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Risk factors and seroprevalence of hepatitis B and C virus infection in Uzbekistan
HEPATOLOGYVol. 34, NO. 4, Pt. 2, 2 0 0 1
AASLD ABSTRACTS
567A
1579
1580
PREVELENCE OF HEPATITS C IN CAP HAITIAN, HAITI. Eric J Lawitz, Shailesh C Kadakia, Brooke A r m y Medical Ctr, SanAntonio, TX; Rod Kelly, Baynes-Jones Medical Ctr, Fort Polk, LA; B E Chalumeau, Hopital Universitaire Jnstinien, Cap Haitian Haiti
HIGH PREVALENCE OF CHRONIC HEPATITIS C AMONG PATIENTS W I T H AUTOANTIBODIES. Basil O Abdo, Terry McNearney, Dianne E Wollaston, Hongbao Ma, Daryl T Lau, University of Texas Medical Branch, Galveston, TX
Backround: The w o r l d health organization reports a 2% prevalence of hepatitis C in Haiti based on a single rural study. Cap Haitian is the second largest city in Haiti however the prevalence of hepatitis C in this city is u n k n o w n . The prevalence of HIV in Cap Haitian is 8%. The m o d e of transmission accounting for most HIV in Haiti is sexual contact. Aim: To determine the prevalence of hepatitis C in Cap Haitian, Haiti. Methods: During Operation Justinien Cause five h u n d r e d r a n d o m s e r u m samples were obtained a n d evaluated for AntiHCV by EIA 3.0 (Abbott Diagnostics, Abbott Park, IL). An epidemiological survey was completed prior to s e r u m testing. Participants were surveyed regarding their exposure to: 1) Blood transfusions 2) Intravenous d r u g 3) Intranasal cocaine 4) Sexual partners (number) 5) N u m b e r of tattoos 6) Education (number of years). Results: Five h u n d r e d samples were obtained. The mean age of participants was 34 years. Sixty-six percent of the sampled population were males. Sixty-nine percent were married. Twenty~two s e r u m samples were reactive representing a seroprevelence of 4.4% (22/500). A logistic regression analysis was performed to determine w h i c h factors were associated with a positive anti-HCV test. The factors that were associated with a positive test included intravenous d r u g use ( p < . 0 5 ) , n u m b e r of sexual partners ( p < . 0 5 ) a n d intranasal cocaine use ( p < . 0 5 ) . Anti-HCV positive participants h a d an average of 7 lifetime sexual partners while anti-HCV negative participants h a d an average of 2.5 lifetime sexual partners. Conclusion: The prevalence of AntiHCV b y EIA in Cap Haitian, Haiti is 4.4%. Risk factors include intravenous d r a g use, n u m e r o u s sexual contacts, a n d intranasaI cocaine use.
Background: The overall seroprevalence of HCV by anti-HCV antibody testing (EIA) is estimated to be 1.8% among the general population in the United States. There are concerns about increased rates of false-positive EIA tests in patients with antoimmuue antibodies such as the presence of ANA and RE in serum. The aims of the study were: 1) to prospectively determine the risk factors and prevalence of HCV infection in patients with Rheumatic diseases, and 2) to evaluate the heahh-related quality of life (HR-QoL) in those with concurrent HCV infection. Methods: Patients were enrolled prospectively from the Rheumatology clinic at UTMB, irrespective of their underlying connective tissue diseases. Blood sample was collected from each subject for anti-HCV testing by a third-generation EIA assay (EIA-3). All the EIA-3 positive samples were further tested for the presence of HCV RNA by transcription-mediated assay (TMA) [Bayer]. In addition, each subject completed a hepatitis C risk assessment form as well as a validated HR-QoL (SF-36) questionnaire at time of enrollment. Results: 257 patients with predominantly females (84%) and a mean age of 49.7 years were enrolled. A high proportion (N=138, 54%) of these patients were tested positive for ANA or RF. Overall, 26 of 257 (10.1%) were anti-HCV positive by EIA-3 and nine(3.5%) had detectable HCV RNA by TMA. The anti-HCV seroprevalence rate was significantly higher among those with ANA or RF then those without (15.2 o%vs. 4.2 o%; p=0.009). More importantly, the proportion of patients with HCV RNA was also higher in those with ANA or RF compared to those without (5.8% vs. 0.8%; p=0.03). The frequency of hepatitis risks was similar between the anti-HCV positive and negative individuals (48.2% vs. 43.7%, p=0.6) with blood transfusion being the most common. In this cohort, only 2 had history of injection drag use and both were anti-HCV and TMA positive. Interestingly, the proportion of patients with elevated ALT levels was no difference between the anti-HCV positive and negative patients (12.5% vs. 10.6%). Abnormal ALT values were more common among those with viremia (22.2 o%); however, it did not reach statistical significance. Most of these patients had multiple non-specific symptoms and reduced quality of life. Formal evaluation with the SF-36 questionnaire could not separate those with or without hepatitis C infection. However, the anti-HCV positive patients appeared to have lower scores in physical functioning compared to anti-HCV negative ones (16.5 vs. 18.6, p = 0 . l) Conclusions: The seroprevalence of anti-HCV, especially those with autoantibodies, was higher among patients with rheumatic diseases than those reported in the U.S. Even though false-positive EIA tests are believed to be more common in these patients, it could not explain the higher rate of chronic hepatitis C infection with viremia among those with ANA or RF. In view of the relatively high HCV prevalence, patients with aut0antibodies should he screened for HCV infection by both E1A and assay to detect HCV RNA in serum. The spectum of clinical manifestations and hepatic pathology associated with the presence of autoimmune antibodies in HCV infection needs further evaluation.
15,81
1582
13C-METHACETIN BREATH TEST AS LIVER FUNCTION TEST IN PATIENTS W I T H CHRONIC HEPATITIS C INFECTION. Barbara Braden, University of Frankfurt, Frankfurt Germany; Christoph Sarrazin, University of Frankfurt, Frankfurt/M Germany; Dominik Faust, Utrike Sarrazin, Stefan Zeuzem, Christoph F Dietrich, Wolfgang F Caspary, University of Frankfurt, Frankfurt G e r m a n y
RISK FACTORS AND SEROPREVAEENCE OF HEPATITIS B AND C VIRUS INFECTION IN UZBEKISTAN. Hideaki Kato, Second Department of Medicine, Nagoya City University Medical School, Nagoya Japan; Ruzibakiev Ruslan, Institute of Immunology, Tashkent Uzbekistan; Ryuzo Ueda, Second Department of Medicine, Nagoya City University Medical School, Nagoya Japan; Nordia Yuldasheva, Tatjana Hegay, Dildora Avazova, Fuat Kurbanov, Mariam Zalalieva, Institute of Immunology, Tashkent Uzbekistan; Masashi Mizokami, Department of Laboratory Medicine, Nagoya City University Medical School, Nagoya J a p a n
Background a n d aims: The 13C-methacetin breath test (MBT) enables the quantitative evaluation of the c y t o c h r o m P450 d e p e n d e n t liver function. The aim of this study was to find out w h e t h e r this breath tests is a sensitive parameter also in non-cirrhotic patients with chronic hepatitis C. Methods: 46 healthy controls ( i 7 m / 2 9 w , 3 6 + 12 years) a n d 68 patients with chronic hepatitis C (43m/27w, 40 + i 1 years) were included in the study. In all patients, a liver biopsy was performed. The liver histolgy was classified according to the histology activity index (Knodell-Score). For the i3C-methacetin breath test, each subject ingested 75 mg ]3C-methacetin solved in 200 ml water. Breath samples were collected at 0, 5, 10, 15, 20, 25, 30, 40, 50 a n d 60 minutes a n d were analyzed by isotope ratio mass spectrometry. Results: The peak 13Cexhalation appeared in patients a n d controls about 15 minutes after substrate ingestion. Delta over baseline-values of the patients at i 5 minutes (DOB 15 min) did not significantly differ from controls (21.0+9.8%o vs. 23.9+6.5%0, p = 0 . 0 9 ) . The cumulative recovery in patients with chronic hepatitis C infection in the ~3C-methacetin breath test after 30 rain (CUPCD 30rain) was i 2 . 6 + 5 . 0 % a n d in healthy controls i 3 . 6 + 2 . 9 % ( p = 0 . 2 2 ) . According to the histology activity index, 33 patients h a d early portal fibrosis (HAI IVB), 23 patients were classified to the stage HAI IVC (bridging fibrosis). 12 patients showed clinically n o n - s y m p t o m a t i c liver cirrhosis (HAl IVD; CHILD A). Patients with fibrosis in stage B did not differ in DOB 15 min (20.9+9.8%0 vs. 24.0+8.5%0, p = 0 . 2 2 ) or cumulative recovery ( 1 2 . 5 + 4 . 9 % vs. 14.3+4.6%, p = 0 . 1 7 ) from patients with advanced fibrosis (HAI IVC). Patients with clinically n o n - s y m p t o m a t i c cirrhosis metabolized ~3C-methacetin significantly less (DOB 15 min: 8.7+3.5%0; p < 0 . 0 0 5 , a n d CUPCD 30 min: 5.9+2.5%, p < 0 . 0 0 3 ) . Conclusion: The non-invasive 13C-methacetin breath test reliably differs between early cirrhotic a n d non-cirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C infection.
Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is a major health problem worldwide. Republic of Uzbekistan is located in the heart of Asia.Accordingto the analysis of immigrants from the former SovietUnion to Gel~nany,this region is speculated to the area with high endemicityof hepatitis A, B, and E virus infection.The aim of this studyis to directly evaluate the seroprevalenceof HBVand HCV in Uzbekistan, and to explore potential correlations between those viruses and socioeconomicalrisk factors.One thousand nine hundred and eighteen subjects were studied. (Materials and Methods) After informed content, serum samples were obtained from 1,918 people in Uzbekistan including Tashkent (North), Fergana valley (East), Samarkand (middle), Termez (South), and Nukns (West) from 1999 to 2000. The subjects including 1,275 individuals (929 general population, 346 blood donor) in Iow risk group, 187 individuals (57 intravenous drug users (IVDU), 51 prostitutes, 9 homosexuals, 40 medical laboratory - employee(ME)) in high risk group, and 456 individuals (72 hematological disease, 85 renal disease,39 human itutuuno-deficiencyvirus infection, 96 acute hepatitis, 164 chronic hepatitis) in patients group. Sera were tested for Hepatitis B virus surface antigen (HBsAg),and anti-HCV. Results: The seroprevalence of HBsAgand anti-HCV in general population were I3.3%, and 13.i%, respectively. Furthermore, the positivity of HBsAgin general population (13.3%) was signifieandyhigher than that in blood donor (p<0.01). The posiivity of HBsAgin high risk group and patients group was higher than that of low risk group (p=0.0I). With respect to HCV infection, the positivity of anti-HCVin general population (13.1%) was significantlyhigher than that in paid donors (6.4%) (p<0.05). Furthermore, the positivity of anti-HCV of paid donor in Fergana (11.9%) was significantlyhigher than that in Tashkent (2.8%). Furthermore, the positivity of anti-HCVin general population (13.3%) was significantlyhigher than that in blood donor (p< 0.01). The p ositivityof anti-HCVin high risk group and patient groupwas significantlyhigher than that of low risk group (p<0.01). The positivity of anti-HCVinfection in IVDU (62.7%) were significantly higher than that in prostitute (9.2%), homosexual (1I.I%), and ME (12.5%) (p<0.01). With respect to age-specificseroprevalence of HCV infections in low risk group, the positivity of HCV increased "oAthage-progress from 2.2% of the 15-to 20 year age group to the highest rate of 17.6%of the 31-40 year age group, then decreased to 0% of the over 60 year age. In high risk group, the positivity of anti-HCVunder 40 year age group was approximately 30% and significantlyhigher than that in low risk group (p<0.01). The risk factors of transmission of HCV in low risk group was blood transfusion (Odds Ratio;OR:8.8,95% ConfidenceInterval;95%CI:5.913.2), operation (OR;19.9, 95%CI;I3.0-30.8), and dental treatment (OR;1.8, 95%C1;1.3-2.7). Furthermore, the risk factors of transmission of HCV was drug abuse (OR18.4, 95%C1;7.8-43.4) and those in patients group were blood transfusion (OR;2.7, 95%CI;1.8-4.2),operation (OR3.7, 95%CI;2.3-5.7),drug abuse (OR;6.2, 95%CI;3.5-11.1)and dental treatment (OR1.6, 95%CI;0.92.6). Conclusions: 1)The seroprevalence of HBVand HCV infection in general population were high in Uzbekistan. 2) High prevalence of HC¥ infection among young injectors is a social problem also in Uzbekistan, and adds urgency to require intensive and sustained preventive measurements. 3)Medical treatment in low risk group, drug abuse in high risk group, and both in patients group were considered to the modes of transmission of HCV.
AASLD ABSTRACTS
567A
1579
1580
PREVELENCE OF HEPATITS C IN CAP HAITIAN, HAITI. Eric J Lawitz, Shailesh C Kadakia, Brooke A r m y Medical Ctr, SanAntonio, TX; Rod Kelly, Baynes-Jones Medical Ctr, Fort Polk, LA; B E Chalumeau, Hopital Universitaire Jnstinien, Cap Haitian Haiti
HIGH PREVALENCE OF CHRONIC HEPATITIS C AMONG PATIENTS W I T H AUTOANTIBODIES. Basil O Abdo, Terry McNearney, Dianne E Wollaston, Hongbao Ma, Daryl T Lau, University of Texas Medical Branch, Galveston, TX
Backround: The w o r l d health organization reports a 2% prevalence of hepatitis C in Haiti based on a single rural study. Cap Haitian is the second largest city in Haiti however the prevalence of hepatitis C in this city is u n k n o w n . The prevalence of HIV in Cap Haitian is 8%. The m o d e of transmission accounting for most HIV in Haiti is sexual contact. Aim: To determine the prevalence of hepatitis C in Cap Haitian, Haiti. Methods: During Operation Justinien Cause five h u n d r e d r a n d o m s e r u m samples were obtained a n d evaluated for AntiHCV by EIA 3.0 (Abbott Diagnostics, Abbott Park, IL). An epidemiological survey was completed prior to s e r u m testing. Participants were surveyed regarding their exposure to: 1) Blood transfusions 2) Intravenous d r u g 3) Intranasal cocaine 4) Sexual partners (number) 5) N u m b e r of tattoos 6) Education (number of years). Results: Five h u n d r e d samples were obtained. The mean age of participants was 34 years. Sixty-six percent of the sampled population were males. Sixty-nine percent were married. Twenty~two s e r u m samples were reactive representing a seroprevelence of 4.4% (22/500). A logistic regression analysis was performed to determine w h i c h factors were associated with a positive anti-HCV test. The factors that were associated with a positive test included intravenous d r u g use ( p < . 0 5 ) , n u m b e r of sexual partners ( p < . 0 5 ) a n d intranasal cocaine use ( p < . 0 5 ) . Anti-HCV positive participants h a d an average of 7 lifetime sexual partners while anti-HCV negative participants h a d an average of 2.5 lifetime sexual partners. Conclusion: The prevalence of AntiHCV b y EIA in Cap Haitian, Haiti is 4.4%. Risk factors include intravenous d r a g use, n u m e r o u s sexual contacts, a n d intranasaI cocaine use.
Background: The overall seroprevalence of HCV by anti-HCV antibody testing (EIA) is estimated to be 1.8% among the general population in the United States. There are concerns about increased rates of false-positive EIA tests in patients with antoimmuue antibodies such as the presence of ANA and RE in serum. The aims of the study were: 1) to prospectively determine the risk factors and prevalence of HCV infection in patients with Rheumatic diseases, and 2) to evaluate the heahh-related quality of life (HR-QoL) in those with concurrent HCV infection. Methods: Patients were enrolled prospectively from the Rheumatology clinic at UTMB, irrespective of their underlying connective tissue diseases. Blood sample was collected from each subject for anti-HCV testing by a third-generation EIA assay (EIA-3). All the EIA-3 positive samples were further tested for the presence of HCV RNA by transcription-mediated assay (TMA) [Bayer]. In addition, each subject completed a hepatitis C risk assessment form as well as a validated HR-QoL (SF-36) questionnaire at time of enrollment. Results: 257 patients with predominantly females (84%) and a mean age of 49.7 years were enrolled. A high proportion (N=138, 54%) of these patients were tested positive for ANA or RF. Overall, 26 of 257 (10.1%) were anti-HCV positive by EIA-3 and nine(3.5%) had detectable HCV RNA by TMA. The anti-HCV seroprevalence rate was significantly higher among those with ANA or RF then those without (15.2 o%vs. 4.2 o%; p=0.009). More importantly, the proportion of patients with HCV RNA was also higher in those with ANA or RF compared to those without (5.8% vs. 0.8%; p=0.03). The frequency of hepatitis risks was similar between the anti-HCV positive and negative individuals (48.2% vs. 43.7%, p=0.6) with blood transfusion being the most common. In this cohort, only 2 had history of injection drag use and both were anti-HCV and TMA positive. Interestingly, the proportion of patients with elevated ALT levels was no difference between the anti-HCV positive and negative patients (12.5% vs. 10.6%). Abnormal ALT values were more common among those with viremia (22.2 o%); however, it did not reach statistical significance. Most of these patients had multiple non-specific symptoms and reduced quality of life. Formal evaluation with the SF-36 questionnaire could not separate those with or without hepatitis C infection. However, the anti-HCV positive patients appeared to have lower scores in physical functioning compared to anti-HCV negative ones (16.5 vs. 18.6, p = 0 . l) Conclusions: The seroprevalence of anti-HCV, especially those with autoantibodies, was higher among patients with rheumatic diseases than those reported in the U.S. Even though false-positive EIA tests are believed to be more common in these patients, it could not explain the higher rate of chronic hepatitis C infection with viremia among those with ANA or RF. In view of the relatively high HCV prevalence, patients with aut0antibodies should he screened for HCV infection by both E1A and assay to detect HCV RNA in serum. The spectum of clinical manifestations and hepatic pathology associated with the presence of autoimmune antibodies in HCV infection needs further evaluation.
15,81
1582
13C-METHACETIN BREATH TEST AS LIVER FUNCTION TEST IN PATIENTS W I T H CHRONIC HEPATITIS C INFECTION. Barbara Braden, University of Frankfurt, Frankfurt Germany; Christoph Sarrazin, University of Frankfurt, Frankfurt/M Germany; Dominik Faust, Utrike Sarrazin, Stefan Zeuzem, Christoph F Dietrich, Wolfgang F Caspary, University of Frankfurt, Frankfurt G e r m a n y
RISK FACTORS AND SEROPREVAEENCE OF HEPATITIS B AND C VIRUS INFECTION IN UZBEKISTAN. Hideaki Kato, Second Department of Medicine, Nagoya City University Medical School, Nagoya Japan; Ruzibakiev Ruslan, Institute of Immunology, Tashkent Uzbekistan; Ryuzo Ueda, Second Department of Medicine, Nagoya City University Medical School, Nagoya Japan; Nordia Yuldasheva, Tatjana Hegay, Dildora Avazova, Fuat Kurbanov, Mariam Zalalieva, Institute of Immunology, Tashkent Uzbekistan; Masashi Mizokami, Department of Laboratory Medicine, Nagoya City University Medical School, Nagoya J a p a n
Background a n d aims: The 13C-methacetin breath test (MBT) enables the quantitative evaluation of the c y t o c h r o m P450 d e p e n d e n t liver function. The aim of this study was to find out w h e t h e r this breath tests is a sensitive parameter also in non-cirrhotic patients with chronic hepatitis C. Methods: 46 healthy controls ( i 7 m / 2 9 w , 3 6 + 12 years) a n d 68 patients with chronic hepatitis C (43m/27w, 40 + i 1 years) were included in the study. In all patients, a liver biopsy was performed. The liver histolgy was classified according to the histology activity index (Knodell-Score). For the i3C-methacetin breath test, each subject ingested 75 mg ]3C-methacetin solved in 200 ml water. Breath samples were collected at 0, 5, 10, 15, 20, 25, 30, 40, 50 a n d 60 minutes a n d were analyzed by isotope ratio mass spectrometry. Results: The peak 13Cexhalation appeared in patients a n d controls about 15 minutes after substrate ingestion. Delta over baseline-values of the patients at i 5 minutes (DOB 15 min) did not significantly differ from controls (21.0+9.8%o vs. 23.9+6.5%0, p = 0 . 0 9 ) . The cumulative recovery in patients with chronic hepatitis C infection in the ~3C-methacetin breath test after 30 rain (CUPCD 30rain) was i 2 . 6 + 5 . 0 % a n d in healthy controls i 3 . 6 + 2 . 9 % ( p = 0 . 2 2 ) . According to the histology activity index, 33 patients h a d early portal fibrosis (HAI IVB), 23 patients were classified to the stage HAI IVC (bridging fibrosis). 12 patients showed clinically n o n - s y m p t o m a t i c liver cirrhosis (HAl IVD; CHILD A). Patients with fibrosis in stage B did not differ in DOB 15 min (20.9+9.8%0 vs. 24.0+8.5%0, p = 0 . 2 2 ) or cumulative recovery ( 1 2 . 5 + 4 . 9 % vs. 14.3+4.6%, p = 0 . 1 7 ) from patients with advanced fibrosis (HAI IVC). Patients with clinically n o n - s y m p t o m a t i c cirrhosis metabolized ~3C-methacetin significantly less (DOB 15 min: 8.7+3.5%0; p < 0 . 0 0 5 , a n d CUPCD 30 min: 5.9+2.5%, p < 0 . 0 0 3 ) . Conclusion: The non-invasive 13C-methacetin breath test reliably differs between early cirrhotic a n d non-cirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C infection.
Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is a major health problem worldwide. Republic of Uzbekistan is located in the heart of Asia.Accordingto the analysis of immigrants from the former SovietUnion to Gel~nany,this region is speculated to the area with high endemicityof hepatitis A, B, and E virus infection.The aim of this studyis to directly evaluate the seroprevalenceof HBVand HCV in Uzbekistan, and to explore potential correlations between those viruses and socioeconomicalrisk factors.One thousand nine hundred and eighteen subjects were studied. (Materials and Methods) After informed content, serum samples were obtained from 1,918 people in Uzbekistan including Tashkent (North), Fergana valley (East), Samarkand (middle), Termez (South), and Nukns (West) from 1999 to 2000. The subjects including 1,275 individuals (929 general population, 346 blood donor) in Iow risk group, 187 individuals (57 intravenous drug users (IVDU), 51 prostitutes, 9 homosexuals, 40 medical laboratory - employee(ME)) in high risk group, and 456 individuals (72 hematological disease, 85 renal disease,39 human itutuuno-deficiencyvirus infection, 96 acute hepatitis, 164 chronic hepatitis) in patients group. Sera were tested for Hepatitis B virus surface antigen (HBsAg),and anti-HCV. Results: The seroprevalence of HBsAgand anti-HCV in general population were I3.3%, and 13.i%, respectively. Furthermore, the positivity of HBsAgin general population (13.3%) was signifieandyhigher than that in blood donor (p<0.01). The posiivity of HBsAgin high risk group and patients group was higher than that of low risk group (p=0.0I). With respect to HCV infection, the positivity of anti-HCVin general population (13.1%) was significantlyhigher than that in paid donors (6.4%) (p<0.05). Furthermore, the positivity of anti-HCV of paid donor in Fergana (11.9%) was significantlyhigher than that in Tashkent (2.8%). Furthermore, the positivity of anti-HCVin general population (13.3%) was significantlyhigher than that in blood donor (p< 0.01). The p ositivityof anti-HCVin high risk group and patient groupwas significantlyhigher than that of low risk group (p<0.01). The positivity of anti-HCVinfection in IVDU (62.7%) were significantly higher than that in prostitute (9.2%), homosexual (1I.I%), and ME (12.5%) (p<0.01). With respect to age-specificseroprevalence of HCV infections in low risk group, the positivity of HCV increased "oAthage-progress from 2.2% of the 15-to 20 year age group to the highest rate of 17.6%of the 31-40 year age group, then decreased to 0% of the over 60 year age. In high risk group, the positivity of anti-HCVunder 40 year age group was approximately 30% and significantlyhigher than that in low risk group (p<0.01). The risk factors of transmission of HCV in low risk group was blood transfusion (Odds Ratio;OR:8.8,95% ConfidenceInterval;95%CI:5.913.2), operation (OR;19.9, 95%CI;I3.0-30.8), and dental treatment (OR;1.8, 95%C1;1.3-2.7). Furthermore, the risk factors of transmission of HCV was drug abuse (OR18.4, 95%C1;7.8-43.4) and those in patients group were blood transfusion (OR;2.7, 95%CI;1.8-4.2),operation (OR3.7, 95%CI;2.3-5.7),drug abuse (OR;6.2, 95%CI;3.5-11.1)and dental treatment (OR1.6, 95%CI;0.92.6). Conclusions: 1)The seroprevalence of HBVand HCV infection in general population were high in Uzbekistan. 2) High prevalence of HC¥ infection among young injectors is a social problem also in Uzbekistan, and adds urgency to require intensive and sustained preventive measurements. 3)Medical treatment in low risk group, drug abuse in high risk group, and both in patients group were considered to the modes of transmission of HCV.