The purpose of the project: The overall aim of the project is to demonstrate that the treatment of chronic HBV infection is possible and an effective method for reducing the incidence of HCC in Tajikistan. Also, by developing a simple diagnostic for HCC, it may be possible to demonstrate that HCC can be detected early and then treated effectively in resource-poor settings. Today there are no governmental programmes for the management of chronic HBV infection in resource poor settings such as in Tajikistan. Following the resolution on viral hepatitis at the 62nd World Health Assembly WHO has committed to develop guidelines for the management of HBV, but there is little data outside of developed countries on which to base the guidance. It is expected to generate vital information on the effectiveness of population based screening, methods of clinical assessment of patients with chronic HBV to determine the need for treatment and the response to treatment with nucleoside analogues. It is expected that many of the methods and techniques will be adopted and used by governmental health authorities in resource limited settings.
People in Tajikistan are not generally tested for HBV, and the infection itself does not cause any symptoms, so most people who are infected do not know it. By extension, there is no warning of cancer risk and no preventive treatment, so those who do get liver cancer generally die within a few weeks of diagnosis.
Our results is based on two platforms; Hepatitis B and the Hepatocellular Carcinoma Study . Effective treatment programmes for HBV infection have not been developed for resource poor settings, such as Tajikstan. As part of the study we will screen over 500 adults in Tajikistan for HBV infection and have invite all who test positive to attend for clinical assessments. A trial of HBV treatment in a group of carefully selected high risk patients will be conducted to demonstrate that the incidence of HCC can be reduced in a Tajikistan population, specifically from Tajikistan. The treatment trial will also be used to evaluate the efficacy of screening by ultrasound, computer tomography for early tumours which can then be treated.
The role of foreign collaborators. The role of foreign collaborators will be in assessment of the project quality, coordination of efforts, help with technical challenges, monitoring the progress of the project. Routine communication will be primarily through the electronic mail and Skype videoconferencing. The cooperation will be coordinated also through the reciprocal visits, which will allow discussions, and preparation of results for publications. The collaborators in this project are Professor Saleem Kamili from Division of Viral Hepatitis, NCHHSTP Centers for Disease Control and Prevention, Atlanta (USA), who are the leading world experts in viral hepatitis. Our collaboration focus jn molecular epidemiology hepatitis B and genotypes HBV, HDV. The world leading experts are represented by: C.-Thomas Bock from Robert Koch – Institute ( Berlin, Germany) . Our collaboration focus jn molecular virology of hepatitis B: HBV mutation (PreS mutations, C1653T, T1753V, and A1762T/G1764A). Prof. H. Blum from Freiburg University (Freiburg, Germany), Our collaboration focus jn clinical aspects and treatment hepatitis B and liver cancer. Prof. M. Mirshahi from 2-UMRS 872, CRC-INSERM, Marie Curie University and University of Paris, France. Our collaboration focus in biomarkers metabonomic in patients with hepatitis B and liver cancer. Many other informal supporters from Europe, America, and Japan. They will provide the necessary level of expertise and knowledge in the area to achieve the tasks in this project.
In the project will be involved of 8 young specialists, they will actively participate in the aspects clinical, epidemiological and treatment hepatitis B and liver cancer ,in the international conferences, as well as the presentation of new projects for submission to the ISTC
