There are 43,500 registered patients with hepatitis C in Ukraine. However, the World Health Organization believes that the real number of infected people is much higher, and estimates that up to 8 percent of people could live with hepatitis C in the country.
“Although data on the prevalence of hepatitis C virus infection in Ukraine are limited, the latest available studies mention that the number of people living with hepatitis C in Ukraine can be up to 3.5 million,” explained Liuba Negru, press officer at the World Health Organization European Office.
Hepatitis C spreads primarily through contact with the blood of an infected person. The specific feature of this disease is its ability to progress in latent form for a long period of time, and it is often not diagnosed until the stage of liver cancer or cirrhosis.
Moreover, the spread of hepatitis C in Ukraine seems to be getting worse since the start of the war. According to International HIV/AIDS Alliance, an organization fighting hepatitis C in Ukraine, the prevalence of the virus among soldiers could be much higher than among the general population.
“The risk of rapid aggravation of the viral hepatitis epidemic in Ukraine rises significantly due to the big numbers of wounded people, deterioration of sanitary, social and economic conditions of life of many Ukrainians in the east of the country,” explained International HIV/AIDS Alliance on a press release.
But the Ministry of Defense doesn’t agree with this statement, and says that the soldiers in the war zone aren’t more likely to get infected.
“These experts (HIV/AIDS Alliance) do not have the necessary information. Viral hepatitis C in a combat zone has the same incidence as in the military units of permanent deployment,” said the Lieutenant Colonel Oksana Gavrylyuk.
However, the HIV/AIDS Alliance carried out a pilot-testing program in the Central Military Clinical Hospital of Kyiv on May, and the results they obtained seem to prove that the prevalence of hepatitis C among soldiers is alarming.
“We conducted a pilot testing in the Military Hospital on May. There were almost 80 military officers who were just back from the east and were tested, and we got really huge results of positive tests,” explained Pavlo Skala, Associate Director of International HIV/AIDS Alliance in Ukraine.
The results of this first program are not enough to know the exact prevalence of hepatitis C among Ukrainian soldiers, so HIV/AIDS Alliance has started launching a new pilot initiative to carry out 5,000 more tests among military personnel.
“At the moment we are just dealing with dozens of cases, but after we evaluate the data from the 5,000 tests, it would not even be hundreds, it would be thousands,” said Skala.
Even though HIV/AIDS Alliance has the support of the Ministry of Defense and the Ministry of Interior to carry out the 5,000 screening tests, Skala says that both Ministries were reluctant to collaborate with them.
“At the last stage, they were almost ready to cancel the press conference and cancel the program because they realized that it could be a huge scandal,” said Skala.
“We told them: ‘Ok, we are going to conduct the press conference and it is up to you. If you refuse, we will tell more information. If you agree, we will kind of decide how to manage this information’,” explained Skala.
Moreover, HIV/AIDS Alliance says that the Ministry of Defense is reluctant to collaborate because of the economic cost that this scandal could have for them If soldiers get tested and are hepatitis C positive, they could say that they got infected in the war, and demand the Ministry of Defense to pay for their treatment.
“The military authorities are not interested in testing or fixing some diagnoses because it would be their responsibility to treat these people (the soldiers), or even to pay for retirement pensions,” explained Skala.
“For them is a disaster. They (the military authorities) told us ‘we haven’t got any money, and it is not a priority’,” said Skala.
Taking into account the price of the treatment for hepatitis C, the economic cost for the Ministry of Defense could definately be a “disaster” for them.
“According to the information we have, currently, the treatment with pegylated interferon and ribavirin is available in Ukraine for the price between $6,000 – $7,000 per treatment course. The government is negotiating with the production companies the introduction of the new hepatitis C treatments for a lower price,” explained Liuba Negru, press oficer at the World Health Organization European Office.
However, the Ministry of Defense denies the HIV/AIDS Alliance’s accusations, and claims that the data of this organization isn’t trustworthy.
“HIV/AIDS Alliance did not specify a representativeness of the sample, extrapolated these data at all armed forces, and did not conduct epidemic investigation of allegedly detected incidents. The Ministry of Defense can’t operate with unverified information,” explained Liutenant Colonel Oksana Gavrylyuk.
Moreover, Gavrylyuk says that the Ministry of Defense isn’t reluctant to carry out more tests, and claimed that they are the first ones who want to know whether Ukrainian soldiers are infected.
“The Ministry of Defense believes that tests should be done before soldiers are called to join the Armed Forces, and before they go back home to determine the possibility of infection during their service,” explained Gavrylyuk.
However, Gavrylyuk also recognizes that right now testing Ukrainian soldiers for hepatitis C is not among the priorities of the Ministry of Defense.
“Testing soldiers or other military personnel for hepatitis C can’t be priority for the Ministry of Defense of Ukraine because this (disease) doesn’t have an epidemic risk,” explained Gavrylyuk.
Even if the data collected by the HIV/AIDS Alliance isn’t trustworthy, the fact that the Ministry of Defense doesn’t consider a priority to test Ukrainian soldiers for hepatitis C is alarming. The specific feature of this disease is its ability to progress without presenting any symptoms, and this is the reason why organizations like the World Health Organization refer to hepatitis C as the “silent epidemic.”
