“The causes of hepatitis infection are drug trafficking of the 90s.
According to statistics, every 12th inhabitant of the planet is a carrier of the hepatitis virus. There are more than 500 million of them in the world, which is 12 times more than those infected with HIV and patients with all types of cancer combined. But, nevertheless, we still continue to ignore the problem of viral hepatitis in some way. What is the result of this?
Reference: More than a million people die from hepatitis every year, which also exceeds the rates of HIV and cancer. Chronic hepatitis without treatment can lead to cirrhosis and liver cancer within 15-30 years. In April last year, WHO issued new guidelines for the treatment of hepatitis C. World Health Assembly delegates from 194 countries adopted a resolution to improve the prevention, diagnosis and treatment of viral hepatitis. Many important issues were discussed at the 50th International Congress on the Study of Liver Disease (EASL).
Although saying that nothing is being done would be wrong. We are talking with the chief specialist of the Ministry of Health of the Samara Region on HIV treatment, the coordinator of the regional program for the treatment of chronic viral hepatitis, Ph.D. Elena Strebkova.
– What is the situation in the region? Does it differ from the all-Russian? If so, why?
Probably, the Samara region is an average region, because in the incidence of hepatitis B we are almost at the same level as the all-Russian indicators, and in hepatitis C it is slightly higher than the Russian level. How can I explain here? In our region, since the 90s, there has been a sharp increase in the incidence of acute hepatitis, and now there is a fairly large detection of chronic hepatitis. And to identify new patients, there is also a growth trend, this is due, first of all, to the fact that in the 90s there was a lot of drug trafficking through Samara, and then, the population accumulated quite large, and the number of new infections continues to increase and now .
– You have implemented a patient registry. What did it give?
Without understanding how much a person is sick, it is impossible to build a treatment strategy for patients, because you need to calculate the resources necessary for their treatment. Initially, according to the form of Rospotrebnadzor, only “fresh” cases and the total number of people who are diagnosed with this territory were taken into account. What does the register give? The register provides demographic, social, hepatitis activity indicators, who received treatment, who did not receive treatment, that is, to make a more accurate portrait of a patient with chronic hepatitis in the region, and most importantly, to understand how many people need treatment, according to which models how many drugs are needed.
– How many people cover the register? Is it possible to identify all patients with hepatitis? Does everyone receive the necessary treatment?
– Our dispensary group is approximately 20 thousand people. This is a mono-infection, without co-infection, and yet we still have the most affected region for HIV, and there is also a very large group of hepatitis. In addition to the federal register, we still have our own, regional. And these 20 thousand are not those who need treatment.
The fact is that you can get medicines only through state medical institutions. The availability of this help is not very high. Therefore, those in need of therapy are actually less. Someone has already been treated, someone has been entered once and never comes again. In reality, about 4 thousand people need treatment. This is approximately 20%.
For four years of the program, about 1.5 thousand people received treatment. But we are one of those regions where, despite the ongoing therapy, the number of new cases is constantly growing.
– Maybe there are more new cases due to improved diagnosis?
– Hard to tell. We will now conduct a study on HIV in our region, it will answer this question. The fact is that the epidemics of hepatitis and HIV in our region were growing almost simultaneously. This study will let us know: are we now new cases of HIV, or are they all those whom we began to identify and “get” from the 90s? And the same can be said for hepatitis.
Causes of hepatitis C – drug trafficking of the 90s
– What are the main causes of infection in our country?
– You can answer by the example of our region. As I have already said, our region “blazed” in the 90s, and our morbidity figures were very high.
The first city to get drugs is Togliatti. AvtoVAZ had a high salary, while the young city did not yet have its own traditions and culture. The city was built by not very socially adapted people, some of them were in custody. All this led to the fact that HIV and hepatitis fell ill with whole streets.
Then the process spread to Samara, located relatively close.