Nutrition (SEGHNP). The objective is to provide updated and consensus-based recommendations on the diagnosis, management, and treatment of chronic HBV and HDV infection, from a multidisciplinary perspective and adapted to real-world clinical practice. The document addresses screening and diagnostic strategies, criteria for assessing liver fibrosis, indications for antiviral treatment, specific management of hepatitis D, and the role of coordination between primary care and hospital care. Likewise, it emphasizes the need to implement strategies to advance toward the goals of viral hepatitis elimination.