547 Epidemiology and natural course of hepatitis C in Greece: Results of the nationwide HEPNET Greece cohort study

Rantonoulou, M.; Tzoumakliotis, D.; Nikolopoulou, Georgia; Skoutelis, Athanasios; Dalekos, Georgios N.; Dimopoulou, Maria; Angelidou, Konstantia; Avgerinos, Andreas; Chatiis, G.; Manolakopoulos, Spilios

doi:10.1016/s0168-8278(06)80547-7

Cited by 23 publications

(47 citation statements)

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“…Genotype 3 predominates in Greece [106], [129], [130], [133], [134], Poland [139] and Slovenia [141] and is common in Austria [120], Belgium [91], France [103], [125] and Italy [136], [137]. Subtype 3a dominates in Belgium [92], Cyprus [96] and France [102], [124].…”

Section: Resultsmentioning

confidence: 99%

Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

et al. 2014

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BackgroundPeople who inject drugs (PWID) are a key population affected by hepatitis C virus (HCV). Treatment options are improving and may enhance prevention; however access for PWID may be poor. The availability in the literature of information on seven main topic areas (incidence, chronicity, genotypes, HIV co-infection, diagnosis and treatment uptake, and burden of disease) to guide HCV treatment and prevention scale-up for PWID in the 27 countries of the European Union is systematically reviewed.Methods and FindingsWe searched MEDLINE, EMBASE and Cochrane Library for publications between 1 January 2000 and 31 December 2012, with a search strategy of general keywords regarding viral hepatitis, substance abuse and geographic scope, as well as topic-specific keywords. Additional articles were found through structured email consultations with a large European expert network. Data availability was highly variable and important limitations existed in comparability and representativeness. Nine of 27 countries had data on HCV incidence among PWID, which was often high (2.7-66/100 person-years, median 13, Interquartile range (IQR) 8.7–28). Most common HCV genotypes were G1 and G3; however, G4 may be increasing, while the proportion of traditionally ‘difficult to treat’ genotypes (G1+G4) showed large variation (median 53, IQR 43–62). Twelve countries reported on HCV chronicity (median 72, IQR 64–81) and 22 on HIV prevalence in HCV-infected PWID (median 3.9%, IQR 0.2–28). Undiagnosed infection, assessed in five countries, was high (median 49%, IQR 38–64), while of those diagnosed, the proportion entering treatment was low (median 9.5%, IQR 3.5–15). Burden of disease, where assessed, was high and will rise in the next decade.ConclusionKey data on HCV epidemiology, care and disease burden among PWID in Europe are sparse but suggest many undiagnosed infections and poor treatment uptake. Stronger efforts are needed to improve data availability to guide an increase in HCV treatment among PWID.

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Section: Resultsmentioning

confidence: 99%

Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

et al. 2014

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“…In our sub-group analysis, inclusive of 23 studies with direct comparison between genders, with a total of 3,211 HCV-4 patients [2,322 (72%) males and 889 (28%) females], we did not observe a significant difference in SVR rates between the two genders. The ratio of males to females likely demonstrates a male treatment bias since the frequency of HCV-4 is similar for both genders based on several epidemiological studies [113–115]. …”

Section: Discussionmentioning

confidence: 99%

Meta-analysis

Yee

Nguyen

Zhang

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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Background The burden of hepatitis C virus genotype 4 (HCV-4) is high in Africa and East Mediterranean countries. Previous reports estimate sustained virologic response (SVR) rates in HCV-4 to be ~20–70%. However, many of these studies are limited by different study designs and small sample sizes. Aim Our aim was to evaluate treatment outcome and host/viral factors on SVR in HCV-4 patients treated with pegylated interferon and ribavirin (PEG IFN+RBV) in a systematic and quantitative fashion. Methods A comprehensive literature search in MEDLINE and EMBASE for ‘genotype 4’ was conducted in November 2013. Abstracts from AASLD, APASL, DDW, and EASL in 2012/2013 were reviewed. Inclusion criteria were original studies with ≥25 treatment-naïve HCV-4 patients treated with PEG IFN+RBV. Exclusion criteria were co-infection with HIV, HBV, or other genotypes. Effect sizes were calculated using random-effects models. Heterogeneity was determined by Cochrane Q-test (p-value <0.05) and I-squared statistic (>50%). Results We included 51 studies (11,102 HCV-4 patients) in the primary analysis. Pooled SVR was 53% (95% CI: 50–55%) (Q-statistic = 269.20, p<0.05; I2 = 81.43). On sub-group analyses, SVR was significantly associated with lower viral load, OR 3.05 (CI 1.80–5.17, p<0.001); mild fibrosis, OR 3.17 (CI 2.19–4.59, p<0.001); and favorable IL28B polymorphisms, rs12979860 CC versus CT/TT, OR 4.70 (CI 2.87–7.69, p<0.001), and rs8099917 TT versus GT/GG, OR 5.21 (CI 2.31–11.73, p<0.001). Conclusions HCV-4 patients treated with PEG IFN+RBV may expect SVR rate of ~50%. Lower viral load, mild fibrosis, and favorable IL28B (rs12979860 CC and rs8099917 TT) are positively associated with SVR.

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“…These fi ndings are consistent with a study performed in Greece that followed hematology service facilities in the country during the years 1997-2006, and revealed that the vast majority of hepatitis C infected intravenous drug users were men with an average age of 33.7 years, and that hepatitis C had been acquired less than 20 years ago in one of every two such individuals. This study suggests that there will soon be a considerable increase in young patients with cirrhosis, liver failure, and hepatocellular carcinoma (38) . Co-infection of individuals with hepatitis C virus and HIV is very common (39) .…”

Section: Methodsmentioning

confidence: 73%

Incidence of hepatitis C in Brazil

Hanus

Ceretta

Simões

et al. 2015

Rev. Soc. Bras. Med. Trop.

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Introduction: Hepatitis C is a public health problem of global dimensions, affecting approximately 200 million people worldwide. The main objective of this study was to estimate the incidence rate of hepatitis C in Brazil during the period between 2001 and 2012. Methods: An epidemiological, temporal, and descriptive study was performed using data from the Information System for Reportable Diseases. Results: Between 2001 and 2012, a total of 151,056 hepatitis C cases were recorded, accounting for 30.3% of all hepatitis notifi cations in Brazil. The average gross coeffi cient for the analysis period was 6.7 new cases per 100,000 inhabitants. The regions with the highest rates were the Southeast region (8.7 new cases/100,000 inhabitants) and the South (13.9 new cases/100,000 inhabitants). There was a predominance of men with respect to the incidence rate (8.0 new cases/100,000 inhabitants) compared to women (5.5 new cases/100,000 inhabitants). Injection drug use was the most common source of infection, and members of the white race, residents of urban areas, and those aged 60 to 64 years had the highest incidences. Conclusions: Over the last 10 years, the incidence of hepatitis C in Brazil has increased, mainly in the South and Southeast. The adoption of fast, accurate diagnostic methods, together with epidemiological awareness, can facilitate early intervention measures for adequate control of the disease.

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547 Epidemiology and natural course of hepatitis C in Greece: Results of the nationwide HEPNET Greece cohort study

Cited by 23 publications

References 0 publications

Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

Meta-analysis

Incidence of hepatitis C in Brazil

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