Estimating the treatment cascade of chronic hepatitis B and C in Greece using a telephone survey

Abstract

SUMMARY. Accurate diagnosis and treatment rates for chronic hepatitis B (HBV) and C virus (HCV) infections are usually missing. Aim of this study was to estimate the HBV and HCV treatment cascade (proportion and absolute numbers of tested, aware/unaware, infected and treated) in Greek adults. A telephone survey was conducted in a sample representative of the Greek adult general population. Prevalence rates were age-standardized for the Greek adult population and corrected for high-risk individuals not included in the survey. Of the 9974 participants, 5255 (52.7%) had been tested for HBV and 2062 (20.7%) for HCV with the proportion varying according to age and being higher in middle-age groups (P < 0.001). HBsAg was reported positive in 111/5255 (2.11%) and anti-HCV in 26/2062 (1.26%) tested cases. The age-adjusted prevalence was estimated to be 2.39% for HBV and 1.79% for HCV. Taking into account individuals at high risk for viral hepatitis not included in the survey, the 'true' prevalence was estimated to be 2.58% for HBV and 1.87% for HCV. Anti-HBV and anti-HCV treatment had been taken by 36/ 111 (32.4%) chronic HBV and 15/26 (57.7%) chronic HCV patients. In conclusion, almost 50% of chronic HBV and 80% of chronic HCV patients in Greece may be unaware of their infection, while only 32% or 58% of diagnosed chronic HBV or HCV patients, respectively, have been ever treated. Therefore, intensive efforts are required to improve the efficacy of screening for HBV and particularly for HCV as well as to reduce the barriers to treatment among diagnosed patients.

Historical epidemiology of hepatitis C virus (HCV) in select countries – volume 2

“…Estimates for prevalence were based upon data reported from a 2012 nationally representative phone survey conducted among Greek adults 18–70 years of age . Prevalence rates were age‐standardized and corrected for high‐risk populations not included in the survey.…”

“…According to a previous study , 58% of diagnosed chronic HCV patients have ever been treated. This corresponds to approximately 15 700 treated patients through 2011.…”

“…Russia has regional registries, and work is underway to consolidate data across the country. Greece recently used an innovative technique of using a randomized national phone survey to quantify the diagnosis rate in the country . Although the method has some limitations, it does provide a quick technique to quantify diagnosis rates in countries where central registries are not available.…”

Strategies to manage hepatitis C virus (HCV) infection disease burden – volume 2

“…The prevalence rate of chronic HCV infection in Greece is among the highest in Western Europe, and the burden of infection is increasing . However, approximately 80% of individuals have never been tested for HCV, and among those diagnosed, 40% have not received treatment . With an older infected population, treatment with new therapies showed a modest decrease (25%) on HCV‐related mortality with no change in treatment structure.…”

Α Cost of Illness Analysis of Hepatitis B Virus Infection in Greece

“…The present analysis suggests that HBV is a costly disease for Greece; at a per patient average annual direct cost of 1,822.5 Euros -a cost that increases almost three-fold in the presence of cirrhosis -the total expenditure attibutable to the disease for an estimated prevalence of 1.05% for known cases would be 211 million Euros or 2.4% of the country's total public expenditure on health [8].…”