Prevalence and epidemiology of hepatitis B and hepatitis D in Uzbekistan—results from a population-based serosurvey, 2022

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Objectives Uzbekistan, historically a country with high hepatitis B virus (HBV) infection endemicity, introduced infant hepatitis B vaccination in 2001 and has sustained ≥90% coverage for hepatitis B vaccine birth dose (HepB-BD) and three or more doses. In 2017, Uzbekistan initiated hepatitis B elimination activities. However, data on hepatitis B prevalence in the general population were lacking. Methods In 2022, we conducted a serosurvey among persons aged ≥5 years using stratified cluster sampling. Blood samples were tested for markers of HBV and hepatitis D virus (HDV) infections. Results We enrolled 9063 adults aged ≥18 years and 4092 children aged 5-17 years. Overall weighted prevalence of HBV surface antigen (HBsAg) was 4.1% (95% confidence interval, 3.1-5.0%); 13.0% (7.8-20.8%) of HBsAg-positive persons had detectable HDV ribonucleic acid (RNA). HBsAg prevalence was lowest (0.4%) among 5-14-year-olds and highest (7.3%) among 40-49-year-olds. Children who had not received HepB-BD had higher HBsAg prevalence (2.3%) than those who had received HepB-BD (0.1%, P < 0.001). Conclusion Successful hepatitis B vaccination resulted in low HBV infection prevalence among children, but hepatitis B remains widespread among adults in Uzbekistan. Expanding HBV prevention, screening, and treatment among adults, and maintaining high infant vaccination coverage may help achieve hepatitis B elimination in Uzbekistan.

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