„This international recognition is an evaluation of the work of all people who contributed to the hepatitis C elimination program in Lithuania. Today, we already see that universal screening allows for early diagnosis of the disease, and modern treatment helps people fully recover. The results achieved in Lithuania show that the screening program for a selected part of the population is effective in a country where the prevalence of hepatitis C virus (HCV) is moderate,” says Prof. L. Kupčinskas, head of the Hepatitis C Elimination Working Group.
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More than half of the country’s population screened in four years
For more than a decade, Prof. L. Kupčinskas consistently sought to make hepatitis C a priority not only for doctors but also for the state in Lithuania. At his initiative, a working group of gastroenterologists, infectologists, epidemiologists, and family doctors was formed, which, together with the Ministry of Health, the State Patients’ Fund, and other partners, prepared the National Hepatitis C Screening and Elimination Program. Launched in May 2022, the program became the first hepatitis C elimination initiative of such scale in Central and Eastern Europe.
In just four years, Lithuania achieved results that garnered international attention. Over 46 months of program implementation, nearly 1.5 million people were tested for hepatitis C antibodies, which is about 85% of the entire target population born between 1945 and 1994. The program helped identify thousands of previously undiagnosed hepatitis C cases, and approximately 9,500 individuals suffering from this chronic disease were newly diagnosed and successfully treated. According to the professor, it is unknown whether all of them understand that the screening program might have saved them from death, as complications of untreated hepatitis C include liver cirrhosis and primary liver cancer.
„We are already seeing the results of the program. A decade ago, about 40% of liver transplants performed at Kaunas Clinics were due to hepatitis C. This year, eleven liver transplants have been performed, and none of them were due to hepatitis C,” comments Prof. L. Kupčinskas on the situation.
It is entirely realistic to achieve the goal set by the screening program – to save about 150 lives, prevent approximately 90 cases of liver cirrhosis, and more than 120 cases of liver cancer.
The biggest challenge – motivating people to get treatment for a deadly disease
„The program’s screening results are encouraging; now our main goal is to ensure that every person whose blood tests positive for hepatitis C antibodies seeks specialists for further examination. Only then will we be able to achieve the WHO goal – to eliminate hepatitis C as a public health problem,” says Prof. L. Kupčinskas.
According to the interviewee, this is currently the biggest challenge – about a third of people whose family doctors detected hepatitis C virus antibodies during the initial test do not visit a gastroenterologist or infectious disease doctor to confirm the diagnosis and start treatment.
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An even larger proportion of those who do not come for further treatment – as much as two-thirds – are among individuals in risk groups. These include people who have used or are using injectable drugs, individuals who have participated in methadone programs, and people living with HIV/AIDS infection.
„It’s hard to say why people, after hearing positive initial test results, do not continue to consult specialists. I think there could be various reasons. Perhaps for some of them, who very rarely visit healthcare institutions, this news hasn’t even reached them, so I would invite family doctors and nurses to pay attention to this once again. Perhaps some feel well and don’t even consider that delaying treatment could cost them their lives in 10-15 years. Therefore, I urge all Lithuanian residents born between 1945 and 1994 to inquire about their hepatitis C test results with their family doctor, and if they are positive, to consult specialists,” urges Prof. L. Kupčinskas.
World Hepatitis Day reminds – treatment is essential
Today, hepatitis C is one of the few chronic viral diseases that can be completely cured – modern direct-acting antiviral drugs allow 96-99% of patients to recover. Untreated, the disease can lead to liver cancer or liver cirrhosis.
The hepatitis C virus was discovered only in 1989. The disease can cause no symptoms for a long time, so many people only learn about the infection after severe liver damage has developed. In Lithuania, as in many other countries in the region, a significant number of people were infected before 1994, when donor blood was not yet screened for the hepatitis C virus, and also during medical or other procedures when today’s infection control requirements were not applied.
World Hepatitis Day, observed on July 28, reminds us that early diagnosis and timely treatment can save lives. The earlier the disease is detected, the greater the chance of full recovery and avoiding severe complications.
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