Review of Albanian studies suggests the need for further efforts to counteract significant hepatitis B virus prevalence

Background: Hepatitis B virus (HBV) is categorized as one of the smallest enveloped DNA viruses and is the prototypical virus of the Hepatoviridae family. It is usually transmitted through body fluids such as blood, semen, and vaginal secretions. The majority (more than 95%) of immunocompetent adults infected with HBV spontaneously clear the infection. In the context of the high prevalence of HBV infection in Albania, the research gap is characterized by the lack of studies aimed at advancing the current understanding and improving the prevailing situation. The main objective of this study was to address the low rate of HBV diagnosis and the lack of a comprehensive national program to facilitate widespread diagnosis. Aim: To analyze the prevalence of HBV infection in Albania and elucidate the persistently high prevalence despite efforts and measures implemented. Methods: Using a systematic literature review, we collected existing research on the epidemiology of HBV in Albania from PubMed, Cochrane Library, Google Scholar, and Albanian Medical Journals, focusing on studies published after the 1980s and conducted solely in the Albanian population. Results: The findings reveal a dynamic shift in HBV prevalence in Albania over several decades. Initially high, the prevalence gradually declined following the implementation of screening and vaccination programs. However, the prevalence rates have remained notably high, exceeding 8% in recent years. Contributing factors include vertical transmission, inadequate healthcare infrastructure, and challenges in screening and diagnosis. Studies among Albanian refugees in neighboring countries also reported high prevalence rates, emphasizing the need for transnational interventions. Despite advancements in screening, vaccination, and healthcare infrastructure, Albania continues to face a substantial burden of HBV infection. Conclusion: The persistence of high prevalence underscores the complexity of the issue, requiring ongoing efforts to ensure a comprehensive understanding and effective mitigation. Addressing gaps in vaccination coverage, improving access to screening and diagnosis, and enhancing public awareness are crucial steps toward reducing HBV prevalence in Albania.