[Prevalence of hepatitis B and C viral infection according to the data on fetal outcomes in Moscow in 2015-2017].

Objective: To elucidate the prevalence of hepatitis B and C viral infection among the people who died in Moscow in 2015-2017, by studying the primary medical records of a representative sample of fatal outcomes, followed by the mathematical extrapolation of the data obtained to the total number of all deaths.

Material And Methods: The 2015-2017 primary medical documentations from 8 therapeutic-and-preventive establishments with morbid anatomy units in the administrative districts and from 2 infectious diseases hospitals of the Moscow Healthcare Department were studied. The sample of those who died was 11.8-12.1% of the total number of all-cause deaths in Moscow during these years and was representative at a 0.95 confidence probability and a ±5% confidence interval. The Bernoulli theorem and the Laplace function for the 95% confidence probability were used to extrapolate the obtained data to the number of all those who died in these years.

Results: The mortality rates associated with acute viral hepatitis B and C were 0.04-0.07 and 0-0.008, respectively, per 100,000 population, which corresponds to the official statistical data. The mortality rates for chronic viral hepatitis and liver cirrhosis in their outcomes, including hepatocellular carcinomas in their presence, exceeded the official statistical data by many times, accounting for 0.5-1.6 and 10.4-12.1 persons with viral hepatitis B and C, respectively, per 100,000 population and rose by 22.5% over 3 years. The rates obtained for hepatitis B virus were 1.7-5.6 lower, and those for hepatitis C virus were, on the contrary, 1.3-1.5 times higher than average in the European Union countries. There was a manifold (7.4-24-fold) prevalence of hepatitis C virus in the etiology of chronic liver damage. The mortality from liver cirrhosis of alcoholic and unknown etiology was 14.4-19.5 persons per 100,000 population and declined by 21% over 3 years. The percentage of deaths caused by acute viral hepatitis was 0.5% per 100,000 population in Moscow in 2017; that caused by chronic viral hepatitis, including liver cirrhosis in the outcome and hepatocellular carcinoma, which had developed in their presence, was 46.3%; and that of liver cirrhosis of alcoholic and unspecified etiology was 48.7% of the total number of all liver lesions.

Conclusion: The study of primary medical records of a representative sample of fatal outcomes, followed by the mathematical extrapolation of the data obtained to the number of all deaths, makes it possible to objectively estimate the burden of mortality from hepatitis B and C viral infection.