Medical University Astana, Kazakhstan
The Scope of the Problem: Viral hepatitis is considered one of the most important global issues of medical health care. Worldwide, 240 million people have some evidence of past or present HBV infection. Nonetheless, coinfection or superinfection with Hepatitis Delta Virus (HDV) described as a more aggressive form of hepatitis B virus is still poorly-elaborated. The prevalence of HBV and HBV-HDV has been unknown in Kazakhstan for a long time. However, in recent years more accurate and extensive data has been collected primarily due to implementation of the state program regarding the screening for viral hepatitis as well introducing the viral hepatitis into the list of socially significant diseases. In addition, establishing Centers of Hepatology and opening Departments of Hepatology within the regional hospitals play an important role in estimating the real prevalence in the country. According to the current statistics, 30 to 50 thousand people become infected every year in Kazakhstan. At least 25% of people become infected with HBV, an estimated 65-75% are infected with hepatitis C virus. What’s more, liver cirrhosis is ranked first among the disorders associated with the gastrointestinal tract. (ÐšÐ°Ð»Ð¸Ð°ÑÐºÐ°Ñ€Ð¾Ð²Ð° Ðš.Ð¡., 2016). Kazakhstan is being considered as a high endemic country within the context of hepatitis B (more than 8%). With regard to the HDV prevalence, Kazakhstan has been referred as a medium endemic country. However, within the country the prevalence of the viral hepatitis is not homogenous and the statistical data are not completely reliable to the full extent. Implementation of the vaccination programs against hepatitis B for the prevention of the disease has resulted in the positive results.However, currently Hepatitis D is diagnosed in the late stages, which is therefore characterized by a rapidly progressive course of the disease, and low efficacy of the antiviral therapy. The epidemiology data regarding the prevalence of the hepatitis B and hepatitis D infection in Kazakhstan is still limited. Aim of the study: To determine prevalence and clinical characteristics of chronic hepatitis B virus with hepatitis D virus in different regions of Kazakhstan. Materials and Methods: The study utilizes epidemiological methods of descriptive statistics of the output data of the SPC "Sanitary-epidemiological expertise and monitoring" of the KZPP MNE RK. The current study analyzes the epidemiological data within the period of 5 years from 2012 to 2016. Results and Discussion: The incidence of chronic viral hepatitis B with the hepatitis D infection in various regions of Kazakhstan throughout the period of 2012-2016. Taking into account the fact that infection with Hepatitis D can only occur in the presence of hepatitis B virus, the prevalence of the chronic form of the hepatitis B virus has been investigated. It was found that in the five-year period from 2012 to 2016 there has been a decrease in the incidence of HBV infection from 35.4 to 29.6 cases per 100,000 people. However, with regard to the HBV infection with HDV, a substantial increase in the disease prevalence has been determined. In particular, the HDV infection disease incidence has increased by 40% reaching a value of 0.39 cases per 100,000 people in 2016.The following endemic regions of the country with the highest disease prevalence has been determined: South Kazakhstan, West Kazakhstan, Zhambyl, Aktobe regions and the city of Astana. The highest disease prevalence of HBV infection has found to be the capital of the country with the value of 1.7 cases per 100,000 people. What’s more, the disease prevalence in Astana has been consistently substantial in comparison to the other parts and regions of Kazakhstan.