Hepatitis С in Russia and the Northwest federal region of Russia: results of the first stage the global programme of infection elimination

Abstract

The objective. To assess the dynamics of the epidemic process of chronic hepatitis C (CHC) in Russia and the Northwest Federal Region for the period 2015–2020. Materials and methods. The article analyzes the data from the state statistical reporting of infectious diseases in the Russian Federation (RF), from the reference-center for the monitoring of viral hepatitis, from statistical tables compiled at Methodological and Research Center for Epidemiological Surveillance of Viral Hepatitis under Pasteur Institute of Epidemiology and Microbiology. The data from the Federal register of patients with viral hepatitis were used.Results. The epidemiological indicators for 2020 should be interpreted taking into account the implementation of anti-epidemic measures for COVID-19 in the context of a pandemic. In 2015–2019, CHC incidence in the RF decreased by 18% (from 38o⁄oooo to 30,9o⁄oooo). For 2020 — by 46% (up to 16,7o⁄oooo). The total number of people with CHC is increasing (in 2015 — 562 622 people, in 2019 — 635 372). There is no clear downward trend in the dynamics of changes in the mortality rate from causes associated with HCV in the RF and the Northwestern Federal Region. The impact of the pandemic on mortality in HCV infection remains to be assessed. In 2019 in Russia, only 8,6% of patients on the register are covered by treatment. In 2020, according to preliminary data, treatment coverage was less than 1% of the estimated number of people with HCV infection (3 million). СHC incidence in the Northwest Federal Region decreased by less than 15% (48o⁄oooo — in 2019, 56,2o⁄oooo — in 2015), for 2020 — by 41% (up to 28,2o⁄oooo). Incidence is 1,5 times higher than in the RF on average. The total number of people with СHC is increasing (in 2015 — 92 780, in 2020 — 106 052). Few people with viral hepatitis know about their diagnosis (35% HCV-infected persons). Government funding for treatment has increased, but only 3% is covered by therapy. In the Northwestern Federal Region, as in the RF, the WHO strategy targets have not been achieved by 2020. The sharp decline in basic epidemiological indicators for 2020 is most likely due to a decrease in the number of patients seeking outpatient care and screening during the implementation of anti-epidemic measures for COVID-19.