Viral hepatitis is not a less threat to humanity than HIV/AIDS but even the 1/10 of international financing provided by international organizations is not used for this disease treatment as it is done in case of HIV/AIDS treatment. This was informed to the NEWS.am Medicine reporter by ViolettaSargyan, M.D., a hepatologist in “Astghik” MC, who commented the recent research of British and American scientists according to which viral hepatitis has become one of the main causes of disability and death in the world equal to tuberculosis, malaria and HIV.
She noted that the types of viral hepatitis, chiefly B and C, are not less dangerous social problems for the humanity, than HIV, for the process of having no symptoms and late manifestation. Though, the morbidity of hepatitis B has reduced in the world and in Armenia due to the mass vaccinations of state programs.
But, in case of hepatitis C, the situation is worrying because in 80% of cases hepatitis C is chronic, proceeds without clinical symptoms, sometimes the disease is detected only when the changes in liver are irreversible: a cirrhosis or hepatocellular carcinoma is being developed. If in case of cirrhosis there is a struggle for patient’s life expectancy (survival), then carcinoma usually causes death. The salvation is the liver transplantation which is not performed in Armenia yet. Besides, it is connected to great difficulties for not only the scarcity of liver donors but also the complications incurring after the transplantation, the patient’s monitoring management, and finally, the huge financial expenses.
Thus, the diagnosis and appropriate treatment on time enable to avoid the life-threatening complications such as cirrhosis and hepatocellular carcinoma (primary liver cancer).
Regarding the prevalence of hepatitis, Armenia is located in the medium prevalence area. But still there are no complete and precise statistics on hepatitis. The collection of data goes on. In the annual report of the RA Ministry of Healthcare hepatitis is included in the line of viral diseases. Meanwhile, as to the specialist, it would be better to present them in a separate line.
For effective hepatitis treatment early detection is very important, and for this purpose screening programs are needed. As to the specialist, in recent years the index of disease detection has increased due to a range of state programs. Particularly, many clinics have launched a mandatory hepatitis testing order before the surgeries.
“Malatia” MC (now “Astghik” MC), the doctor says, is the first to adopt this practice. Besides, a mandatory testing is provided for pregnant women, patients with dialysis, as well as the medical workers who deal with blood and, consequently, form a risk group. The intravenous drug users are also included in a risk group, especially the HIV/AIDS patients. They also pass a mandatory hepatitis testing. Prostitutes and homosexuals are also in the risk group because the viruses of hepatitis C and especially B are transferred not only by blood but also sexually.
As to Violeta Sargsyan, sometimes the hepatitis is detected randomly during the research for other diseases. First, antibodies are detected in blood after which the virus is confirmed by a PCR method. If the antibodies are detected and the virus is not, this means that an elimination of virus has occurred. Sometimes the virus of hepatitis C may leave the body itself without infecting the liver.
As it is informed by the hepatologist, “Malatia” MC (now “Astghik” MC) is one of the first hospitals which hasstarted to use the PCR method, including elastometry – the examination that provides an important information on the degree of liver tissueinfection – fibrosis, which is extremely important for choosing the treatment scheme and determining the duration.
But, besides the detection of hepatitis, the next important problem is the treatment affordability. Today there are many effective brand and generic drugs. The latter are more affordable than the medications which were available before and considered as drugs of “golden standard”; however they are not affordable for all patients with hepatitis.
The state program takes care for only inpatient pathogenic treatment in the acute disease stage. As it has already been noted, hepatitis C is rarely detected in acute stage, and patients with chronic hepatitis C and B need a durable antiviral treatment which is beyond most patients’ ability to pay. Unfortunately, most people do not get the treatment, even being aware of their disease, besides many drugs are not yet registered in Armenia.
And for that reason, as the specialist thinks, the international organizations and national governments should not pay less attention to the hepatitis problem, than the tuberculosis and HIV.