Acute hepatitis A, B and C but not D is still prevalent in Mongolia: a time trend analysis

Abstract

Background/aims: Mongolia has one of the highest hepatitis A, C, B and D infection incidences worldwide. We sought to investigate changes in the proportion of acute viral hepatitis types in Mongolia over the last decade.

Methods: The cohort comprised 546 consecutive patients clinically diagnosed with acute viral hepatitis from January 2012 to December 2014 in Ulaanbaatar Hospital, Mongolia. A time trend analysis investigating the change in proportion of acute hepatitis A virus, hepatitis C virus (HCV), hepatitis B virus (HBV) and hepatitis delta virus (HDV) infection among the cohort with respect to a previous published study was undertaken.

Results: Acute hepatitis A, B and C was diagnosed in 50.9%, 26.2% and 6.0% of the cohort. Notably, 16.8% of the cohort had a dual infection. The etiologies of acute viral hepatitis were varied by age groups. The most common cause of acute viral hepatitis among 2-19 year olds was hepatitis A, HBV and superinfection with HDV among 20-40 year olds, and HCV among 40-49 year olds. Patients with more than one hepatitis virus infection were significantly older, more likely to be male and had a higher prevalence of all risk factors for disease acquisition. These patients also had more severe liver disease at presentation compared to those with mono-infection.

Conclusions: Acute viral hepatitis is still prevalent in Mongolia. Thus, the need for proper infection control is increasing in this country.

Keywords: Acute hepatitis; Hepatitis A; Hepatitis B; Hepatitis C; Hepatitis D.

Figure 1.

Changes in the proportion of acute hepatitis A, B, C and D in Mongolia. HAV, hepatitis A virus; HBV, hepatitis B virus; HDV, hepatitis delta virus; HCV, hepatitis C virus.

Figure 2.

The comparison of proportion in acute viral hepatitis with previous data. (A) acute hepatitis A, (B) acute hepatitis B, (C) acute hepatitis C, (D) co-infection with HBV and HDV, (E) HDV superinfection.