Shaginyan V. The role of perinatal mode transmission in spreading of the hepatitis B and C and improving the epidemiological surveillance system

The dissertation is devoted to the investigation of epidemiological features of perinatal hepatitis B (HB) and C (HC) spreading in Ukraine and the development of its prevention strategy. The variation both of qualitative and quantitative HB and HC epidemic process parameters at present conditions is established. The leading role of the occult component, the intensive involving of the fertility age persons, the steady rise of the role of sexual transmission of HB virus (HBV) in the epidemic process are demonstrated. All the above factors promote the elevation of the epidemiological significance of the perinatal transmission of these pathogens. The criteria of the specific serological diagnostics of the HBV- and HCV- infections are developed. The approach and algorithms of pregnant women testing for the determination of the risk of perinatal HCV transmission is suggested. The scheme immunizations of the newborns against the HB are proposed. The prevalence of HBV- and HCV -infections in the HIV-infected pregnant women and their children are determined for the first time in Ukraine. The prevalence of the perinatal HB (6.6 %) and HC (2.4 %) of the children born from HIV-infected mothers is defined. The efficiency of the conducting in Ukraine immunisation of the newborns to be insufficient against perinatal HB is demonstrated. At the same time, the vaccination of the newborns performed in 2000-2004 years promoted the decrease of the indices of the HB infection of 3-6 years old children. The strategy of the preventive measures and the concept of the perinatal viral hepatitis epidemiological surveillance system are developed.