Aim. To determine epidemiological features of acute and chronic viral hepatitis B in the Kyrgyz Republic over the period 1997-2017. Меthоds. Analysis was performed on data bases of the National accounting forms on treated cases of acute and chronic hepatitis B cumulated by the Medical Information Centre of the Ministry of Health of Kyrgyz Republic for the period of 1997 to 2017 as well as 384 medical records of patients with chronic hepatitis B treated in the Hepatologic Centre “Tsadmir”. Results. In the Kyrgyz Republic among all acute cases of acute viral hepatitides, hepatitis A comprises 60.5 %, hepatitis B - 16.9 %, the ratio of unverified non-A non-C viral hepatitis - 15.2%. With the introduction of HBV vaccination of children (2000) and improvement of infectious control in healthcare settings, a decline of acute HBV incidence is observed - from 26.7 0/0000 to 5.3 0/0000 due to the decrease of acute hepatitis B among children and adolescents to isolated cases, adults from risk groups. The highest incidence of acute hepatitis B is recorded in Osh and Bishkek, in Jalal-Abad and Chuy Regions. This can be explained by that in the southern and northern capitals of the Kyrgyz Republic and in the near lying areas with high population density, access to laboratory and instrumental methods of diagnosis of viral hepatitides is better, along with the higher awareness of its inhabitants regarding the prevention compared to other regions. At the same time an increase of chronic hepatitis B incidence is observed. Predominant modes of transmission are medical-parenteral exposure and household contact (60.9 %), with frequent formation of family clusters (23.8 %). Imperfections were found in the early detection, reporting and accounting of cases of chronic viral hepatitides as well as in examination of hepatitis B virus carriers. Conclusion. The performed analysis of the incidence and prevalence of acute and chronic hepatitis B in the Kyrgyz Republic allowed assessing the dynamics of the epidemiologic situation in the country regarding this disease, revealed shortcomings in the detection and examination of viral hepatitis B carriers, contributed to development of a new guide for epidemiological surveillance of viral hepatitides.

Objective. To compare epidemiological, clinical and laboratory characteristics of chronic hepatitis B (ChHB) associated with/without delta agent (ChHB+DV) study.Materials and methods. The Kyrgyzstan State Reporting Form No. 12 covering 2010–2017 period was examined. For this, 133 and 130 case histories of ChHB and ChHB+DV patients, respectively, were analyzed. The data were statiastically processed by using Microsoft Office Excel software.Results and discussion. Over the 2010–2017 period, prevalence of the “HBV Carrier” (60.4 ) was higher by 20-fold than that one for ChHB [3.8 , 95% CI (2.4–4.0)] and CVHD [3.4 , 95% CI (2.2–3.4)], as the vast majority of patients were not thoroughly examined after detecting HBsAg, and the HBV Carrier was empirically diagnosed at the primary health care units. As a result, routine case definitions for such conditions were revised and an improved system of epidemiological surveillance of viral hepatitis was developed, according to the 2016 WHO recommendations approved by the Ministry of Health of the Kyrgyz Republic (Order No. 524, dated of July 20, 2018). Asthenia was observed in ~60% of patients in both groups, whereas arthralgia — in ~5–10% of patients, more often in those comorbid with ChHB+DV, and myalgia — in as low as ~3% of cases. Impaired central nervous system functions manifested as headache and restless sleep were evenly recorded in about 10–15% of patients, without significant difference between groups. In contrast, dominating dyspeptic manifestations such as poor appetite (72±3.9% vs. 20.6±3.5%, p < 0,05), nausea (23.8±3.7% vs. 7.3±2.3%, p < 0,05), vomiting (12.3±2.6% vs. 3.3±1.5%, p < 0,05) and flatulence (27±3.9% and 13±2.9%, p < 0,05) were revealed in ChHB+DV patients. Pain in the right hypochondrium was noted in 52–56% of patients, insignificantly differed between patient groups. Incidence of yellowness of the sclera and skin layers as well as skin itching were recorded by 2–3 and 8 times, respectively, more frequently in ChHB+DV patients. A more profound cytolysis and signs of altered bilirubin metabolism were also more common in HBV patients comorbid with the delta agent. Thus, a more severe ChHB+DV course requires that all patients with primary HBsAg detection were mandatorily examined for anti-HDV antibodies to ensure early diagnostics and timely organization of the secondary and tertiary preventive measures in the Kyrgyzstan.

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