Assuntos
Fibrose/epidemiologia , Hepatite B/epidemiologia , Hepatite D/epidemiologia , Vírus Delta da Hepatite/isolamento & purificação , Hepatopatias/virologia , Adulto , Doença Crônica , Feminino , Fibrose/mortalidade , Carga Global da Doença , Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Hepatite D/complicações , Hepatite D/tratamento farmacológico , Hepatite D/mortalidade , Vírus Delta da Hepatite/imunologia , Humanos , Incidência , Interferon-alfa/economia , Interferon-alfa/uso terapêutico , Lipopeptídeos/uso terapêutico , Hepatopatias/epidemiologia , Hepatopatias/imunologia , Masculino , Pessoa de Meia-Idade , Piperidinas/uso terapêutico , Prevalência , Piridinas/uso terapêutico , Fatores de Risco , Superinfecção/complicações , Uzbequistão/epidemiologiaRESUMO
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.
