From 2024, clinical examination will include screening for hepatitis C for the first time

From 2024, for the first time, preventive measures will include testing for antibodies to hepatitis C. All Russians over 25 years of age will be able to undergo screening for free once every ten years. The Ministry of Health of the Russian Federation published an order about this for public discussion. The department explains that such a measure will facilitate early detection of the disease, as well as clarify information about its prevalence in Russia. The public organization “Together against Hepatitis” told Kommersant that this decision “exceeded the expectations of the patient community.” The examinations will be carried out with the consent of the citizen, the Ministry of Health assured.

As part of preventive examinations and medical examinations, the Ministry of Health of the Russian Federation proposes to conduct examinations for hepatitis C. The draft order of the department has been published for public discussion. Citizens aged 25 years and older will be able to undergo screening once every ten years starting in 2024. The explanatory note states that the examination will be carried out subject to the voluntary consent of the citizen or his legal representative at the expense of compulsory health insurance (CHI).

“Early detection of the disease, which is often asymptomatic, will avoid serious damage to health. This is the first time that such an examination is being included as part of preventive measures,” the department said. The document was prepared following a meeting of the working group of the Council under the President of the Russian Federation on strategic development and national projects, which took place in July.

The Ministry of Health also notes that it is necessary to organize early detection “in order to clarify information about the prevalence of hepatitis C in Russia.” A federal register of carriers of viral hepatitis is being prepared for launch, which is designed to systematize records and help maintain continuity at all stages of care. Let us note that currently the medical department has registered about 620 thousand patients with hepatitis C. However, the estimated number of cases ranges from 2.2 million to 4.9 million. No more than 2–3% of patients receive treatment annually. Thus, from January to September of this year, about 30 thousand people received therapy (this is approximately 4.8% of the register list, 1.2% of the estimated number). According to the chief infectious disease specialist of the Ministry of Health of the Russian Federation, Vladimir Chulanov, in 2022, no more than 15 thousand patients with hepatitis C received assistance at the expense of compulsory medical insurance. In March, the medical department approved the criteria for providing medical care to patients with hepatitis C in a hospital. And although public organizations were dissatisfied with the fact that the list included only patients in the later stages of development of this disease, the Ministry of Health assured that the establishment of criteria provides an opportunity to more than fivefold increase the coverage of therapy, especially for citizens with a high risk of developing life-threatening conditions.

Nikita Kovalenko, head of the interregional public organization “Together against Hepatitis,” says that the decision of the medical department “exceeded the expectations of the patient community.” “First of all, the order came very quickly. To be honest, we were expecting it at the end of February. Secondly, instead of singling out “certain groups of the population,” the Ministry of Health immediately included screening for hepatitis C for everyone,” comments Mr. Kovalenko. “At first, I was confused by the frequency – once every ten years: we recommend it annually. But, as I understand it, the task now is to first identify all those infected. And from this point of view everything is fine.”

Nikita Kovalenko reminds that the presence of antibodies to the hepatitis C virus alone does not allow a diagnosis. The diagnosis of “viral hepatitis C” is made only if there is RNA of the hepatitis C virus in the blood, detected by PCR. According to the SanPiN for infectious diseases, a patient with newly detected antibodies must be referred to an infectious disease specialist within three days on an outpatient basis and 24 hours on an inpatient basis.

Earlier, Mr. Kovalenko noted that in recent years, treatment coverage for patients with hepatitis C has been expanding, and “serious plans” for treatment under compulsory medical insurance have been announced. However, as Kommersant reported, the patient community expressed dissatisfaction with the absence of expenses for the treatment of hepatitis C as a monoinfection in the recently adopted federal budget. They note that Russian President Vladimir Putin ordered to find a source of funding for these purposes by October 20. The Ministry of Health told Kommersant that “appropriate funds have been provided and will be allocated for these purposes by separate government decisions.”

Natalia Kostarnova