{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:25:40Z","timestamp":1786947940213,"version":"build-2736575974"},"reference-count":69,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infect Dis Poverty"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Uzbekistan faces a substantial burden of hepatitis B and D virus (HBV and HDV) infections despite implementing universal hepatitis B vaccination in 1998. Regional variation in disease distribution and contemporary transmission dynamics remain inadequately characterized. Our objective was to evaluate the geographically stratified prevalence of HBV and HDV, while also identifying the key risk factors fueling transmission within the adult population of Uzbekistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide cross-sectional study of 10,552 adults across seven regions of Uzbekistan from July 2022 to June 2024. Participants were selected using stratified random sampling from a parent cohort of 1,048,575 individuals. Serological testing included hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), anti-HDV antibodies, and viral RNA detection. Multivariate logistic regression identified independent risk factors for HBV and HDV infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall HBsAg prevalence was 4.7% (95%\n                      <jats:italic>CI<\/jats:italic>\n                      : 4.3\u20135.1%), with substantial geographic heterogeneity ranging from 3.2% in Tashkent to 6.3% in Bukhara. Among HBsAg-positive individuals, 68.1% had detectable HBV DNA and 12.7% had HDV superinfection. HDV RNA prevalence among HBV DNA-positive individuals ranged from 2.5% to 23.7% across regions. Age-cohort analysis demonstrated vaccination program impact, with older unvaccinated adults bearing disproportionate disease burden. Female sex associated with 31% lower odds of chronic HBsAg carriage. Married status, healthcare-associated exposures, and body piercings correlated with increased anti-HBc positivity. Remarkably, sharing personal hygiene items showed striking HDV-specific association (a\n                      <jats:italic>O<\/jats:italic>\n                      <jats:italic>R<\/jats:italic>\n                      2.34, 95%\n                      <jats:italic>CI<\/jats:italic>\n                      : 1.16\u20134.74;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02) but no association with HBV markers, suggesting distinct transmission pathways for HDV superinfection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Persistent HBV burden with notable regional clustering and HDV superinfection necessitates targeted interventions. The identification of personal hygiene item sharing as a specific HDV transmission route provides an actionable household-level prevention target. Intensified screening and treatment of unvaccinated adults remain critical for hepatitis elimination efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40249-026-01487-w","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T03:40:06Z","timestamp":1786938006000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatitis B and D burden in Uzbekistan: comprehensive analysis of seroprevalence and risk correlates from a countrywide study"],"prefix":"10.1186","volume":"15","author":[{"given":"Erkin Isakovich","family":"Musabaev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malika Erkinovna","family":"Khodjaeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziza Saydullaevna","family":"Khikmatullaeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nargiz Sapievna","family":"Ibadullaeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima Shokir kizi","family":"Shodieva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnara Karimovna","family":"Khudaykulova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigora Ubaydullaevna","family":"Tadjieva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sobirjon Bakhtiyorovich","family":"Amonov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2986-5660","authenticated-orcid":false,"given":"Ulugbek Khudayberdievich","family":"Mirzaev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"1487_CR1","unstructured":"Hepatitis B. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-b. Accessed 18 Nov 2025."},{"key":"1487_CR2","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.15585\/mmwr.mm6934a3","volume":"69","author":"R Dunn","year":"2020","unstructured":"Dunn R, Musabaev E, Razavi H, Sadirova S, Bakieva S, Razavi-Shearer K, et al. Progress toward hepatitis B and hepatitis C elimination using a catalytic funding model \u2014 Tashkent, Uzbekistan, December 6, 2019\u2013March 15, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1161\u20135.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"1487_CR3","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1111\/liv.15514","volume":"43","author":"E Musabaev","year":"2023","unstructured":"Musabaev E, Estes C, Sadirova S, Bakieva S, Brigida K, Dunn R, et al. Viral hepatitis elimination challenges in low- and middle-income countries\u2014Uzbekistan Hepatitis Elimination Program (UHEP). Liver Int. 2023;43:773\u201384.","journal-title":"Liver Int"},{"key":"1487_CR4","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1016\/S1473-3099(16)30204-3","volume":"16","author":"S Nayagam","year":"2016","unstructured":"Nayagam S, Thursz M, Sicuri E, Conteh L, Wiktor S, Low-Beer D, et al. Requirements for global elimination of hepatitis B: a modelling study. Lancet Infect Dis. 2016;16:1399\u2013408.","journal-title":"Lancet Infect Dis"},{"key":"1487_CR5","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.4976667","author":"M Sadeghimehr","year":"2024","unstructured":"Sadeghimehr M, Mosina L, Sim SY, Datta SS. Health and economic impact of hepatitis B vaccination in Belarus, Georgia, Kyrgyzstan, Republic of Moldova. Turkmenistan and Uzbekistan-a modelling study. 2024. https:\/\/doi.org\/10.2139\/ssrn.4976667.","journal-title":"Turkmenistan and Uzbekistan-a modelling study"},{"key":"1487_CR6","unstructured":"Hepatitis D. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-d. Accessed 18 Nov 2025."},{"key":"1487_CR7","unstructured":"Hepatitis D changing context global prevalence. https:\/\/www.natap.org\/2022\/HBV\/021022_01.htm. Accessed 18 Nov 2025."},{"key":"1487_CR8","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.jhep.2020.04.008","volume":"73","author":"AJ Stockdale","year":"2020","unstructured":"Stockdale AJ, Kreuels B, Henrion MYR, Giorgi E, Kyomuhangi I, de Martel C, et al. The global prevalence of hepatitis D virus infection: systematic review and meta-analysis. J Hepatol. 2020;73:523\u201332.","journal-title":"J Hepatol"},{"key":"1487_CR9","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1093\/eurpub\/ckaf136","volume":"35","author":"UY Ismoilov","year":"2025","unstructured":"Ismoilov UY, Musabaev EI, Khikmatullaeva AS, Ibadullaeva NS, Kan NG, Sadirova SS, et al. Hepatitis B and C landscape in Uzbekistan: epidemiological patterns revealed in a study of 1,040,000 people. Eur J Public Health. 2025;35:1014.","journal-title":"Eur J Public Health"},{"key":"1487_CR10","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1111\/liv.15519","volume":"43","author":"C B\u00e9guelin","year":"2023","unstructured":"B\u00e9guelin C, Atkinson A, Boyd A, Falconer K, Kirkby N, Suter-Riniker F, et al. Hepatitis delta infection among persons living with HIV in Europe. Liver Int. 2023;43:819\u201328.","journal-title":"Liver Int"},{"key":"1487_CR11","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1002\/cld.1106","volume":"18","author":"H Gokcan","year":"2021","unstructured":"Gokcan H, Idilman R. Hepatitis D infection in Asia: a perspective from an endemic region. Clin Liver Dis (Hoboken). 2021;18:26.","journal-title":"Clin Liver Dis (Hoboken)"},{"key":"1487_CR12","unstructured":"InTec. In vitro diagnostics tests, rapid diagnostic tests, ELISA test kits. https:\/\/www.intecasi.com\/. Accessed 16 Jul 2026."},{"key":"1487_CR13","unstructured":"Vector-Best. Hepatitis B. https:\/\/en.vector-best.ru\/catalog\/IFA\/kits\/hepatitis-viruses-a-b-c-d-e\/hepatitis-b\/. Accessed 16 Jul 2026."},{"key":"1487_CR14","unstructured":"Federal Budgetary Institution of Science Central Research Institute of Epidemiology of Rospotrebnadzor. AmpliSens\u00ae HBV-Monitor-FL. Quantitative determination of hepatitis B virus (HBV) DNA. https:\/\/www.amplisens.ru\/catalog\/4-nabory-reagentov-dlya-ptsrdiagnostiki-infektsionnykh-bolezney-cheloveka\/42-virusnye-gepatity\/amplisens-hbvmonitorfl-kolichestvennoe-opredeleniya-dnk-virusa-gepatita-v\/. Accessed 16 Jul 2026."},{"key":"1487_CR15","unstructured":"Vector-Best. Hepatitis D. https:\/\/en.vector-best.ru\/catalog\/IFA\/kits\/hepatitis-viruses-a-b-c-d-e\/hepatitis-d\/. Accessed 16 Jul 2026."},{"key":"1487_CR16","unstructured":"Federal Budgetary Institution of Science Central Research Institute of Epidemiology of Rospotrebnadzor. AmpliSens\u00ae HDV-FL. Detection of hepatitis D virus (HDV) RNA. https:\/\/www.amplisens.ru\/catalog\/4-nabory-reagentov-dlya-ptsrdiagnostiki-infektsionnykh-bolezney-cheloveka\/42-virusnye-gepatity\/amplisens-hdvfl-vyyavlenie-rnk-virusa-gepatita-d\/. Accessed 16 Jul 2026."},{"key":"1487_CR17","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1093\/eurpub\/ckaf136","volume":"35","author":"UY Ismoilov","year":"2025","unstructured":"Ismoilov UY, Musabaev EI, Khodjaeva M. Hepatitis B and C landscape in Uzbekistan. Eur J Public Health. 2025;35:1014\u201320.","journal-title":"Eur J Public Health"},{"key":"1487_CR18","doi-asserted-by":"publisher","DOI":"10.1186\/1751-0473-3-17","volume":"3","author":"Z Bursac","year":"2008","unstructured":"Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:17.","journal-title":"Source Code Biol Med"},{"key":"1487_CR19","doi-asserted-by":"publisher","DOI":"10.1002\/9781118548387","volume-title":"Applied logistic regression","author":"DW Hosmer","year":"2013","unstructured":"Hosmer DW, Lemeshow S, Sturdivant RX. Applied logistic regression. 3rd ed. Hoboken (NJ): Wiley; 2013.","edition":"3rd ed"},{"key":"1487_CR20","volume":"15","author":"Z Abbas","year":"2023","unstructured":"Abbas Z, Abbas M. An insight into the factors affecting the prevalence and natural history of hepatitis D. Cureus. 2023;15:e43362.","journal-title":"Cureus"},{"key":"1487_CR21","first-page":"1","volume":"29","author":"N \u00d6rmeci","year":"2023","unstructured":"\u00d6rmeci N, Erdem H. Changing trends in the epidemiology of delta virus infection. Bezmialem Sci. 2023;29:1\u20139.","journal-title":"Bezmialem Sci"},{"key":"1487_CR22","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1093\/infdis\/jiz633","volume":"221","author":"Z Miao","year":"2020","unstructured":"Miao Z, Zhang S, Ou X, Li S, Ma Z, Wang W, et al. Estimating the global prevalence, disease progression, and clinical outcome of hepatitis delta virus infection. J Infect Dis. 2020;221:1677\u201387.","journal-title":"J Infect Dis"},{"key":"1487_CR23","doi-asserted-by":"publisher","DOI":"10.3390\/v12101112","volume":"12","author":"D Amerzhanov","year":"2020","unstructured":"Amerzhanov D, Suleimenova I, Davlidova S, Nugmanova Z, Ali S. HBV prevention and treatment in countries of Central Asia and the Caucasus. Viruses. 2020;12:1112.","journal-title":"Viruses"},{"key":"1487_CR24","doi-asserted-by":"publisher","first-page":"3237","DOI":"10.1007\/s10620-023-07960-y","volume":"68","author":"C Pan","year":"2023","unstructured":"Pan C, Gish R, Jacobson IM, Hu KQ, Wedemeyer H, Martin P. Diagnosis and management of hepatitis delta virus infection. Dig Dis Sci. 2023;68:3237\u201348.","journal-title":"Dig Dis Sci"},{"key":"1487_CR25","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1016\/j.jiph.2023.05.003","volume":"16","author":"S Athalye","year":"2023","unstructured":"Athalye S, Khargekar N, Shinde S, Parmar T, Chavan S, Swamidurai G, et al. Exploring risk factors and transmission dynamics of hepatitis B infection among Indian families: implications and perspective. J Infect Public Health. 2023;16:1109\u201314.","journal-title":"J Infect Public Health"},{"key":"1487_CR26","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1002\/jmv.21035","volume":"80","author":"D Avazova","year":"2008","unstructured":"Avazova D, Kurbanov F, Tanaka Y, Sugiyama M, Radchenko I, Ruziev D, et al. Hepatitis B virus transmission pattern and vaccination efficiency in Uzbekistan. J Med Virol. 2008;80:217\u201324.","journal-title":"J Med Virol"},{"key":"1487_CR27","doi-asserted-by":"publisher","first-page":"765","DOI":"10.3201\/eid2305.161477","volume":"23","author":"F Cui","year":"2017","unstructured":"Cui F, Shen L, Li L, Wang H, Wang F, Bi S, et al. Prevention of chronic hepatitis B after 3 decades of escalating vaccination policy, China. Emerg Infect Dis. 2017;23:765\u201372.","journal-title":"Emerg Infect Dis"},{"key":"1487_CR28","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1002\/jmv.21035","volume":"80","author":"EI Musabaev","year":"2008","unstructured":"Musabaev EI, Dalimova D, Aripov T. Hepatitis B virus transmission pattern and vaccination efficiency in Uzbekistan. J Med Virol. 2008;80:217\u201324.","journal-title":"J Med Virol"},{"key":"1487_CR29","first-page":"34","volume":"3","author":"SB Khujamova","year":"2024","unstructured":"Khujamova SB. Geography of the spread of virus diseases in Uzbekistan and nosogeographic environment ways to improve. Teoreticheskie aspekty stanovleniya pedagogicheskikh nauk. 2024;3:34\u20137.","journal-title":"Teoreticheskie aspekty stanovleniya pedagogicheskikh nauk"},{"key":"1487_CR30","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.3390\/pathogens13121082","volume":"13","author":"J Heisig","year":"2024","unstructured":"Heisig J, Nurmatov ZS, Riese P, Trittel S, Sattarova GJ, Temirbekova SN, et al. Vaccination schedule and age influence impaired responsiveness to hepatitis B vaccination: a randomized trial in Central Asia. Pathogens. 2024;13:1082.","journal-title":"Pathogens"},{"key":"1487_CR31","doi-asserted-by":"publisher","first-page":"32","DOI":"10.12688\/wellcomeopenres.17601.3","volume":"7","author":"R Brown","year":"2022","unstructured":"Brown R, Goulder P, Matthews PC. Sexual dimorphism in chronic hepatitis B virus (HBV) infection: evidence to inform elimination efforts. Wellcome Open Res. 2022;7:32.","journal-title":"Wellcome Open Res"},{"key":"1487_CR32","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.3748\/wjg.v23.i9.1602","volume":"23","author":"F Li","year":"2017","unstructured":"Li F, Li X, Zou GZ, Gao YF, Ye J. Association between TLR7 copy number variations and hepatitis B virus infection outcome in Chinese. World J Gastroenterol. 2017;23:1602.","journal-title":"World J Gastroenterol"},{"key":"1487_CR33","doi-asserted-by":"publisher","first-page":"838","DOI":"10.3390\/vaccines9080838","volume":"9","author":"RB Hamidu","year":"2021","unstructured":"Hamidu RB, Chalikonda DM, Hann HW. Gender disparity in host responses to hepatitis B-related hepatocellular carcinoma: a case series. Vaccines (Basel). 2021;9:838.","journal-title":"Vaccines (Basel)"},{"key":"1487_CR34","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1111\/jgh.12934","volume":"30","author":"SH Wang","year":"2015","unstructured":"Wang SH, Chen PJ, Yeh SH. Gender disparity in chronic hepatitis B: mechanisms of sex hormones. J Gastroenterol Hepatol. 2015;30:1237\u201345.","journal-title":"J Gastroenterol Hepatol"},{"key":"1487_CR35","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.13828","volume":"10","author":"M Liu","year":"2022","unstructured":"Liu M, Li L, Zhao J, Ungvari GS, Ng CH, Duan Z, et al. Gender differences in demographic and clinical characteristics in patients with HBV-related liver diseases in China. PeerJ. 2022;10:e13828.","journal-title":"PeerJ"},{"key":"1487_CR36","doi-asserted-by":"publisher","first-page":"1068078","DOI":"10.3389\/fpubh.2022.1068078","volume":"10","author":"AC Wang","year":"2022","unstructured":"Wang AC, Geng JH, Wang CW, Wu DW, Chen SC. Sex difference in the associations among risk factors with hepatitis B and C infections in a large Taiwanese population study. Front Public Health. 2022;10:1068078.","journal-title":"Front Public Health"},{"key":"1487_CR37","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-20556-y","volume":"15","author":"M Geta","year":"2025","unstructured":"Geta M, Yizengaw E, Ejigu K, Hailu A, Woldeamanuel Y. Hepatitis B virus infection and associated risk factors among mothers attending public health facilities in Bahir Dar, Northwest Ethiopia. Sci Rep. 2025;15:36416.","journal-title":"Sci Rep"},{"key":"1487_CR38","doi-asserted-by":"publisher","first-page":"288","DOI":"10.3390\/vaccines12030288","volume":"12","author":"SA Al-Busafi","year":"2024","unstructured":"Al-Busafi SA, Alwassief A. Global perspectives on hepatitis B vaccination: challenges, achievements, and the road to elimination by 2030. Vaccines (Basel). 2024;12:288.","journal-title":"Vaccines (Basel)"},{"key":"1487_CR39","doi-asserted-by":"publisher","first-page":"484","DOI":"10.2471\/BLT.17.205153","volume":"96","author":"K Whitford","year":"2018","unstructured":"Whitford K, Liu B, Micallef J, Yin JK, Macartney K, Van Damme P, et al. Long-term impact of infant immunization on hepatitis B prevalence: a systematic review and meta-analysis. Bull World Health Organ. 2018;96:484.","journal-title":"Bull World Health Organ"},{"key":"1487_CR40","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s12939-022-01678-5","volume":"21","author":"HA Ali","year":"2022","unstructured":"Ali HA, Hartner AM, Echeverria-Londono S, Roth J, Li X, Abbas K, et al. Vaccine equity in low and middle income countries: a systematic review and meta-analysis. Int J Equity Health. 2022;21:82.","journal-title":"Int J Equity Health"},{"key":"1487_CR41","doi-asserted-by":"publisher","first-page":"794","DOI":"10.2471\/BLT.15.162172","volume":"94","author":"MC Restrepo-M\u00e9ndez","year":"2016","unstructured":"Restrepo-M\u00e9ndez MC, Barros AJD, Wong KLM, Johnson HL, Pariyo G, Fran\u00e7a GVA, et al. Inequalities in full immunization coverage: trends in low- and middle-income countries. Bull World Health Organ. 2016;94:794-805A.","journal-title":"Bull World Health Organ"},{"key":"1487_CR42","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.30870","volume":"6","author":"J Zhao","year":"2023","unstructured":"Zhao J, Xuan Y, Zhang Y, Hong X, Zhang H, Zhang R, et al. Assessment of prior infection with hepatitis B virus and fecundability in couples planning pregnancy. JAMA Netw Open. 2023;6:e2330870.","journal-title":"JAMA Netw Open"},{"key":"1487_CR43","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s41182-025-00781-x","volume":"53","author":"F Cindibu Kalonji","year":"2025","unstructured":"Cindibu Kalonji F, Nakagama Y, Tshibangu-Kabamba E, Kayiba Kalenda E, Nakagama S, Nakagama S, et al. Intra-familial transmission of hepatitis B virus in a peri-urban community from the Democratic Republic of the Congo. Trop Med Health. 2025;53:99.","journal-title":"Trop Med Health"},{"key":"1487_CR44","volume":"51","author":"S Sabeena","year":"2022","unstructured":"Sabeena S, Ravishankar N. Horizontal modes of transmission of hepatitis B virus (HBV): a systematic review and meta-analysis. Iran J Public Health. 2022;51:2181.","journal-title":"Iran J Public Health"},{"key":"1487_CR45","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.ijregi.2023.12.007","volume":"10","author":"I Mangowi","year":"2024","unstructured":"Mangowi I, Mirambo MM, Kilonzo SB, Mlewa M, Nyawale M, Majinge D, et al. Hepatitis B virus infection, associated factors, knowledge and vaccination status among household contacts of hepatitis B index cases in Mwanza, Tanzania. IJID Regions. 2024;10:168\u201373.","journal-title":"IJID Regions"},{"key":"1487_CR46","doi-asserted-by":"publisher","first-page":"1818","DOI":"10.1080\/21645515.2020.1847951","volume":"17","author":"X Zhao","year":"2021","unstructured":"Zhao X, Shi X, Lv M, Yuan B, Wu J. Prevalence and factors associated with hepatitis B virus infection among household members: a cross-sectional study in Beijing. Hum Vaccin Immunother. 2021;17:1818.","journal-title":"Hum Vaccin Immunother"},{"key":"1487_CR47","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.29006","volume":"95","author":"X Ye","year":"2023","unstructured":"Ye X, Li T, Yu B, Zeng J, Shi Y, Xie H, et al. The high prevalence of occult hepatitis B infections among the partners of chronically infected HBV blood donors emphasizes the potential residual risk to blood safety. J Med Virol. 2023;95:e29006.","journal-title":"J Med Virol"},{"key":"1487_CR48","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-061165","volume":"13","author":"Z Liang","year":"2023","unstructured":"Liang Z, Qiu J, Xiang Q, Yi J, Zhu J, Zhao Q. Epidemiology of hepatitis B virus infection among preconception couples in South China: a cross-sectional study. BMJ Open. 2023;13:e061165.","journal-title":"BMJ Open"},{"key":"1487_CR49","volume":"16","author":"RH Agwa","year":"2024","unstructured":"Agwa RH, Elwan TH, Alghamdi HAS, Alghamdi AAS, Altaweel FIA, Alghamdi AA, et al. Awareness of hepatitis B virus screening before marriage and pregnancy among adults in the Al-Baha region. Saudi Arabia Cureus. 2024;16:e52057.","journal-title":"Saudi Arabia Cureus"},{"key":"1487_CR50","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100264","volume":"19","author":"W Jing","year":"2020","unstructured":"Jing W, Liu J, Wu Y, Ma Q, Liu M. Cost-effectiveness of couple-based immunization strategy to prevent mother-to-child transmission of hepatitis B virus in China: a decision-analytic Markov model. EClinicalMedicine. 2020;19:100264.","journal-title":"EClinicalMedicine"},{"key":"1487_CR51","doi-asserted-by":"publisher","first-page":"6","DOI":"10.4103\/INJMS.INJMS_40_18","volume":"10","author":"B Kashyap","year":"2019","unstructured":"Kashyap B, Tiwari U, Prakash A. Hepatitis B virus transmission and health-care workers: prevention, management, and awareness toward the disease. Indian J Med Spec. 2019;10:6.","journal-title":"Indian J Med Spec"},{"key":"1487_CR52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.29245\/2689-9981\/2018\/2.1113","volume":"1","author":"A Altaf","year":"2018","unstructured":"Altaf A. Unsafe injection practices by medical practitioners in South Asia associated with hepatitis and HIV outbreaks. J Infectiol. 2018;1:1\u20133.","journal-title":"J Infectiol"},{"key":"1487_CR53","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14726-0","volume":"22","author":"J Singh","year":"2006","unstructured":"Singh J, Stoitsova S, Zakrzewska K, Henszel L, Rosi\u0144ska M, Duffell E. Healthcare-associated hepatitis B and C transmission to patients in the EU\/EEA and UK: a systematic review of reported outbreaks between 2006 and 2021. BMC Public Health. 2006;22:14726.","journal-title":"BMC Public Health"},{"key":"1487_CR54","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001893","volume":"94","author":"S Yang","year":"2015","unstructured":"Yang S, Wang D, Zhang Y, Yu C, Ren J, Xu K, et al. Transmission of hepatitis B and C virus infection through body piercing: a systematic review and meta-analysis. Medicine (Baltimore). 2015;94:e1893.","journal-title":"Medicine (Baltimore)"},{"key":"1487_CR55","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001535","volume":"3","author":"FO Mboya","year":"2023","unstructured":"Mboya FO, Daud II, Ondondo R, Onguru D. Hepatitis B virus infection status and associated factors among health care workers in selected hospitals in Kisumu County, Kenya: a cross-sectional study. PLoS Glob Public Health. 2023;3:e0001535.","journal-title":"PLoS Glob Public Health"},{"key":"1487_CR56","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.puhe.2022.01.035","volume":"205","author":"A Sindoni","year":"2022","unstructured":"Sindoni A, Valeriani F, Protano C, Liguori G, Romano Spica V, Vitali M, et al. Health risks for body pierced community: a systematic review. Public Health. 2022;205:202\u201315.","journal-title":"Public Health"},{"key":"1487_CR57","doi-asserted-by":"publisher","first-page":"713","DOI":"10.2147\/RMHP.S361711","volume":"15","author":"A Tamene","year":"2022","unstructured":"Tamene A, Yemane B. A study of body modification artists\u2019 knowledge, attitudes, and practices toward infection control: a questionnaire-based cross-sectional study. Risk Manag Healthc Policy. 2022;15:713\u201325.","journal-title":"Risk Manag Healthc Policy"},{"key":"1487_CR58","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1007\/s11901-024-00643-w","volume":"23","author":"H Gopalakrishna","year":"2024","unstructured":"Gopalakrishna H, Mironova M, Dahari H, Koh C, Heller T. Advances and challenges in managing hepatitis D virus: evolving strategies. Curr Hepatol Rep. 2024;23:32.","journal-title":"Curr Hepatol Rep"},{"key":"1487_CR59","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0262990","volume":"17","author":"SH Lim","year":"2022","unstructured":"Lim SH, Lee S, Lee YB, Lee CH, Lee JW, Lee SH, et al. Increased prevalence of transfusion-transmitted diseases among people with tattoos: a systematic review and meta-analysis. PLoS ONE. 2022;17:e0262990.","journal-title":"PLoS ONE"},{"key":"1487_CR60","doi-asserted-by":"publisher","first-page":"518","DOI":"10.3889\/oamjms.2021.6406","volume":"9","author":"NT Kambuno","year":"2021","unstructured":"Kambuno NT, Octrysdey K, Nurdin KE, Novicadlitha Y, Barung EN, Hafid F. Sharing of personal sanitary kits as one risk factor of horizontal transmission of hepatitis B among children resident at orphanage. Open Access Maced J Med Sci. 2021;9:518\u201323.","journal-title":"Open Access Maced J Med Sci"},{"key":"1487_CR61","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1093\/infdis\/jiy620","volume":"219","author":"TT Than","year":"2018","unstructured":"Than TT, Jo E, Todt D, Nguyen PH, Steinmann J, Steinmann E, et al. High environmental stability of hepatitis B virus and inactivation requirements for chemical biocides. J Infect Dis. 2018;219:1044.","journal-title":"J Infect Dis"},{"key":"1487_CR62","doi-asserted-by":"publisher","DOI":"10.1128\/msystems.00120-18","volume":"3","author":"CA Pinho-Nascimento","year":"2018","unstructured":"Pinho-Nascimento CA, Bratschi MW, H\u00f6fer R, Soares CC, Warryn L, Pe\u010derska J, et al. Transmission of hepatitis B and D viruses in an African rural community. mSystems. 2018;3:10.1128\/msystems.00120-18.","journal-title":"mSystems"},{"key":"1487_CR63","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1016\/S0168-8278(99)80185-8","volume":"30","author":"GA Niro","year":"1999","unstructured":"Niro GA, Casey JL, Gravinese E, Garrubba M, Conoscitore P, Sagnelli E, et al. Intrafamilial transmission of hepatitis delta virus: molecular evidence. J Hepatol. 1999;30:564\u20139.","journal-title":"J Hepatol"},{"key":"1487_CR64","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1136\/gutjnl-2019-320027","volume":"69","author":"C Besombes","year":"2020","unstructured":"Besombes C, Njouom R, Paireau J, Lachenal G, Texier G, Tejiokem M, et al. The epidemiology of hepatitis delta virus infection in Cameroon. Gut. 2020;69:1294\u2013300.","journal-title":"Gut"},{"key":"1487_CR65","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.3390\/microorganisms11051140","volume":"11","author":"CA Pinho-Nascimento","year":"2023","unstructured":"Pinho-Nascimento CA, Bratschi MW, H\u00f6fer R, Soares CC, Warryn L, Pe\u010derska J, et al. Vertical transmission of hepatitis B virus\u2014an update. Microorganisms. 2023;11:1140.","journal-title":"Microorganisms"},{"key":"1487_CR66","unstructured":"Hepatitis D. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-d?utm_source=chatgpt.com. Accessed 19 Nov 2025."},{"key":"1487_CR67","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1111\/liv.15579","volume":"43","author":"A Tharwani","year":"2023","unstructured":"Tharwani A, Hamid S. Elimination of HDV: epidemiologic implications and public health perspectives. Liver Int. 2023;43:101\u20137.","journal-title":"Liver Int"},{"key":"1487_CR68","doi-asserted-by":"publisher","first-page":"a021550","DOI":"10.1101\/cshperspect.a021550","volume":"4","author":"F Negro","year":"2014","unstructured":"Negro F. Hepatitis D virus coinfection and superinfection. Cold Spring Harb Perspect Med. 2014;4:a021550.","journal-title":"Cold Spring Harb Perspect Med"},{"key":"1487_CR69","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1186\/s12879-020-05359-y","volume":"20","author":"A Scheibe","year":"2020","unstructured":"Scheibe A, Young K, Versfeld A, Spearman CW, Sonderup MW, Prabdial-Sing N, et al. Hepatitis B, hepatitis C and HIV prevalence and related sexual and substance use risk practices among key populations who access HIV prevention, treatment and related services in South Africa: findings from a seven-city cross-sectional survey (2017). BMC Infect Dis. 2020;20:655.","journal-title":"BMC Infect Dis"}],"container-title":["Infectious Diseases of Poverty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40249-026-01487-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40249-026-01487-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40249-026-01487-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:02:04Z","timestamp":1786946524000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40249-026-01487-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":69,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1487"],"URL":"https:\/\/doi.org\/10.1186\/s40249-026-01487-w","relation":{},"ISSN":["2049-9957"],"issn-type":[{"value":"2049-9957","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"assertion":[{"value":"9 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted as part of the nationwide hepatitis screening program approved by the Ethics Committee (26.04.2019 under #04) of the Ministry of Health of the Republic of Uzbekistan. Informed consent was obtained from every participant in parent study. All research activities were carried out in conformity with the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interest.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"88"}}