Development & Aid, Europe, Headlines, Health

ROMANIA: A European Home to Hepatitis

Claudia Ciobanu

BUCHAREST, Feb 19 2007 (IPS) - About two million of Romania’s 22 million people are carrying some form of hepatitis, in the highest infection rates in Europe.

Between 6 to 8 percent suffer from hepatitis B, and between 8 to 12 percent from hepatitis C. Hepatitis is the main cause for hospitalisation.

Hepatitis B is a liver disease caused by the hepatitis B virus. Hepatitis C is a more aggressive liver illness transmitted usually through blood transfusion. Hepatitis B can also be transmitted this way, but also more through sexual contact.

Medical reports suggest that most people in Romania got infected during the 1980s because of poor conditions in hospitals and polyclinics and negligent medical practices such as using non-sterile syringes and transfusions with untested blood.

“The medical staff are to blame for the HBV (hepatitis B virus) infections because, having no conscience, they used the same needle to give injections to dozens of people,” Dr. Mihai Voiculescu, a leading specialist in infectious diseases told media.

While the hepatitis C virus was only identified in 1990, hepatitis B has been known since 1965.

Compulsory testing for the two viruses and vaccination campaigns were only introduced in the 1990s, and then mostly to reduce risks for AIDS patients, whose condition is seriously aggravated if they carry hepatitis as well.

Tests and vaccines are expensive, and the national health system only covers expenses for limited categories of the population.

The ministry of health has still not launched a campaign to inform the public how widespread these infections are.

It is estimated that around 1.5 million Romanians carry one of the viruses without being aware of it. In many cases, the viruses can infect the body without leading to an acute condition. These people can then unknowingly transmit the viruses to others.

Infected people who are aware of their condition often know little about hepatitis.

“I was afraid of a biopsy to see how my liver is doing,” said 32-year-old Cristina standing in front of the doctor’s office at Matei Bals Hospital for Infectious Diseases in Bucharest. “Who knows what I will discover? I feel well, I try not to worry.”

People with chronic hepatitis only start feeling sick at a stage when it may be too late to cure the disease. A timely biopsy is an essential step in the treatment.

A report presented at the National Conference for Liver Diseases in Bucharest September 2006 details the effects of the hepatitis viruses. Five to 6 percent of the cases of infection with the viruses B or C turn into chronic hepatitis. Roughly 20 percent of these people develop cirrhosis, and about a fifth of the cirrhosis patients get liver cancer.

The national health system has resources to treat just 6 to 8 percent of the infected people, Dr Adrian Abagiu from Matei Bals told IPS. Only the most serious cases get the needed treatment, a combination of stimulants for the immune system and substances that limit reproduction of the virus.

In order to qualify for state-subsidised care, a patient has to have a significantly sick liver and aggressive infection in the blood. The rest are asked to get on with their lives as if they were healthy.

“But the serious cases have the least chances of getting cured,” Dr. Abagiu said. “Young people are the most likely to succeed. But those almost never meet the criteria.”

Treatment can cost thousands of euro, in a country where the average monthly salary is less than 350 euro.

“They told me to go on with my life as if nothing happened,” wrote a contributor to a patients’ online forum. “But it’s not like that. I am afraid I can make other people sick, I feel awkward to talk about it to my sexual partners. I wish there was more information and openness about it.”

The World Health Organisation says Romania has the highest rate of deaths from hepatitis in Europe. About 260,000 in a million patients with chronic hepatitis die of it.

The study presented showed that it would be cheaper to carry out vaccination campaigns and provide antiviral treatment to all infected people, rather than treat patients only when their condition becomes serious.

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