Subject(s)
Fibrosis/epidemiology , Hepatitis B/epidemiology , Hepatitis D/epidemiology , Hepatitis Delta Virus/isolation & purification , Liver Diseases/virology , Adult , Chronic Disease , Female , Fibrosis/mortality , Global Burden of Disease , Hepatitis B Surface Antigens/immunology , Hepatitis B virus/isolation & purification , Hepatitis D/complications , Hepatitis D/drug therapy , Hepatitis D/mortality , Hepatitis Delta Virus/immunology , Humans , Incidence , Interferon-alpha/economics , Interferon-alpha/therapeutic use , Lipopeptides/therapeutic use , Liver Diseases/epidemiology , Liver Diseases/immunology , Male , Middle Aged , Piperidines/therapeutic use , Prevalence , Pyridines/therapeutic use , Risk Factors , Superinfection/complications , Uzbekistan/epidemiologyABSTRACT
BACKGROUND & AIMS: The hepatitis B virus (HBV) is endemic in Uzbekistan but the medical impact of infection with the HBV-dependent hepatitis D virus (HDV) is unknown in the Country. An Hepatology Center was recently established at the Institute of Virology in Tashkent, which has set up a database enlisting patients with chronic viral liver disorders from all over Uzbekistan; it provides an observatory on the current scenario of viral hepatitis in the Country. METHODS: The prevalence of HBV monoinfection, hepatitis C virus (HCV) infection and HDV superinfection on hepatitis B surface antigen (HBsAg)-positive cirrhosis was determined in 6589 patients with viral cirrhosis collected in the last 3 years. RESULTS: Of 1089, 1150 and 1455 carriers of the HBsAg with cirrhosis recruited in 2016, 2017 and 2018, 834 (76.5%), 926 (80.5%) and 1224 (84%) respectively, had antibody to the HDV. In 2016, 2017 and 2018, the prevalence of HDV infection has been 41%, 45% and 49.1% respectively, largely exceeding the prevalence of HBV monoinfection (12.5%, 11% and 9.3% respectively) and surpassing the prevalence of HCV in 2017 and 2018 (44% and 41.5% respectively). The median age of the patients with HDV cirrhosis was 39 years, distinctly lower than that of HBV and HCV patients (46 and 55). CONCLUSIONS: Superinfection with the HDV is present in over 80% of the HBsAg-positive cirrhosis in Uzbekistan. The HDV appears to be the major cause of advanced viral liver disease and of juvenile cirrhosis in the Country.