Modern epidemiologic trends in hepatitis C

The aim: to characterize modern epidemic trends of viral hepatitis C and its outcomes in the Russian Federation and NorthWest Russia.

Material and methods. The retrospective epidemiological analysis of hepatitis C incidence in the Russian Federation and Northwestern Federal District was carried out according to the data of state statistical reporting (Form No 2 and Form No 65), analytical tables (Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, Central Research Institute of Epidemiology of Rospotrebnadzor). The study included 700 patients with HCV in the day hospital of S. P. Botkin Clinical Infectious Diseases from 2016 to 2022. Epidemiological and statistical methods of research (statistical package SPSS, software product «WinPepi») were used in the work.

Results and discussion. After a strong tendency of decline in the incidence of HCV in the Russian Federation in 2001–2021, a statistically significant increase to 0.75 and 0.95 per 100,000 population (2022–2023) is observed. Since 2011 in the Russia Federation — predominance of HCV among first-time registered cases of chronic viral hepatitis (78.7% in 2023). During the postpandemic period, there is an increase in the incidence rate of HCV (in 2023 exceeds HBV by 3.7 times), but below the annual average by 13.7%, with an increase in the cumulative number of patients. Similar trends are also noted in the Northwestern Federal District. According to the data of Form 65 in the Russia Federation, Northwestern Federal District and our own observation, a quarter of patients require urgent treatment (F3, F4 according to METAVIR) with prevalence of 1b and 3a genotype. In 2021–2023 increase in the incidence of fatal outcomes from liver diseases caused by HCV. In 2023 in the Russia Federation specific therapy for HCV 7% of those in need, but for the first time the number of those treated exceeded the number of those detected.

Conclusion. Effective prevention measures may include strategies for minimizing harm, such as safe injection practices. When highly effective antiviral drugs become available, focus should be placed on the availability of screening and treatment for atrisk patients. The ideal prevention solution would be a hepatitis C vaccine, but due to the genetic diversity of the virus and the poor understanding of the immune response, its development is still at an early preclinical stage.

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