Hepatitis C treatment is a complex and long-lasting process, in which antiviral medications are used to treat the infection. Along with the medication, the treatment period includes a strict diet.
The wide spread of the hepatitis C in the Republic of Moldova during the period of 1990-1995 created an epidemiological situation in the country. The number of patients with chronic hepatitis C in 1990 was 39,552, while in 1995 it was 53,862. The mortality rate caused by the hepatitis C virus and virus-induced cirrhosis increased significantly from 2,973 in 1990 to 3,848 in 1995.
National Program, 1997
The epidemiological situation has created the premise of the urgent fight against the viral hepatitis from both, a medical and economical point of view (the annual cost of the treatment was 54-55 million lei). The first national Program for the control of viral hepatitis was launched in July 1997. It included comprehensive measures of specific and nonspecific prophylaxis. The main objective of the nonspecific prophylaxis in the medical institutions was to eliminate the risk of transmission of the viral hepatitis C from patients to the medical staff, and others using the medical institutions’ services.
Nonspecific prophylaxis
The nonspecific prophylaxis included a rigorous selection of blood donors and other biological fluids as well as their extensive testing for the presence of hepatitis C virus. The sterilization of medical instruments in all hospitals and clinics became mandatory, and the unreasonable parenteral manipulation in medical institutions was reduced to the minimum. In non-medical institutions, like beauty salons (spa, acupuncture, manicure, pedicure salons) nonspecific prophylaxis were carried out by ensuring the sterilization of the working tools. Within the rest of the society a nonspecific prophylaxis was performed by ensuring the individual use of shaving devices, toothbrushes and other elements that may affect the integrity of the skin and mucous membranes.
Social Mobilization
The main task of social mobilization campaign was to inform the population, especially the risk groups, about the epidemiological situation and the serious consequences of the disease on these infections, about the effectiveness of specific and non-specific preventive measures to increase the responsibility of medical staff. To successfully implement the social mobilization, the following activities were carried out: informative and educational materials (brochures, booklets, posters) were published; publication of press articles at national and local level; radio and TV shows were organized; republican scientific and practical conferences, regional and national seminars were organized; systematic conversations of health workers with the population, particularly with risk groups; the process of social mobilization involved the experience of other states, of non-governmental organizations and scientific societies.
National Program, 2007-2011
As a result of the implementation of specific and non-specific preventive measures provided by the National Program for Combating Viral Hepatitis B, C and D for the years 1997–2006, the situation in the country has improved significantly. The incidence of VHC decreased from 266 cases in 1997 to 127 cases in 2005. According to available statistics, annually in Moldova were identified approximatively 2.700 carriers of hepatitis C virus and 7.000 people with chronic hepatitis and hepatic cirrhosis. As a result of these complications, approximately 3.000 people in the republic died annually. Due to the implementation of preventive measures within the National Control Program of Hepatitis B, C and D, it was possible to stabilize the incident rates of chronic hepatitis and cirrhosis in children. Thus in 2004, as compared with 2003, the incidence of these diseases among children aged 0–17 years decreased from 99.5% (909) cases to 66.1% (559 cases).
The prevalence of liver cirrhosis in the Republic of Moldova in 2009 increased by 18.1% compared to 2005 (1922.4 cases per 100.000 inhabitants and 1628.1 cases per 100.000 respectively). This phenomenon has a growth tendency at the municipal level (from 1126,3 cases per 100,000 inhabitants in 2005 to 1358,2 cases per 100,000 inhabitants in 2009) and at district level (from 1802,7 cases per 100.000 inhabitants in 2005 to 2103,4 cases per 100.000 inhabitants in 2009).