RESUMO
AIM: Evaluate the effect of mass vaccination against hepatitis B implemented within the framework of national project Health on the rate of development of unfavorable outcomes of infection and on average lifetime of the population of Russia. MATERIALS AND METHODS: Hepatitis B markers (HBsAg, anti-HBc, HBeAg, anti-HBe) were determined by enzyme immunoassayin 6211 blood serum samples from conditionally healthy population of 6 regions of the Russian Federation. Analysis of damage to health of the population caused by hepatitis B and favorable effect of mass vaccination against hepatitis B was performed by using mathematical model by Goldstein S.T. et al. (2005), that used results of detection of hepatitis B markers in discrete groups (women of childbearing age, children up to 5 years of age, adults aged 30 years and older). A formula developed by us was used to evaluate the effect of vaccination on the average lifespan of the population of the Russian Federation. RESULTS: The rate of HBsAg detection in the conditionally healthy population of the Tuva Republic was significantly higher (8.1%) than in other studied regions of the Russian Federation (p < 0.05): in Moscow Region--1.6%, in Rostov Region--1.6%, in Sverdlovsk Region--1.2%, Khabarosvk Region--2.0%, in Sakha (Yakutia) Republic--2.5%. The rate of detection of anti-HBc was significantly higher in the Tuva Republic and Sakha (Yakutia) Republic (46.2% and 42.3%, respectively); in other regions: Moscow Region--13.6%, Rostov Region--18.9%, Sverdlovsk Region--17.5%, Khabarovsk Region--21.0%. HBeAg in women of childbearing age was detected only in the Tuva Republic (0.4%). The mathematical analysis performed demonstrated that the level of coverage of vaccination of newborn children that in the studied regions is 96.1-99.6% may lead to the reduction of morbidity and mortality from hepatitis B and its outcomes by 91-95% that exceeds the similar parameter obtained by using our model, described in the literature for Africa, Asia and Europe. The calculated level of decrease of morbidity and mortality from hepatitis B and its outcomes may lead to the increase of average lifespan of the population of the Russian Federation by 1.44 - 4.08 months. CONCLUSION: The strategy of vaccination of newborn children against hepatitis B employed in the Russian Federation significantly reduces the risk of this disease and development of unfavorable outcomes of the disease especially in hyper endemic regions and promotes the increase of average lifespan of the population of Russia.