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High Rates of Advanced Chronic Liver Disease in Patients With Chronic Hepatitis D Virus Infection in Uzbekistan

Malika E Khodjaeva1,2, Aziza S Khikmatullaeva1, Nargiz S Ibadullaeva1

  • 1Scientific Research Institute of Virology, Tashkent, Uzbekistan.

Liver International : Official Journal of the International Association for the Study of the Liver
|July 17, 2026
PubMed

Insights

Hepatitis D virus (HDV) coinfection is more common and severe than hepatitis B virus (HBV) monoinfection in Uzbekistan. Most HDV patients have advanced liver disease and lack access to effective HDV treatment.

Area of Science:

  • Hepatology
  • Virology
  • Epidemiology

Background:

  • Chronic hepatitis B virus (HBV) infection is a significant public health concern in Uzbekistan.
  • Previous studies indicated a high prevalence of anti-hepatitis D virus (HDV) antibodies among HBsAg-positive individuals.
  • Limited data exist on the clinical spectrum, treatment accessibility, and hepatocellular carcinoma (HCC) rates in Uzbek patients with chronic HDV infection.

Purpose of the Study:

  • To investigate the prevalence and clinical characteristics of HDV coinfection compared to HBV monoinfection in Uzbekistan.
  • To assess disease severity, treatment patterns, and HCC incidence in HDV-coinfected patients.
  • To evaluate the current management and therapeutic gaps for HDV infection in the region.

Main Methods:

  • A retrospective analysis of epidemiological, clinical, and laboratory data was conducted.
  • Data were collected from 1393 HBsAg-positive patients presenting to the Scientific Research Institute of Virology (SRIoV) between June 2023 and May 2024.
  • HDV-coinfected and HBV-monoinfected patient groups were compared.

Main Results:

  • HDV coinfection (73.9%) was significantly more prevalent than HBV monoinfection (26.1%).
  • HDV-infected patients were younger and exhibited higher rates of cirrhosis (78.4% vs. 43.9%) and advanced liver disease (Child-Pugh score B in 57.8%).
  • Less than 1% of HDV-coinfected patients received anti-HDV treatment, with detectable HDV RNA in 78.9% and low HCC detection rates due to insufficient screening.

Conclusions:

  • HDV coinfection is highly prevalent and associated with greater disease severity compared to HBV monoinfection in Uzbekistan.
  • The majority of HDV-infected patients present with advanced liver disease.
  • There is a critical lack of access to HDV-directed therapies, highlighting a significant unmet medical need.
Abstract

Keywords:
CHDCentral AsiaHCCHDVhepatitis delta

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