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. 2025 Jul;30(29):2500015.
doi: 10.2807/1560-7917.ES.2025.30.29.2500015.

National representative seroprevalence of viral hepatitis B, C, and D seromarkers in Ukraine, 2021

Ludmila Kasatkina  1 , Vladyslav Fedorchenko  1 , Iryna Sidorova  2 , Lidia Gomenyuk  2 , Oleksandra Yakovets  2 , Michael Brandl  3   4 , Iryna Ivanchuk  1 , Sandra Dudareva  3   5 , Olena Nesterova  1
Affiliations

National representative seroprevalence of viral hepatitis B, C, and D seromarkers in Ukraine, 2021

Ludmila Kasatkina et al. Euro Surveill. 2025 Jul.

Abstract

BACKGROUNDAligned with World Health Organization (WHO) goals, Ukraine aims to eliminate viral hepatitis. While some data on viral hepatitis B and C prevalence exist among key populations, nationwide prevalence in the general population has never been assessed.AIMTo assess the prevalence of viral hepatitis B, C, and D seromarkers in Ukraine in 2021 to plan and monitor elimination measures.METHODSBlood samples available from a cross-sectional household-based SARS-CoV-2 serosurvey conducted in 2021 were tested for hepatitis C virus (HCV) antibodies, total antibodies against hepatitis B virus (HBV) core antigen (HBc), hepatitis B surface antigen (HBsAg) and hepatitis D virus (HDV) antibodies. We calculated crude and weighted proportions for anti-HCV, anti-HBc and HBsAg positivity. To account for differences in sex, age group and urbanisation level, we applied post-stratification weights using inverse probability weighting based on the distribution of the Ukrainian population. We calculated proportions positive for anti-HDV among HBsAg-positive cases and weighted regional estimates for HBV and HCV seromarkers.RESULTSWeighted prevalence of anti-HCV was 3.3% (95% CI: 2.8-4.0), anti-HBc 11.6% (95% CI: 10.8-12.5) and HBsAg 0.9% (95% CI: 0.7-1.2). Among HBsAg-positive individuals, 7.5% (95% СI: 3.0-17.9) were anti-HDV positive. We found higher prevalence of HBV and HCV seromarkers among men and in southern Ukraine.CONCLUSIONHBsAg prevalence and considerably high anti-HBc and anti-HCV prevalence indicate substantial lifetime exposure. This reinforces the necessity of sustained prevention such as HBV vaccination of newborns and groups at increased risk, regular hepatitis B and C screening, early treatment, and raising awareness to reduce ongoing transmission.

Keywords: Ukraine; hepatitis B; hepatitis B virus surface antigen; hepatitis C; hepatitis D; nationwide representative serosurvey; seroprevalence; viral hepatitis.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

The algorithm for testing blood samples for the presence or absence of viral hepatitis C markers (A), and viral hepatitis B and D markers (B), in a sample of the healthy adult population of Ukraine (during June–July 2021).
Figure 1
Flowchart of test results for viral hepatitis seromarkers and applied testing algorithm, Ukraine, 2021 (n = 6,376)
Population-weighted prevalence of hepatitis B and C seromarkers across Ukrainian regions.
Figure 2
Weighted prevalence of hepatitis B virus and hepatitis C virus seromarkers at the regional level, Ukraine, 2021 (n = 6,376)
See this image and copyright information in PMC

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