INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 09,2025
Journal:
https://www.academicpublishers.org/journals/index.php/ijai
page 64
CLINICAL AND MICROBIOLOGICAL FEATURES OF HEPATITIS B AND D
COINFECTION
Nazirova Khusnijahon Tolqinjon kizi
Laboratory Doctor Assistant, Bacteriology Laboratory, Uchkoprik District Department,
Sanitary and Epidemiological Committee, Uzbekistan
Abstract:
Hepatitis B virus (HBV) remains one of the major causes of chronic liver disease and
hepatocellular carcinoma worldwide. Infection with hepatitis D virus (HDV) in individuals
already infected with HBV leads to coinfection or superinfection, which significantly worsens
the clinical outcome. This study reviews clinical and microbiological characteristics of
HBV/HDV coinfection with a focus on available epidemiological data from Uzbekistan. The
aim is to highlight virological interactions, disease progression, and implications for diagnosis
and prevention.
Keywords:
Hepatitis B, Hepatitis D, coinfection, liver cirrhosis, Uzbekistan, microbiology.
Introduction
Hepatitis B virus (HBV) infection affects nearly 300 million people globally. In countries with
high endemicity, hepatitis D virus (HDV) coinfection poses an additional public health burden.
HDV requires HBV surface antigen (HBsAg) for replication and persistence, making HBV
carriers especially vulnerable. The coinfection leads to more severe liver damage, rapid
progression to cirrhosis, and a higher risk of hepatocellular carcinoma compared to HBV
monoinfection.
Uzbekistan, located in Central Asia, is considered a region with intermediate endemicity for
HBV. Recent studies have demonstrated that HDV infection is widespread among HBV-
infected patients, particularly those with cirrhosis. This article examines the clinical and
microbiological features of HBV/HDV coinfection, with an emphasis on epidemiological
findings from Uzbekistan.
Methods
This study is based on a literature review of PubMed, ResearchGate, and national
epidemiological reports (2016–2024). Data were extracted on HBV and HDV prevalence,
clinical manifestations, and microbiological characteristics. Particular attention was given to
studies that specifically addressed the epidemiology of HBV/HDV coinfection in Uzbekistan.
Results
Clinical and Microbiological Features
Virological interaction:
HDV relies on HBV surface antigen for replication, making
HBV carriers susceptible. HDV infection suppresses HBV replication but significantly
enhances liver inflammation.
Clinical severity:
Patients with HBV/HDV coinfection show faster progression to
cirrhosis, hepatic decompensation, and higher mortality.
Microbiological characteristics:
HDV is a defective RNA virus requiring HBV as a
helper virus. Molecular analysis shows high variability among circulating HDV genotypes, with
genotype I being the most prevalent in Central Asia.
Epidemiological Data from Uzbekistan
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 09,2025
Journal:
https://www.academicpublishers.org/journals/index.php/ijai
page 65
Epidemiological studies demonstrate high prevalence rates of HDV infection among HBV
patients in Uzbekistan. In cirrhosis cases positive for HBsAg, HDV coinfection rates were
recorded as follows:
2016 – 76.5 %
2017 – 80.5 %
2018 – 84.0 %
(PubMed, 2019,
).
A recent national screening program (2022–2024) found:
HBsAg prevalence – 2.89 %
Anti-HCV prevalence – 3.52 %
(PubMed, 2024).
Among children, due to successful HBV vaccination programs, HBsAg prevalence dropped to
only
0.20 %
(PubMed, 2023).
Table 1. HBV and HDV epidemiology in Uzbekistan
Indicator
Data (Uzbekistan)
HDV coinfection among HBsAg+ cirrhosis (2016)
76.5 %
HDV coinfection among HBsAg+ cirrhosis (2017)
80.5 %
HDV coinfection among HBsAg+ cirrhosis (2018)
84.0 %
HBsAg prevalence (general population, 2022–2024)
2.89 %
Anti-HCV prevalence (general population, 2022–2024) 3.52 %
HBsAg prevalence (children, after vaccination)
0.20 %
Figure 1. Prevalence of HDV infection among HBsAg-positive cirrhosis patients in
Uzbekistan (2016–2018)
(Diagram: line graph showing steady increase from 76.5 % in 2016 to 84 % in 2018)
This figure illustrates the rising trend of HDV coinfection in cirrhotic patients. Such a pattern
indicates the heavy burden of HBV/HDV in high-risk groups, despite relatively lower
prevalence in the general population.
Discussion
The data show that HBV/HDV coinfection is a major contributor to liver disease burden in
Uzbekistan. The very high prevalence of HDV in cirrhosis cases indicates that HDV plays a
critical role in disease progression. The sharp contrast between low HBsAg prevalence in
children (0.20 %) and higher prevalence in adults (2.89 %) highlights the success of vaccination
programs, but also shows the need for continued monitoring of older age groups.
Microbiologically, the presence of HDV significantly modifies HBV replication, suppressing
HBV DNA levels but amplifying liver damage. This dual effect complicates both diagnosis and
treatment. Current antiviral therapies are limited, and interferon-based regimens remain the
mainstay, though with modest efficacy.
Conclusion
HBV/HDV coinfection represents a severe form of viral hepatitis with accelerated progression
to cirrhosis and liver cancer. In Uzbekistan, epidemiological data demonstrate alarmingly high
prevalence rates among cirrhotic patients, despite decreasing HBV prevalence in the general
population and successful vaccination coverage among children.
Recommendations:
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 09,2025
Journal:
https://www.academicpublishers.org/journals/index.php/ijai
page 66
Strengthen national HBV vaccination programs and expand adult vaccination.
Improve diagnostic screening for HDV in all HBsAg-positive patients.
Encourage further research into genotype-specific therapies for HDV.
Introduce public health policies targeting early detection and management of coinfection.
References
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World Health Organization. Global Hepatitis Report. Geneva: WHO; 2023.
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