Infectious diseases represent a public health threat both in the world and in Montenegro, and early detection of HIV and hepatitis C and reduction of stigma and discrimination are important both for the most efficient treatment of patients and for the prevention of new cases of the disease.
This was assessed at an expert meeting organized by the Medical magazine, where there was talk of established prevention and harm reduction programs, stigma as the biggest obstacle to the prevention of the spread of these diseases, good clinical practice in the treatment of HIV and hepatitis C, and new therapies.
Dr. Alma Čičić from the Institute of Public Health (IJZ) said that Montenegro is a country where the prevalence of HIV is low compared to the general population, but almost a third of those infected have never been tested and diagnosed.
"Testing and detection at an early stage with the inclusion of therapy prevents the transmission of infection, which is a fantastic thing because this is how we affect the source of infection. As for the prevention of HIV and viral hepatitis itself, it is a chain of interrelated interventions. "Harm reduction programs and voluntary and verifiable counseling and testing are, along with therapy, the most important measures to stop the epidemic," Čičić said.
She replied that in recent years the number of HIV-positive people being diagnosed has been increasing, which does not mean that the number of infected people is also increasing, but that more cases are being discovered. She said that recently there is a phenomenon of migration, which means that people who are registered as HIV positive in other countries are coming into our system. Čičić also said that last year the IJZ registered 54 newly infected people.
She emphasized that the problem in Montenegro that they face is late diagnosis, because it takes an average of two years from infection to confirmation of HIV positive status.
"According to data from the European Center for Disease Prevention and Control (ECDC), we are in first place in terms of late diagnosis," Čičić said. She also answered that, unlike the statistics for HIV, there is no registry for Hepatitis C, but data on patients is collected as part of the reporting of infectious diseases, but that for various reasons not all infected people are reported. She explained that the dominant cause of transmission of hepatitis C is through blood, due to the use of drugs.
Dr. Brankica Dupanović from the Clinical Center of Montenegro (KCCG) said that the treatment of these diseases began 40 years ago with drugs that had a much worse safety profile compared to today's. There were, he claims, many more side effects, and the patients drank from six to eight tablets a day, while the essence of treatment today is antiviral therapy of, say, three or two drugs that are combined, which stops the reproduction of the virus.
"When the virus is not present in blood and other fluids, an infected person cannot transmit HIV. The goal is to test people in order to know their status. "HIV has turned from a 100 percent fatal disease into a disease that can be treated, that is, it contributes to the fact that the virus does not reproduce, and immunity improves to the level of a healthy person," she said.
Dupanović pointed out that patients, if they go without therapy for a day, can be in trouble, saying that taking medicine every day and regularly supplying institutions is very important. Answering the question of whether there are shortages, she said that according to the claims of patients, there are occasional delays in the procurement of medicines. She also said that one new drug was placed on the positive list, but that it must be expanded.
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