Epidemiological manifestations of hepatitis C in the Republic of Sakha (Yakutia) during the global infection elimination program in the Russian Federation

The Republic of Sakha (Yakutia) is the largest administrative-territorial unit in the world, more than 40% of its territory is located beyond the Arctic Circle. At the same time, the population of the republic is the lowest among all subjects of the Russian Federation (0.32 people/km2). All this together significantly distinguishes this region from other territories of Russia. The purpose of this study: to assess the main manifestations of the epidemic process of chronic hepatitis C on the territory of the Republic of Sakha (Yakutia) at the stage of implementation of the national program for the elimination of viral hepatitis. Materials and methods. An epidemiological analysis of chronic hepatitis C and liver cancer was carried out for the period from 2000 to 2019. The incidence of liver cancer was assessed according to ICD-10, in which malignant neoplasms of the liver and intrahepatic bile ducts are summarized under code C22. Statistical analysis was carried out in the application package R. The study of differences in the distribution of incidence rates of chronic hepatitis C and malignant liver diseases between the Russian Federation and the Republic of Sakha (Yakutia) was carried out using the method of nonparametric assessment of the weighted average median of the Mann-Whitney test. Results and discussion. The decrease in the intensity of the incidence of acute and chronic hepatitis C in Russia was unidirectional in nature with a fairly close manifestation of their longterm movement. In contrast, in the Republic of Sakha (Yakutia) there was a significantly less pronounced decrease in the incidence of acute hepatitis C (4.9 times, rate of increase -6.2%), and the incidence of chronic hepatitis C in general for the entire analyzed period was cyclical and had a pronounced upward trend (2.4 times growth, rate of increase +2.6%). It was shown that there are statistically significant differences (p<0.01) between the median incidence rates of chronic hepatitis C and malignant liver diseases between the Russian Federation and the Republic of Sakha (Yakutia). Conclusion. To achieve the appropriate targets for hepatitis C elimination in the country, it is necessary to take into account the specific natural, climatic, social and ethnic characteristics of the Republic of Sakha (Yakutia). 

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