Hepatitis B and C landscape in Uzbekistan: epidemiological patterns revealed in a study of 1 040 000 people

Abstract

Uzbekistan initiated a nationwide screening program for viral hepatitis B (HBV) and C (HCV) in response to the global call for viral hepatitis elimination by 2030. This study aimed to assess HBV and HCV prevalence among the general population, provide treatment for diagnosed cases, and evaluate the effectiveness of direct-acting antiviral (DAA) therapy for HCV. From July 2022 to June 2024, 1 048 575 individuals aged 1-95 years were screened at local healthcare facilities using rapid immunochromatographic tests for hepatitis B surface antigen (HBsAg) and antibodies against hepatitis C virus (anti-HCV). Positive cases underwent confirmatory testing and were linked to care. HCV RNA-positive patients were assessed for DAA treatment eligibility. Overall HBsAg prevalence was 2.89% and anti-HCV prevalence was 3.52%. HBV prevalence decreased from 3.25% in those born before 2000 to 0.77% in those born after (P < .01), reflecting the impact of the national HBV vaccination program. Of 32 132 anti-HCV positive individuals, 20 039 (62.4%) were confirmed HCV RNA positive. Among these, 18 327 were eligible for DAA treatment. The majority received a 12-week treatment course, while 2126 (11%) with advanced liver fibrosis received a 24-week regimen. The sustained virological response rate was high, with only 1.17% of patients with advanced fibrosis and 0.96% without advanced fibrosis failing to achieve viral clearance. This large-scale study demonstrates the effectiveness of Uzbekistan's HBV vaccination program and the success of DAA treatment in achieving high cure rates for HCV. The study provides crucial data to guide public health strategies for combating viral hepatitis in Uzbekistan and progressing towards the World Health Organization's 2030 elimination targets.