THE ANALYSIS OF THE FREQUENCY OF PARENTERAL INTERVENTIONS IN PATIENTS WITH VIRAL HEPATITIS B AND C
Khilko A.S., Chemych O.M.
Scientific supervisor - doctor of medicine, professor M.D Chemych
Sumy State University, infectious diseases and epidemiology department
Chronic viral hepatitis (CVH) remains one of the most actual problems of the public health nowadays. The main reasons are: the considerable spread of CVH among the population of all age groups; the great percentage of the subclinic and non-jaundice forms, which are not diagnosed; the development of the irreversible changes in liver, which lead to the malignant neoplasms; mixed-hepatitis are often for last years and they have unfavorable influence on the clinical course and the prognosis of the disease. There are no reliable etiotropic drugs for the treatment and no universal methods of the specific prophylaxis of viral hepatitis. The high percentage of not in time diagnosed cases, high virus capability to mutations, unfavorable social conditions (drug-addiction, prostitution) and also the widespread usage of the invasive methods of diagnostics and treatment, the usage of blood preparations lead to the spread of the viral hepatitis among the population.
The aim of this study is to determine the number of cases of invasive interventions in patients with CVH with parenteral ways of transmission (B, C, mixed). To study the epidemiological features of chronic viral hepatitis B and C in Sumy region. We have analyzed the data of Sumy regional clinical infectious hospital named after Z.Y. Krasovytskiy in the period from 2005 to 2009.
The total chronic hepatitis (CH) – 650 cases (100 %), non-differentiated – 235 (36,2 %), parenteral viral – 415 (63,8 %). In the result of the study we have found out that patients with parenteral CVH had in anamnesis medical invasive interventions in 47 % of cases, and patients with non-differentiated CH – 10 %. Among the invasive interventions, the major attention was given to the operative interventions, endoscopic methods of diagnostics, blood transfusions, donating blood, teeth extraction, ISD of wounds, piercing and tattoo. There is no reliable information about the invasive interventions in the anamnesis of the patients with the parenteral CVH in 13,8 % of cases, in patients with non-differentiated CH – 34 %. (The absence of the reliable information may testify that patients didn’t have any parenteral and invasive interventions in the anamnesis, but it is also may testify that the anamnesis was not collected properly).
So, after the analysis of the obtained data, we may suggest that among the patients with chronic viral hepatitis men prevailed, 2/3 of patients had chronic viral hepatitis C. One of the most common ways of transmission of hepatitis B and C were iatrogenic (operations, transfusions of blood and its components, endoscopic methods of diagnostic, etc.). Only 1 patient out of 10 with chronic viral hepatitis C was vaccinated against VHB. The most of the examined patients did not know of close relatives infected with viral hepatitis.