“Yes, although modern medicine allows these diseases to be successfully treated, and hepatitis C can even be completely cured – the reality remains paradoxical: treatment exists, but some patients do not seek it,” says Professor Raimonda Matulionytė, from the Infectious Diseases and Dermatovenerology Clinic of Vilnius University Faculty of Medicine, and consultant doctor at the Infectious Diseases Center of VUL Santaros Clinics.
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Viruses can remain dormant silently in the body for a long time
Although viruses differ, their transmission methods – unsafe sexual contacts, contact with blood, or intravenous drug use – and the highest risk groups are very similar. This results in a significant frequency of co-infections. One reason why these viruses remain undiagnosed for a long time is that both HIV and hepatitis C can remain asymptomatic for a long period. In the case of hepatitis C, the disease can silently progress for 15–30 years until liver cirrhosis or cancer develops. HIV infection can also remain undetected for 5–7 years until the immune system begins to weaken. Often, the disease is diagnosed only when other infections appear – tuberculosis remains one of the most common in Lithuania.
According to Prof. R. Matulionytė, many people in Lithuania still live unaware of the infection they have. This means not only worse outcomes for their own disease but also a higher risk of virus spread in society – unknowingly infected individuals transmit the virus to others. The situation is further complicated by the fact that the disease is often diagnosed latest in those who do not even consider themselves at risk – older people, heterosexuals, and those living in regions.
By AIDS incidence rates – Lithuania among the leaders
By AIDS incidence rates, Lithuania is among the leaders in the European Union (EU) – remaining close to the top five, in 2024* only Latvia, Portugal, Romania, Luxembourg, and Bulgaria surpassed us.
Worldwide, nearly 41 million people are infected with HIV. According to the World Health Organization (WHO), about 2.14 million HIV-infected people live in Europe, mostly in Eastern Europe. The majority – about 65% of all new diagnoses – are recorded here. In 2024, 196 new HIV cases were identified in our country. Migration also increases the number of HIV infections, but 65% of new cases were diagnosed in Lithuanian residents.
According to the interviewee, the pattern of HIV spread is also changing. While previously in Lithuania infection through intravenous drug use dominated, today the infection is increasingly spreading through sexual contacts. According to the National Public Health Center data, in 2024 the most common mode of HIV infection in Lithuania was sexual contact (58.2% of cases), of which 84 cases (42.9%) were heterosexual and 30 cases (15.3%) homosexual; 20 people (10.2%) were infected through intravenous drug use, and in 60 cases (30.6%) the mode of infection was not determined.
This shows that the infection has long ceased to be a problem only for narrow risk groups.
Effective treatment exists
At the same time, treatment options have fundamentally changed over the past decades. “Today, antiretroviral drugs are effective, well tolerated, and easy to take. Usually, one tablet per day is enough,” says Prof. R. Matulionytė. Starting treatment on time, a person can live a full life and no longer spread the virus.
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Even clearer progress is seen in treating hepatitis C. Lithuania started the hepatitis C elimination program in 2022 and it is already considered one of the most successful in Europe. Family doctors and nurses have tested more than 80% of the population born between 1945 and 1994 – about 1.45 million people. More than 8,000 infected individuals have already been cured, many of whom today do not even realize they have avoided a deadly disease. However, even here the same problem remains – some people, after learning about a positive test result, do not seek specialists.
“If we detect the HIV virus, we also test such a patient for hepatitis C virus. Up to 50% of cases, depending on the mode of infection, have a positive initial response. The reverse situation should also apply – upon detecting hepatitis C virus, testing for HIV should be done, as hepatitis C is an HIV indicator disease. Moreover, some infected patients come from those who rarely visit doctors,” draws colleagues’ attention Prof. R. Matulionytė.
WHO and the European Centre for Disease Prevention and Control especially recommend integrated testing programs and services for blood-borne viruses, which positively affect health indicators related to the prevention, diagnosis, and treatment of these viruses, especially when implemented in hospital emergency departments and correctional facilities. Studies show that such integration increases screening coverage, reduces structural barriers, and helps better reach vulnerable groups.
Today the situation is clear: HIV is no longer a death sentence, and hepatitis C is one of the few viral diseases that can be completely cured. But this only works if the disease is diagnosed in time, so it is very important to regularly visit your family doctor and, if there are suspicions, to perform a blood test to detect HIV or hepatitis C infection, and if the virus is detected, immediately consult a gastroenterologist or infectious disease doctor.
HIV is no longer a death sentence, and hepatitis C is one of the few viral diseases that can be completely cured.
The message from medical professionals to the public remains simple – if there is an opportunity, get tested, because the greatest risk arises not for those who are sick, but for those who do not know about their disease.
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