The Problem of Late Diagnosis of Viral Hepatitis B and C in the Kyrgyz Republic: Current Aspects and Solutions

Background. Chronic viral hepatitis B and C remain among the most pressing problems of infectious medicine. Despite the availability of effective diagnostic and therapeutic tools, a substantial proportion of cases are identified at the stage of cirrhosis or hepatocellular carcinoma, which significantly worsens the prognosis. Aim. To systematize current data on the causes of late detection of chronic hepatitis B and C and to propose approaches to optimizing the diagnostic process at the primary health care level in the Kyrgyz Republic. Materials and methods. Narrative literature review. PubMed/MEDLINE, eLibrary, Google Scholar, the Cochrane Library and the websites of WHO and professional societies were searched for January 2016 – September 2026; official data of the Ministry of Health of the Kyrgyz Republic were used. The review included 19 sources: 10 WHO documents and international clinical guidelines, 6 peer-reviewed studies and 3 official statements of the Ministry of Health. Main findings. In 2022, only 13% of people with chronic hepatitis B and 36% of those with hepatitis C worldwide had been diagnosed. In Kyrgyzstan, population-based seroprevalence was 2.2% for HBsAg and 3.8% for anti-HCV (Bishkek, 2018). Since 2023, a state programme has provided free rapid testing, vaccination and treatment; by July 2026, about 1.45 million people had been tested for each infection, with positive results in approximately 3.3% (HBV) and 1.8% (HCV), and 7,541 patients had received HCV treatment. The main factors of late diagnosis are the asymptomatic course, missed testing opportunities in primary care, incomplete screening coverage and losses along the cascade of care, socioeconomic barriers and limited access to molecular diagnostics. Conclusion. A comprehensive approach is required: expanding the coverage of the national programme, reflex HCV RNA testing, decentralization of treatment to primary care according to WHO simplified models, vaccination of seronegative persons, intersectoral collaboration, electronic reminders and systematic professional development of health workers. These measures can bring Kyrgyzstan closer to the WHO targets for the elimination of viral hepatitis by 2030.

Keywords: viral hepatitis, late diagnosis, screening, HBV, HCV, liver cirrhosis, hepatocellular carcinoma, Kyrgyzstan.