Инфекция и иммунитет (Dec 2024)
Epidemic manifestations of HIV combined with chronic viral hepatitis in the Far Eastern Federal District
Abstract
Coinfection is one of the most complex public health issues and is challenging both in choosing treatment strategy and in implementing epidemiological surveillance. The latter in the Russian Federation includes no specific monitoring after HIV and chronic viral hepatitis (CVH) coinfection. The objective of the study was to perform a retrospective epidemiological analysis of CVH, HIV-infection, HIV+CVH coinfection incidence, conduct integral assessment of HIV+CVH coinfection epidemic manifestations in the Far Eastern Federal District (FEFD) during the years 2007–2022. It was established that HIV-infection and HIV+CVH coinfection incidence showed a unilateral long-term growth trend reaching in 2022 up to 4.3 cases/100 000 population (by 6-fold higher than in 2007), which for HIV-infection incidence was as high as 30.7 cases/100 000 population (by 2-fold higher than in 2007). CVH incidence decrease with average long-term decline comprising 4.4% per year and in 2022 reaching 26.1 cases/100 000 population. Primorye Territory had highest incidence of HIV+CVH coinfection in 2022 that exceeded average level recorded among territories of the FEFD by 2.3-fold. Primorye Territory is a territory historically characterized by widespread of HIV-infection and CVH in human population partly due to broad drug use. Ranking of HIV+CVH coinfection incidence revealed territories with favorable epidemic situation as follows: Kamchatka Territory, Khabarovsk Territory, Republic of Sakha (Yakutia), Magadan Region. HIV infection and CVH are long-lasting conditions therefore individuals with verified diagnosis may remain a source of infection. Hence, the analysis of the disease incidence alone was found to be insufficient for assessing epidemic situation. Therefore, a comprehensive analysis was carried out to calculate integral index based on the sum of ranks of HIV+CVH coinfection incidence, prevalence and average long-term incidence, prevalence of CVH among HIV-positive subjects. Ranking of the integral index established unfavorable epidemic situation for HIV+CVH coinfection in the Magadan Region and Republic of Sakha (Yakutia). Both territories had an upward incidence trend, high prevalence of CVH among HIV-positive subjects. In addition, the Magadan Region had highest prevalence of HIV+CVH coinfection. Primorye Territory and Jewish Autonomous Region were also classified as unfavorable. Existing epidemiological surveillance after HIV-infection needs to be supplemented with separate monitoring over HIV+CVH coinfection. Estimating an integral index in addition to evaluation of incidence for assessment of the epidemic situation over coinfection will improve the analysis.
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