scholarly journals Trends for incidence of chronic hepatitis B monoinfection and chronic hepatitis B+D co-infection in the Kyrgyz Republic for the period of 2010-2012

2014 ◽  
Vol 95 (6) ◽  
pp. 921-924 ◽  
Author(s):  
K A Nogoybaeva ◽  
S T Tobokalova ◽  
K T Kasymbekova ◽  
G M Zairova
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Medical Information ◽  
Chronic Viral Hepatitis ◽  
Kyrgyz Republic ◽  
Hepatitis D ◽  
Viral Hepatitis B ◽  
Epidemiological Situation

Aim. To assess the trends for the epidemiological situation of chronic hepatitis B monoinfection and chronic hepatitis B+D co-infection in the Kyrgyz Republic for the period of 2010-2012 for the development of anti-epidemic measures depending on the intensity of the process. Methods. The analysis of a database of national reporting forms on the treated cases of chronic viral hepatitis B monoinfection and chronic hepatitis B+D co-infection in primary health care units, cumulated by Republican Medical Information Center of the Ministry of Healthcare of the Kyrgyz Republic for the period of 2010-2012 was performed. Results. The incidence of chronic viral hepatitis D is identical to that of chronic viral hepatitis B (23 and 21 per 100 000 of population respectively) in the Kyrgyz Republic. Over the period of 2010-2012 the high level of total chronic hepatitis B incidence was reported in the northern part of the country (the Issyk-Kul region, 71 per 100 000, and chronic hepatitis D - in the southern part of the country (Osh, 62 per 100 000 of population). Statistically significant increase in the incidence of chronic hepatitis B in almost all regions of the country was recorded whereas only an upward trend was revealed in chronic hepatitis D incidence. Conclusion. Separate registration of patients with chronic viral hepatitis B and D in the Kyrgyz Republic starting from 2010 allowed evaluating the trends for the epidemiological situation of these diseases in different areas and developing preventive and anti-epidemic measures in regions of Kyrgyz Republic.

scholarly journals PROSPECTS OF THE USE "STIMFORTE" IN CHRONIC HEPATITIS B

2013 ◽  
Vol 18 (5) ◽  
pp. 15-20
Author(s):  
L. V Pogorelskaya ◽  
I. N Khlopova ◽  
S. S Grigoryan ◽  
I. P Tryakina ◽  
N. A Rick ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Viral Load ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Well Being ◽  
Chronic Viral Hepatitis ◽  
Control Group ◽  
Positive Hbsag ◽  
Viral Hepatitis B

Despite the fact that over the last few years downward trend in the incidence of acute forms of viral hepatitis B continues, the incidence of chronic hepatitis B (CHV) has increased by 2.5 times since 1998. To date, there are a sufficient number of antiviral drugs, but their use is associated with a set of contraindications, as well as the development of resistance. In this study there was performed an evaluation of a new national drug " Stimforte " in patients with chronic viral hepatitis B (CVHB - DNA positive, HBsAg - positive) at the stage of exacerbation. In the study there were included 28 patients with chronic hepatitis B (HBsAg positive), at different grades of activity, at a stage of viral replication. The diagnosis of chronic hepatitis B was made on the presence in a history acute viral hepatitis for more than 1 year, complaints, hepatolienal, astenovegetative, cytolytic syndromes, the presence of DNA-HBV, anti-HBcore IgM, HBsAg. After 1 course of treatment with " Stimforte " the well-being of patients has improved: in 30% of patients asthenic- vegetative syndrome had disappeared, weakness, fatigue and dyspeptic symptoms were decreased. The use of "Stimforte" in chronic hepatitis B with positive HBsAg at the stage of exacerbation contributed to a more rapid normalization of such indices as ALT, AST, compared with those in the control group. Long-term biochemical and virological remission was achieved in 40 %. It is established that during the treatment the viral load was reduced progressively until the undetectable or low level of HBV DNA and anti-HBc IgM disappeared. In only one case an allergic reaction was observed, which has not hindered to perform a complete course of treatment. No other side effects were detected. The inclusion of the drug "Stimforte" in the complex therapy of patients with exacerbation of chronic hepatitis B reduces the time of recovery of immune status and functional activity of IFN system and contributes to reduction of the viral load or elimination of the virus.

Current Issues of Epidemiological Surveillance of Chronic Viral Hepatitis B, C, D and Hepatocellular Carcinoma at the Regional Level

2021 ◽  
pp. 76-84
Author(s):  
EV Khorkova ◽  
LV Lyalina ◽  
OM Mikailova ◽  
AYu Kovelenov ◽  
YuV Ostankova ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Epidemiological Surveillance ◽  
Leningrad Region ◽  
Hepatitis D ◽  
Viral Hepatitis B

Introduction. To achieve the goal of eliminating viral hepatitis by 2030, it is necessary to assess the real situation, improve epidemiological surveillance and prevention of these infections. Objectives: To evaluate the results of epidemiological surveillance of chronic viral hepatitis B, C, D and hepatocellular carcinoma in order to optimize the surveillance system at the regional level. Materials and methods: We analyzed the incidence of viral hepatitis B, C and liver cancer in the regions of the Northwestern and Central Federal Districts of the Russian Federation over the past 10 years. We also studied the prevalence of hepatitis B, C, D, and hepatitis C virus genotypes (6,020 cases), and examined 465 case histories of patients with hepatocellular carcinoma in the Leningrad Region using techniques of epidemiological analysis, ELISA, PCR, and statistical methods. Results: We established a tendency towards a decrease in the incidence of chronic hepatitis B and C in all study areas. In 2020, high rates of hepatitis B (26.2 and 9.1) and hepatitis C (49.2 and 39.2) were registered in St. Petersburg and Moscow per 100,000 population, respectively. The prevalence of hepatitis D in the Leningrad Region was 6.3 per 100,000 population. Hepatitis C virus genotypes 1 and 3 prevailed (48.9 % and 43.9 %, respectively). A high incidence of liver cancer was established in St. Petersburg, the Pskov and Novgorod Regions. Conclusions: Our findings prove the efficiency of the surveillance system and prevention of chronic hepatitis B and C. The main objectives are to further reduce the incidence rate, screen all patients with chronic hepatitis B for hepatitis D, and use the results of molecular genetic studies and cancer registries for epidemiological surveillance purposes.

Epidemiological situation of hepatitis B in the Samara region

2020 ◽  
pp. 9-16
Author(s):  
O. Churbakova ◽  
V. Akimkin ◽  
D. Pechkurov
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Acute Hepatitis ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Causative Agent ◽  
Child Population ◽  
Acute Hepatitis B ◽  
Viral Hepatitis B ◽  
Epidemiological Situation

The article presents an analysis of the primary incidence of hepatitis B in the Samara region from 1997 to 2018. It was noted that during the 1997–2000 period there was an increase in the carrying levels of viral hepatitis B agent, the incidence of acute hepatitis B, first detected by chronic hepatitis B. Since 2000–2001, there has been a dynamic decrease in the incidence of hepatitis B. It should be noted that from the 2006 (beginning of immunoprophylaxis) to 2018. in the Samara region more intensive decrease in indicators of incidence of hepatitis B was noted. Rates of decrease in incidence of an acute hepatitis In from 2006 to 2018 in the Samara region from 7,10 ⁄ 0000 to 0,70 ⁄ 0000v 10,1 times were observed (p < 0.01). Decrease in incidence of chronic hepatitis B was noted from 2006 to 2018 by 1.4 times (p < 0.01) from 14,50 ⁄ 0000 to 10,30 ⁄ 0000. Decrease in indicators of carriage of the causative agent of viral hepatitis B from 2006 to 2018 happened more in high gear, in comparison with indicators of incidence of chronic hepatitis B to 55,60 ⁄ 0000 to 6,60 ⁄ 0000 by 8.4 times (p < 0.01). From 2008 to 2018, the vaccination coverage against hepatitis B of the child population was 99.3–99.5 %, which led to a significant decrease in the incidence of hepatitis B in the Samara region. From 2011 to 2018, no cases of acute hepatitis B of the child population of the Samara region were registered. In the last three years, no cases of chronic hepatitis B of the child population have been recorded in the Samara region.

scholarly journals THE INCIDENCE OF CHRONIC VIRAL HEPATITIS B AND C IN CHILDREN OF NIZHNY NOVGOROD REGION IN 2000-2015

2019 ◽  
Vol 24 (1) ◽  
pp. 11-18
Author(s):  
Elena A. Galova
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Age Groups ◽  
Chronic Viral Hepatitis ◽  
Epidemic Process ◽  
Viral Hepatitis B ◽  
Age Appropriate ◽  
Nizhny Novgorod Region

The article presents the results of analysis of reported incidence of chronic hepatitis B and chronic hepatitis С in children of Nizhny Novgorod region in 2000-2015. Description of epidemiology of chronic hepatitis B and chronic hepatitis С in children in different age groups is provided. Distinction of the incidence of chronic hepatitis B and chronic hepatitis С in children indicate about different mechanisms of the epidemic process of disease and determine the need to develop age-appropriate approach to their prevention.

scholarly journals Epidemiological features of acute and chronic hepatitis B in the Kyrgyz Republic over the 20-year period (1997-2017)

2018 ◽  
Vol 99 (6) ◽  
pp. 986-993 ◽  
Author(s):  
S T Tobokalova ◽  
D S Bekenova ◽  
G M Zairova ◽  
Z Sh Nurmatov ◽  
Zh N Nazarbaeva ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Acute Hepatitis ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Kyrgyz Republic ◽  
Epidemiological Features ◽  
Acute Hepatitis B ◽  
Viral Hepatitis B ◽  
Acute And Chronic Hepatitis

Aim. To determine epidemiological features of acute and chronic viral hepatitis B in the Kyrgyz Republic over the period 1997-2017. Меthоds. Analysis was performed on data bases of the National accounting forms on treated cases of acute and chronic hepatitis B cumulated by the Medical Information Centre of the Ministry of Health of Kyrgyz Republic for the period of 1997 to 2017 as well as 384 medical records of patients with chronic hepatitis B treated in the Hepatologic Centre “Tsadmir”. Results. In the Kyrgyz Republic among all acute cases of acute viral hepatitides, hepatitis A comprises 60.5 %, hepatitis B - 16.9 %, the ratio of unverified non-A non-C viral hepatitis - 15.2%. With the introduction of HBV vaccination of children (2000) and improvement of infectious control in healthcare settings, a decline of acute HBV incidence is observed - from 26.7 0/0000 to 5.3 0/0000 due to the decrease of acute hepatitis B among children and adolescents to isolated cases, adults from risk groups. The highest incidence of acute hepatitis B is recorded in Osh and Bishkek, in Jalal-Abad and Chuy Regions. This can be explained by that in the southern and northern capitals of the Kyrgyz Republic and in the near lying areas with high population density, access to laboratory and instrumental methods of diagnosis of viral hepatitides is better, along with the higher awareness of its inhabitants regarding the prevention compared to other regions. At the same time an increase of chronic hepatitis B incidence is observed. Predominant modes of transmission are medical-parenteral exposure and household contact (60.9 %), with frequent formation of family clusters (23.8 %). Imperfections were found in the early detection, reporting and accounting of cases of chronic viral hepatitides as well as in examination of hepatitis B virus carriers. Conclusion. The performed analysis of the incidence and prevalence of acute and chronic hepatitis B in the Kyrgyz Republic allowed assessing the dynamics of the epidemiologic situation in the country regarding this disease, revealed shortcomings in the detection and examination of viral hepatitis B carriers, contributed to development of a new guide for epidemiological surveillance of viral hepatitides.

scholarly journals Efficacy of a self-management program in patients with chronic viral hepatitis in China

BMC Nursing ◽  
2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ying’ai Cui ◽  
Michiko Moriyama ◽  
Kazuaki Chayama ◽  
Yanhui Liu ◽  
Chunmei Ya ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Intervention Group ◽  
Chronic Viral Hepatitis ◽  
Management Program ◽  
Behavioral Changes ◽  
Self Management ◽  
Control Group

Abstract Background Chronic hepatitis, mainly B or C, increases the risk of hepatocellular carcinoma and remains an emerging issue in the globe. China has high rates of liver cancer incidence and mortality in the world. To address such challenges, adequate management of chronic hepatitis is required. Self-management education is one alternative for improving the hepatitis patients’ knowledge of the disease, mental health, and clinical management. This study aimed to examine the quality of life (QOL), psychological effects, and behavioral changes of a self-management program which allows continuity of care for chronic hepatitis B and C patients. Method In a six-month, randomized controlled trial, we invited 73 chronic hepatitis B/C inpatients to receive (i) two face-to-face education sessions provided by a nurse during hospitalization, and monthly telephone counseling at home after discharge; (ii) or usual care treatment (control group). The primary endpoint (patients’ QOL) and secondary outcomes (including self-efficacy, depression symptoms, perceived cognition of illness and behavioral changes) were assessed. In addition, we conducted qualitative data analysis to facilitate the evaluation of the interventions. Results Sixty (82.2%) out of 73 eligible patients with chronic hepatitis B/C (aged 34.9 ± 8.9 years) participated in the study. The intervention group (n = 30) significantly improved on outcomes including QOL, self-efficacy, perceived cognition of illness, and behavioral changes, whereas the control group significantly decreased their healthy behaviors. In terms of behavioral changes, alcohol avoidance, dietary adherence, and stress management also improved in the intervention group. However, there were no significant improvements in symptoms of depression. Most participants (80%) in the intervention group stated that they benefited from the program. Conclusions This program contributed to patients’ acquisition of self-management skills to cope with their illnesses, and significantly improved their QOL. This program serves as a reminder for nurses who care for patients with chronic viral hepatitis to acquire these skills as it would help them address the daily needs of their patients. Trial registration UMIN000025378. Registered December 23, 2016.

THE PREVALENCE CLINICALLY SIGNIFICANT VIRUS MUTATIONS AMONG PATIENTS WITH CHRONIC VIRAL HEPATITIS B

2020 ◽  
Vol 65 (1) ◽  
pp. 61-66
Author(s):  
Yu. V. Ostankova ◽  
A. V. Semenov ◽  
E. B. Zueva ◽  
K. A. Nogoybaeva ◽  
K. T. Kasymbekova ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Vaccination Strategy ◽  
Chronic Viral Hepatitis ◽  
Kyrgyz Republic ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Viral Hepatitis B ◽  
Clinically Significant

The prevalence of clinically significant virus mutations in patients with chronic viral hepatitis B from the Kyrgyz Republic was analyzed. Blood plasma samples of 64 patients with verified chronic viral hepatitis B obtained from Kyrgyzstan indigenous people were used in the work. Asymmetric PCR was carried out with extended oligonucleotides and the first reaction amplification product was further used in a new PCR with one of the nested pairs overlapping primers that flanked the entire HBV genome together, followed by sequencing. Based on the phylogenetic analysis of 64 HBV isolates obtained from patients from the Kyrgyz Republic, it was shown that only the genotype D virus was present in the examined group, the HBV subgenotype D1 (68.75%) prevailed compared with the HBV subgenotype D2 (18.75%) and subgenotype D3 (12.5%). For all subgenotypes, several independent infection sources are obvious, subclusters that include isolates from Kyrgyzstan, Kazakhstan and Uzbekistan are distinguished, as well as subclusters that include isolates only from Kyrgyzstan, which are less similar to isolates previously deposited in the international database, which probably indicates an independent HBV homologous evolution in the region. Clinically significant mutations were identified in 26.5% of patients. Including 12.5% with escape mutations that prevent the virus detection and / or allow the virus to replicate despite the vaccine (122K, 128V, 133I, 134N). Another 12.5% of the isolates are characterized by mutations that are independently associated with the liver cirrhosis and hepatocellular carcinoma development, including 21, 24, 27 nucleotides deletions in the Pre-S2 region and the S11F mutation in the PreCore region. In one case, unusual 236S and 250P mutations were found in the positions described as drug resistance sites of the P region associated with the resistance development to adefovir, tenofovir, and entecavir. The hepatitis B virus genetic structure analysis, early virus mutations detection in patients with chronic hepatitis B virus can help to choose the right vaccination strategy, antiviral and immunosuppressive therapy, as well as predict the clinical course and disease progression.

scholarly journals Transcriptomic Analysis of Chronic Hepatitis B and C and Liver Cancer Reveals MicroRNA-Mediated Control of Cholesterol Synthesis Programs

mBio ◽  
2015 ◽  
Vol 6 (6) ◽  
Author(s):  
Sara R. Selitsky ◽  
Timothy A. Dinh ◽  
Cynthia L. Toth ◽  
C. Lisa Kurtz ◽  
Masao Honda ◽  
...  
Keyword(s):  
Gene Expression ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Cholesterol Synthesis ◽  
Chronic Viral Hepatitis ◽  
Cholesterol Homeostasis ◽  
Disease States

ABSTRACT Chronic hepatitis B (CHB), chronic hepatitis C (CHC), and associated hepatocellular carcinoma (HCC) are characterized by cholesterol imbalance and dyslipidemia; however, the key regulatory drivers of these phenotypes are incompletely understood. Using gene expression microarrays and high-throughput sequencing of small RNAs, we performed integrative analysis of microRNA (miRNA) and gene expression in nonmalignant and matched cancer tissue samples from human subjects with CHB or CHC and HCC. We also carried out follow-up functional studies of specific miRNAs in a cell-based system. These studies led to four major findings. First, pathways affecting cholesterol homeostasis were among the most significantly overrepresented among genes dysregulated in chronic viral hepatitis and especially in tumor tissue. Second, for each disease state, specific miRNA signatures that included miRNAs not previously associated with chronic viral hepatitis, such as miR-1307 in CHC, were identified. Notably, a few miRNAs, including miR-27 and miR-224, were components of the miRNA signatures of all four disease states: CHB, CHC, CHB-associated HCC, and CHC-associated HCC. Third, using a statistical simulation method (miRHub) applied to the gene expression data, we identified candidate master miRNA regulators of pathways controlling cholesterol homeostasis in chronic viral hepatitis and HCC, including miR-21, miR-27, and miR-33. Last, we validated in human hepatoma cells that both miR-21 and miR-27 significantly repress cholesterol synthesis and that miR-27 does so in part through regulation of the gene that codes for the rate-limiting enzyme 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase (HMGCR). IMPORTANCE Hepatitis B virus (HBV) and hepatitis C virus (HCV) are phylogenetically unrelated hepatotropic viruses that persistently infect hundreds of millions of people world-wide, often leading to chronic liver disease and hepatocellular carcinoma (HCC). Chronic hepatitis B (CHB), chronic hepatitis C (CHC), and associated HCC often lead to cholesterol imbalance and dyslipidemia. However, the regulatory mechanisms underlying the dysregulation of lipid pathways in these disease states are incompletely understood. MicroRNAs (miRNAs) have emerged as critical modulators of lipid homeostasis. Here we use a blend of genomic, molecular, and biochemical strategies to identify key miRNAs that drive the lipid phenotypes of chronic viral hepatitis and HCC. These findings provide a panoramic view of the miRNA landscape in chronic viral hepatitis, which could contribute to the development of novel and more-effective miRNA-based therapeutic strategies.

scholarly journals Chronic viral hepatitis B and D in pregnant women: course and outcomes (review)

2021 ◽  
Vol 13 (2) ◽  
pp. 29-37
Author(s):  
M. D. Akhmedova ◽  
Sh. A. Tashpulatova ◽  
G. A. Ikhtiyarova ◽  
M. T. Karimova
Keyword(s):  
Hepatitis B ◽  
Pregnant Women ◽  
Viral Hepatitis ◽  
Vascular Wall ◽  
High Viral Load ◽  
Chronic Viral Hepatitis ◽  
Current Data ◽  
Hepatitis D ◽  
Increased Risk ◽  
Viral Hepatitis B

Hepatitis B is most common among young people, which is explained by the ways of infection – parenteral, sexual and vertical. Mother-to-child transmission is the main route of infection for children in areas where the hepatitis B virus (HBV) is endemic.The available current data on the course and outcomes of chronic viral hepatitis B are contradictory in pregnant women. Some authors argue that the exacerbation of chronic hepatitis B is more common in the first and third trimesters in pregnant women, and with an increase in gestation, there is a deterioration in liver function and an increased risk of fulminant liver failure. Other researchers note a more severe course in the second half of pregnancy or in the first months after delivery.High replication of the virus increases the frequency of gestational diabetes mellitus, hemostatic disorders, the threat of termination of pregnancy, gestosis, fetoplacental insufficiency, risk of bleeding in childbirth, premature birth, untimely discharge of amniotic fluid, and the birth of premature babies.Children become chronic carriers of HBsAd in neonatal hepatitis. These findings suggest that transplacental infection before birth may be a mechanism contributing to higher rates of failed prevention in newborns born to women with a high viral load.We could not find data on the features of the course and outcomes of viral hepatitis D in pregnant women in the available sources,. At the same time, it is known that mixed infection is more severe.Polymorphisms of genes associated with the regulation of the state of the vascular wall can have a significant impact on the course of infection.The high prevalence of hepatitis D infection in different parts of the world indicates the need for a comprehensive study of this disease, followed by the development of special programs for the prevention, early diagnosis and treatment of hepatitis B and D in pregnant women. 

scholarly journals LETHALITY OF TB PATIENTS, COMBINED WITH THE VIRAL HEPATITIS AND HIV INFECTION IN SAINT-PETERSBURG

2019 ◽  
Vol 11 (2) ◽  
pp. 42-47
Author(s):  
A. K. Ivanov ◽  
V. V. Nechaev ◽  
L. N. Pozhidayeva ◽  
V. B. Musatov ◽  
V. S. Belyakov ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Hiv Infection ◽  
Viral Hepatitis ◽  
Fatal Outcome ◽  
Chronic Viral Hepatitis ◽  
Unknown Etiology ◽  
Saint Petersburg ◽  
Viral Hepatitis B ◽  
High Level

Сombination of tuberculosis and viral hepatitis have been registered 2525 newly identified patients in Saint-Petersburg for the period 2006–2017. Some of these patients have been infected with HIV. Fatal outcome in 625 (24,7%) was noted. Patients with tuberculosis and chronic viral hepatitis have had a combination of viral hepatitis B and C in 36% of cases. Patients with combination tuberculosis and chronic hepatitis of unknown etiology experienced a more frequent death (60%) than patients with combination tuberculosis and other chronic viral hepatitis. In patients with concurrent tuberculosis, chronic viral hepatitis and HIV infection, patients infected viral hepatitis B and C were 31,6%. In 160 patients with fatal outcomes had a combination of infections (tuberculosis, viral hepatitis and HIV infection), the mortality rate of persons with hepatitis of unknown etiology was the lowest (42%), compared with a group of individuals affected by viral hepatitis B and C simultaneously (83%). Among patients with tuberculosis, chronic hepatitis and HIV infection, the highest incidence of tuberculosis of the intrathoracic lymph nodes and disseminated pulmonary tuberculosis was registered. Lethal outcomes most often occur in individuals with advanced tuberculosis, in whom the secretion of mycobacteria tuberculosis into the external environment has not been established. Given the high level of mortality in patients with simultaneous defeat of tuberculosis, viral hepatitis and HIV infection, it is necessary to establish their centralized registration in order to study the epidemiological patterns and clinical features of co-infections.

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