The disease burden of hepatitis B in Uzbekistan

Objective: To describe the burden of hepatitis B illness in Uzbekistan by m eans of model-based estimates. Methods: A mathematical simulation model was developed to mimic the disease evolution of hepatitis B and calculate the size and age of specific HBV pa tient groups, defined according to the evolution of their illness. Results: The calculations indicate that of 678 000 neonates in Uzbekistan, 159 185 (235 per 1000) would incur an HEY infection at some time during the ir lives. About 55 095 persons (81 per 1000) would become chronic carriers of hepatitis B and 6307 persons (9.3 per 1000) are expected to die due to h epatitis B before they would die from another cause, In the overall populat ion, we calculated that about 3074 Uzbeki die each year from the consequenc es of hepatitis B. Only 3.2% of these premature HBV-deaths are due to acute hepatitis B, whereas 96.8% are due to chronic hepatitis B, It was calculat ed that 2.1% of all deaths (or 1 in 47 deaths), and nearly 25% of deaths (o r one in four deaths) between 30 and 40 pars of age in Uzbekistan are due t o hepatitis B, Vaccination seems easily defensible an the basis of rudiment ary but very conservative cost-effectiveness calculations ($84 per carrier prevented; $735 per death prevented and S 22 per life-year gained). Conclusions: Hepatitis B represents a huge health problem in Uzbekistan, es pecially in young adults, The potential for prevention by vaccination seems very high, but demands a long-term vision if chronic hepatitis, in particu lar is to be reduced. Routine hepatitis B vaccination was found to be a rel atively cost-effective intervention in Uzbekistan. (C) 2000 The British inf ection Society.