Prevalence of parenteral viral hepatitis markers in the Kherson Region

Background. Parenteral hepatitis B (HBV), C (HCV), and D (HDV) virus infections pose a global public health problem. It is critical to conduct epidemiological study for planning effective preventive and therapeutic interventions in the Kherson Region during post-crisis healthcare restoration. The study was aimed to comprehensively assess prevalence of population parenteral viral hepatitis markers in the Kherson Region, taking into account infection and vaccination status as well as sociodemographic characteristics. Materials and methods. A cross-sectional randomized study on the representative Kherson Region sample (N = 2806), stratified into 9 age groups was carried out. Anamnestic data on vaccination and former infections were collected. Serological markers (HBsAg, anti-HBc, anti-HBs, anti-HCV, anti-HDV) were quantitated by ELISA, verified further in case of positive HBsAg and anti-HCV results. Molecular markers (HBV DNA, HCV RNA, HDV RNA) were assessed by PCR, including a highly sensitive method for occult hepatitis B (OBI). Results. Prevalence of HBsAg-positive infection comprised 1.4%, peaking in the 40–49 age group (2.6%). Anti-HBc prevalence progressively increased with age (from 1.7% in under 18 to 21.5% in 70+). Total protective post-vaccination/infection immunity (anti-HBs ≥ 10 IU/L) was low (25.2%), peaking in children aged 1–5 years (58.9%), with sharp decline in adolescents and adults. A key finding: OBI (HBV DNA without HBsAg) dominated over manifest forms. HBV DNA was detected in 4.1% participants, of which 81.6% (3.3% total sample) were referred to OBI. Former iatrogenic interventions served as an OBI risk factor. Self-reported HBV vaccination coverage was 36.5%, but protective antibodies were found in only 31.6% of such vaccinated individuals. Anti-HCV prevalence was 4.1%, increasing with age; HCV RNA was detected in 1.2%. Anti-HDV antibody prevalence was 0.5%, not paralleled with HDV RNA detection. Conclusion. The Kherson Region shows a contradictory epidemiological situation: despite low HBV/HCV infection rates in the younger individuals, a critical issue is posed by insufficient population immunity due to low and ineffective HBV vaccination coverage, OBI dominance resulting in uncontrolled infection reservoir as well as association with iatrogenic interventions. These findings justify a need to strengthen routine immunization, implement catch-up vaccination, and introduce OBI screening in at-risk groups.