The role of primary care physicians in diagnosis and follow-up of patients with chronic viral hepatites B, C and D

D Sh Enaleeva; Еналеева Диляра Шакировна; V Kh Fazylov; Фазылов Вильдан Хайруллаевич

doi:10.17816/KMJ1532

The role of primary care physicians in diagnosis and follow-up of patients with chronic viral hepatites B, C and D

Authors: Enaleeva DS.¹, Fazylov VK.¹
Affiliations:
1. Kazan State Medical University, Kazan, Russia
Issue: Vol 95, No 3 (2014)
Pages: 439-445
Section: Lectures
URL: https://journals.rcsi.science/kazanmedj/article/view/1532
DOI: https://doi.org/10.17816/KMJ1532
ID: 1532

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Abstract

By 01.01.2013 in the Republic of Tatarstan there were 23 970 Hepatitis B Surface Antigen carriers and 4546 patients with active Hepatitis B out of 28 516 registered patients who were infected with Hepatitis B. Our experience shows that not only inactive chronic Hepatitis B Surface Antigen carriers, but also patients with different clinical forms of Hepatitis B might be estimated as Hepatitis B Surface Antigen carriers. The feature of chronic viral hepatitides is a discrepancy between the scarce clinical picture and presence (in 15-30% of cases) of active inflammation in liver tissue. Since 2009, patients with positive ELISA test for antibodies to Hepatitis C virus are no longer registered in the national registry of infective diseases of Russian Federation. In the Republic of Tatarstan, such patients with antibodies to Hepatitis C virus were still registered up to 2012 (50 266 patients were registered by 01.01.2012). According to our own data, Hepatitis C viral RNA was found at polymerase chain reaction to Hepatitis C virus in 61% of cases out of 957 patients tested. According to our own data, when using the combined treatment (interferon alpha and ribavirin), lasting virologic response was obtained in 65.7% cases of type 1 genotype of Hepatitis C and almost in 100% of cases of other genotypes out of 163 cases of chronic Hepatitis C, which corresponds to worldwide standards. By 01.01.2013, 295 patients with liver cirrhosis as the result of chronic Hepatitis C were followed up at the consultative and diagnostic center of Republican Clinical Hospital of Infective Diseases with the upward trend. The retrospective analysis of 130 case histories of patients with liver cirrhosis revealed that Hepatitis C was firstly diagnosed at the stage of established liver cirrhosis in 57.7% of cases. Timely diagnosis and periodic medical examination in cases of chronic Hepatitis C allows to implement the individual, personalized approach in such patients and to choose the adequate treatment and follow-up.