Viral hepatitis B and C are infectious diseases that affect the liver. When chronic, they can lead to liver fibrosis, cirrhosis, and liver cancer.
In Kazakhstan, the diagnosis, treatment, and ongoing medical monitoring of patients with viral hepatitis B and C are carried out in accordance with the legislation of the Republic of Kazakhstan, clinical protocols, and standards of medical care.
Certain types of examinations and medications are provided free of charge under the Guaranteed Volume of Free Medical Care (GVFMC) and the compulsory social health insurance (CSHI) system, subject to the established conditions.
This article explains where to seek medical assistance if hepatitis is suspected, how to undergo testing, obtain a referral to a specialist, and find out about eligibility for free treatment.
If examination results indicate signs of viral hepatitis B or C, consult a doctor at the outpatient clinic where you are registered.
A positive initial test result requires further examination to confirm the diagnosis.
Step-by-Step Procedure
Make an appointment with a general practitioner, district physician, or infectious disease specialist.
Provide any available laboratory test results.
If the enzyme-linked immunosorbent assay (ELISA) result is positive, undergo a polymerase chain reaction (PCR) test as prescribed by your doctor.
If the infection is confirmed, undergo additional examinations to assess liver health and disease activity.
Obtain a referral for a consultation with a gastroenterologist or infectious disease specialist.
Based on the examination results, the doctor will determine whether ongoing medical monitoring is necessary and whether antiviral therapy is indicated.
In accordance with the Standard for the Organization of Gastroenterological and Hepatological Care:
If the ELISA result is positive, a qualitative PCR test is prescribed within 10 working days.
If the qualitative PCR result is positive, the primary healthcare (PHC) doctor arranges the required additional examinations and a consultation with a relevant specialist within 20 working days.
If chronic viral hepatitis is confirmed, the patient's information is entered into the electronic registry of patients under dispensary observation.
Important! Not every patient diagnosed with chronic hepatitis B requires antiviral therapy immediately after diagnosis. The need for treatment is determined based on examination results. Modern treatments for hepatitis C can achieve a cure in most patients.
To receive planned medical care, you must contact the outpatient clinic where you are registered.
If you are not registered with a healthcare organization, submit an application for registration.
How to Register Through eGov.kz?
Sign in to the eGov.kz e-government portal.
Find the government service “Registration with a Medical Organization Providing Primary Healthcare.”
Select a healthcare organization in accordance with the established registration rules.
Complete the electronic application.
Submit your request and wait for the result.
A notification confirming your registration or a reasoned refusal will be sent to your personal account.
Once registered, you can make an appointment with a doctor and obtain referrals for the necessary medical examinations in accordance with the established procedure.
Important! If you experience symptoms requiring emergency medical care, do not delay seeking medical assistance until the registration process is completed.
In Kazakhstan, patients with chronic viral hepatitis B and C may receive medical care and antiviral medications free of charge under established government programs.
Who Is Eligible for Free Medications?
The List of Medicines Provided Free of Charge or at Reduced Cost for Outpatient Treatment includes medications for all categories of patients with the relevant diagnoses who are under ongoing medical monitoring, subject to medical indications.
What Requirements Must Be Met?
Undergo medical examinations and obtain confirmation of the diagnosis.
Be registered for ongoing medical monitoring in accordance with the established procedure.
Obtain a specialist's assessment confirming the need for antiviral therapy.
Obtain a doctor's prescription for medications included in the current approved list.
How Is Treatment Funded?
Medical care for patients with viral hepatitis is provided under the Guaranteed Volume of Free Medical Care (GVFMC) and the compulsory social health insurance (CSHI) system, depending on the type of medical service and the conditions under which it is provided.
Medication coverage is provided in accordance with the current List of Medicines Available Free of Charge or at Reduced Cost.
Important! A confirmed diagnosis does not automatically mean that antiviral medications must be prescribed. The decision to initiate treatment, select a medication, and determine the duration of therapy is made by a doctor based on medical indications.
If viral hepatitis B or C is suspected, the doctor prescribes examinations to confirm the infection, assess liver health, and determine the appropriate treatment plan.
What Tests May Be Required?
Blood tests for hepatitis B and C viral markers.
Polymerase chain reaction (PCR) testing to confirm the presence of the virus.
Complete blood count, including platelet count.
Biochemical blood tests, including ALT, AST, and bilirubin levels.
Quantitative measurement of viral load.
Ultrasound examination of the abdominal organs.
Assessment of the degree of liver fibrosis, including elastography (FibroScan), if medically indicated.
Additional tests as prescribed by the doctor.
How to Obtain a Referral?
Consult a primary healthcare (PHC) doctor and provide any available test results.
Undergo the prescribed examinations.
Obtain a referral for a consultation with a gastroenterologist or infectious disease specialist.
If chronic viral hepatitis is confirmed, clarify the procedure for registration for ongoing medical monitoring.
Important! The list of required tests depends on the type of hepatitis, initial test results, and the patient's health condition. Not all the listed examinations are mandatory for every patient.
Patients with chronic viral hepatitis B and C who are under ongoing medical monitoring undergo periodic examinations to assess liver health and monitor disease progression.
What Tests May Be Prescribed?
Biochemical indicators of liver function, including ALT and AST levels.
Complete blood count, including platelet count.
Viral load testing using the PCR method.
Ultrasound examination of the abdominal organs.
Assessment of the degree of liver fibrosis.
Additional tests based on medical indications.
How Often Should Tests Be Performed?
The frequency of medical monitoring and laboratory testing is determined by the current regulations on ongoing medical monitoring and clinical protocols.
The doctor develops an individualized examination plan, taking into account the type of hepatitis, infection activity, degree of liver damage, ongoing treatment, and any coexisting medical conditions.
Important! Patients should not determine the frequency of PCR testing or other examinations on their own. Monitoring schedules differ for hepatitis B and C, and additional tests may be required during antiviral therapy.
Antiviral medications are used to treat chronic viral hepatitis B and C. These medications are prescribed by a doctor based on clinical protocols, examination results, and medical indications.
Treatment of Hepatitis C
The current List of Medicines Provided Free of Charge or at Reduced Cost for Outpatient Treatment includes:
sofosbuvir and velpatasvir;
ribavirin.
Treatment of Hepatitis B
The current list includes:
tenofovir disoproxil;
tenofovir alafenamide;
peginterferon alfa-2a.
How to Obtain Medications Free of Charge?
Confirm your diagnosis and undergo the necessary medical examinations.
Register for ongoing medical monitoring.
Obtain a specialist's assessment and a treatment prescription.
Contact your healthcare organization to clarify the procedure for obtaining a prescription and receiving the prescribed medication.
Important! The listed medications are not interchangeable. Only a doctor can determine the treatment regimen, dosage, and duration of therapy. Patients must not start or discontinue antiviral therapy on their own.
Viral hepatitis C is primarily transmitted through contact with infected blood.
There is currently no vaccine against hepatitis C.
How Can You Reduce the Risk of Infection?
Do not share razors, toothbrushes, manicure tools, or other personal items that may have traces of blood on them.
When getting tattoos, piercings, or cosmetic procedures, choose establishments that comply with sanitary requirements.
Make sure that sterile or single-use instruments are used during medical procedures.
Use personal protective equipment when assisting someone who is bleeding.
If you have risk factors for infection, consult a doctor to get tested for viral hepatitis C.
Important! Hepatitis C is not transmitted through everyday social contact, handshakes, hugs, or sharing food. If the infection is confirmed, consult a doctor to determine the appropriate treatment plan.
Viral hepatitis B can be transmitted through blood and other bodily fluids, including through sexual contact, as well as from mother to child during childbirth.
Main Preventive Measures
1. Vaccination
Vaccination is the primary method of preventing viral hepatitis B.
Vaccinations are administered in accordance with the National Immunization Schedule of the Republic of Kazakhstan and medical indications.
2. Personal Hygiene
Do not share razors, toothbrushes, manicure tools, or other personal items that may have traces of blood on them.
3. Safety of Medical and Cosmetic Procedures
Choose healthcare facilities and cosmetic service providers that comply with sanitary requirements for instrument sterilization and infection prevention.
4. Prevention of Sexual Transmission
Using barrier methods of contraception reduces the risk of transmitting the infection.
5. Screening During Pregnancy
Pregnant women must undergo the prescribed medical screening tests for viral hepatitis B.
If an infection is detected, healthcare professionals determine the necessary measures to prevent transmission of the virus to the child.
Important! If you come into contact with the blood of a person infected with hepatitis B virus, seek medical attention promptly to assess the need for emergency preventive measures.