Hepatitis C in the Russian Federation: challenges and future directions

Abstract

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.

Insights on the Russian HCV care cascade: minimal HCV treatment for HIV/HCV co-infected PWID in St. Petersburg

“…A recent study of HCV prevalence in eight Russian cities reported that PWID in St. Petersburg had the highest prevalence of HCV (90 %) [ 10 ]. Recent estimates of HCV prevalence in Russia suggest that 3–4 % of the population is infected [ 1 , 11 – 13 ].…”

Streamlining the screening cascade for active Hepatitis C in Russia: A cost-effectiveness analysis

“…Input assumptions are shown in Tables 1 and 2. Hepatitis C seroprevalence, viremic rate, and prevalence rate of acute infection was estimated based on epidemiological studies from Russia [3, 17, 24, 25]. Viremic rate refers to the proportion of chronic infected individuals out of all seropositive cases.…”

“…Since a loss to follow-up occurs at each step of the process, the need to consolidate the screening cascade has become apparent [11, 19, 21]. Suggested simplified algorithms, and even a one-step diagnostic procedure, have been proposed [17, 22], but in most instances a sound health economic evaluation is lacking, since studies are usually focused on direct costs only [15, 18]. The objective of this study was therefore to evaluate the cost-effectiveness of different screening algorithms for identifying patients with active hepatitis C infections while considering implications on the screening cascade in Russia.…”

Ranking of Administrative Districts of Almaty City by Incidence of Hepatitis B and C

“…The behavior of the epidemic process was assessed by the annual dynamics of the cumulative incidence of hepatitis B and C. (8)(9)(10) Results and Discussion Table 1 shows the average incidence rate for AHB in Almaty's adult population at 4-year intervals for 2003-2014: the AHB incidence by city areas steadily decreased by 3 or more times. These data conclusively demonstrate the epidemiological effectiveness of HBV vaccination.…”