THE ORGANIZATION OF MEDICAL CARE FOR PATIENTS WITH CHRONIC VIRAL HEPATITIS IN THE REPUBLIC SAKHA (YAKUTIA)
AIM. To identify the risk factors for primary liver cancer in patients with chronic viral hepatitis in the Republic of Sakha (Yakutia) and develop an organizational model of treatment and prevention of viral hepatitis and primary liver cancer. METHODS. Clinical, epidemiological and molecular biological methods were used. RESULTS. There is a high prevalence of chronic viral hepatitis B, C and D in the Republic of Sakha (Yakutia), as well as their distant adverse outcomes. Disclosed the problem of the combined effects of risk factors for primary liver cancer in people indigenous nationality of the Republic of Sakha (Yakutia), mostly male, living in rural areas, which is the simultaneous replication of hepatitis viruses B, C and D in patients with genetically predisposed changes in the activity of alcohol dehydrogenase and aldehyde dehydrogenase. The modernization of the training algorithms of patients for liver transplantation and management of patients with cirrhosis and liver cancer in the outcome of chronic viral hepatitis, liver transplantation is justified from a related donor with a high level of specific antibodies of patients with primary liver cancer, as well as phasing held medical diagnostic and organizational and methodological measures. Created was an annual Republican «liver-school» for physicians, gastroenterologists, internists, pediatricians, epidemiologists, introduced the publication of conference materials for use on the entire territory of the Republic of Sakha (Yakutia). CONCLUSION. Multi-component structural-functional model of service prevention and control of viral hepatitis has allowed to develop a program to address the medical and social protection of different groups of the population to create a unified register «Chronic viral hepatitis in the Republic of Sakha (Yakutia)», as well as long-term programs for complex vaccine prophylactics and modernization of services for prevention and control of viral hepatitis.