Viral hepatitis is a leading cause of morbidity and mortality worldwide [1]. Vaccination programs, demographic and socioeconomic changes, safer medical and nursing practices, screening of blood donors, access to healthcare and the availability of new treatments have resulted in a significant decline in chronic viral hepatitis infections in Greece during the last decade. Thus, the course of the hepatitis B virus (HBV) infection has changed, which may have also indirectly affected the natural course of hepatitis D viral (HDV) infection [2,3].