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Simplified test and treat protocols for population level screening
and elimination of hepatitis B and hepatitis C in Uzbekistan
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E. MUSABAEV1, S. SADIROVA1, S. BAKIEVA1, K. BRIGIDA1, R. DUNN2, K. RAZAVI-SHEARER2, H. RAZAVI2
1 Uzbekistan Research Institute of Virology
2 Center for Disease Analysis Foundation
We had 771 HBV patients and 325 HCV patients who started treatment in 2020. More details on the cascade of care and our findings can be viewed on our website (https://cdafound.org/uhep-data/). Unfortunately, the treatment rate dropped after March 2020 (COVID-19) as many patients were concerned about their income as result of COVID-19 shut down (lasted 6 months but the government did not rule out additional shutdowns).
Uzbekistan is the first country to adopt a test and treat guideline for HBV. This means that HBV patients received one rapid HBsAg test. If HBsAg positive, they received an HIV rapid test and creatinine rapid test. If HBsAg+ and HIV+ (a total of 1 patient), they were referred to an HIV clinic for treatment. If any sign of renal failure (creatinine test), they were referred to a hepatology specialist. All others saw a GP immediately (about 30 minutes from the first test) and were given a prescription for Tenofovir. There was no PCR, HBeAg, ALT, Fibroscan.... Thus, similar to HIV, the patients were put on treatment immediately. This was viewed as a very positive approach to the patients and we had many patients crying and thanking us for not sending them out for additional tests and waiting until they have cirrhosis or high viral load with an age restriction of over 35 (the previous guideline).
The HCV cascade was also simplified. Our SVR12 was a 100% among all treated.
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