•Hepatitis B virus (HBV) infection is a major health problem worldwide. Indonesia is an intermediate-to-high HBV endemic region. Despite a decrease in the incidence of acute HBV infection in Indonesia resulting from the universal newborn HBV immunization program, the number of patients with advanced liver disease (ALD) associated with chronic HBV infection is increasing
In Indonesia, genotype B is the predominant HBV genotype, particularly in the Western region, whereas genotype C is predominant in the Eastern region Because HBV and HCV share a similar mode of transmission, co-infections are possible. Most cases of HBV and HCV co-infection occur among Intravenous drug users, unscreened blood products, or exposure to dirty needles and unsterilized medical equipment. Co-infection of these two viruses can cause more severe liver disease and increase the risk for primary liver cancer (Hepatocellular Carcinoma).