Hepatitis C virus (HCV) infection is one of the most prevalent health problems in the world. Official registration of HCV infections in the Russian Federation started in 1994. Two clinical forms of infection – acute and chronic hepatitis C – are registered separately. Moreover, the HCV national surveillance system also includes reports from laboratories on results from testing ∼20 population risk groups for antibodies to HCV; approximately 15–16 million tests are performed annually. Modern epidemiological features of HCV infection in the Russian Federation are characterized by low incidence of the acute form of infection (acute HCV; one to two per 100,000) and a dramatic increase in chronic HCV (CHCV) cases. In 2013, the average nationwide rate of newly detected CHCV cases was 39.3/100,000. In the same year, the prevalence of CHCV demonstrating an accumulation of chronically infected patients in the country was much higher – 335.8/100,000. Four risk groups were identified as greatly affected by HCV, which were demonstrated by a high prevalence of antibodies to HCV: newborns from chronically infected women, persons from correctional facilities, patients with chronic liver diseases, and clients from clinics for sexually transmitted disease patients and drug users. It was found that several HCV genotypes circulated in different regions of the country; HCV1b had a prevalence of 55%–80% in almost every part of the country. However, in St Petersburg during the final decade of the last century and from 2001–2005, HCV3a subtype expanded circulation among young people due to increased intravenous drug addiction. Intravenous drug users were the major cause of a higher registration of double infection, with two different virus subtypes, and the appearance in Russia of new recombinant virus RF_2k/1b. It can be concluded that CHCV infection should be a focus of the health care system in Russia because serious epidemics of liver cirrhosis and hepatocellular carcinoma will be seen in the near future that will require urgent preventive and therapeutic measures.
The epidemiological features of hepatitis A virus (HAV) infection were studied in eleven territories located in the north-western region of the Russian Federation. The dynamics of HAV infection in Russia and in the region were evaluated during a 17-year period. The age-specific incidence was calculated and 229 305 patients with acute HAV were identified. The analysed database included HA mixed with other viral hepatitis infections: it included information about 8 809 HAV patients. Special attention has been paid to the sero-epidemiological studies conducted in St Petersburg city. These studies included analysis of age-specific incidence in persons 20 years of age and older during 6 years and testing of blood sera from 1 892 healthy persons for IgG anti-HAV. In general there is a trend to reduction of HAV incidence in Russia, and in the north-western region, high indices were registered in some provinces in different years. It was established three types of age-specific incidence distribution: predominated incidence in 3-14 years of age (first type), 15-29 years of age (second type) and uniform distribution in different age groups (third type). It was shown that decrease of HAV incidence in children and young adults lead to the reduction of sero-positivity level in the groups 20+ years of age. These characteristics should be taken in account to define indications for HAV vaccine prophylaxis. HAV infection in 10-13% of cases mixed with acute or chronic hepatitis B and C in the last 15 years in St Petersburg. In the middle of 1990s, HAV mostly mixed with acute viral hepatitis of different aetiology, but in the modern time predominated type of mixture was presented by HAV and chronic HBV and HCV infections. The obtained results are useful for viral hepatitis surveillance and control.
Резюме. В статье представлена информация о заболеваемости, превалентности и болезненности хроническими вирусными гепатитами (ХВГ) н а территориях Российской Федерации за период с 1999 по 2009 гг. Особое внимание уделено многолетней динамике регистрации ХВГ, распределению заболеваемости по федеральным округам и отдельным территориям, заболеваемости в отдельных возрастных группах.
Резюме. С момента открытия вируса гепатита С в 1989 г. и официальной регистрации острых и хронических форм гепатита С (ГС) в Российской Федерации с 1994 г. накоплены многочисленные данные, дающие представления о развитии эпидемического процесса ГС в стране и особенностях эпидемиологии этой инфекции.
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