Hepatitis B and C prevalence and incidence in key population groups with multiple risk factors in the EU/EEA: a systematic review

Abstract

Background People living with HIV (PLHIV) and people in prison are population groups with a potentially high risk and/or prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Aim We conducted a systematic review in order to find prevalence and incidence estimates in these populations in the European Union/European Economic Area (EU/EEA). Methods Original research articles published between January 2005 and February 2017 were retrieved from PubMed and Embase in February 2017. Results Fifty-two articles were included, providing 97 estimates of HBV/HCV infection prevalence or incidence. Estimates of HBV infection prevalence ranged between 2.9% and43.4% in PLHIV and 0.0% and 25.2% in people in prison. Estimates of HCV infection prevalence ranged from 2.9% to 43.4% in PLHIV and 0.0% to 25.2% in people in prison. Incidence estimates ranged between 0.0 and 2.5 cases per 100 person-years for HBV infection in PLHIV. No such data was available for people in prison. HCV infection incidence ranged between 0.3 and 0.9 cases per 100 person-years in PLHIV and between 1 and 1.2 cases per 100 person-years in people in prison. Prevalence estimates were generally higher than in the general population, especially for HCV infection and among groups with multiple risk factors. Conclusions PLHIV, people in prison and groups with multiple risk factors, have a high prevalence of HBV and HCV and may be at ongoing risk of infection. These groups should be among the populations prioritised and targeted for active case finding and prevention programmes in the EU/EEA.

HCV micro‐elimination in two prisons in Milan, Italy: A model of care

“…In order to achieve the global goal of HCV elimination, as set forward by the WHO, certain population groups with high burden of disease would need to be targeted and prioritized for adequate interventions 3 People in prison are certainly one of those, due to the increased risk of acquisition and high prevalence of disease that characterize this population. 5,23,24 In this context, our study showed how a targeted and well-implemented HCV test-and-treat intervention in prison was feasible and effective in achieving micro-elimination, in two large institutions in Italy. We assessed the impact of such intervention over the period of two years in a jail (SV), characterized by high turnover, and a prison for sentenced individuals (OP).…”

“…among incarcerated PWID was in fact significantly higher, confirming previous observation. 4 HCV burden among women was also elevated as compared to men. This gender difference can be attributed to the F I G U R E 3 Cascade of treatment for study population in 2018.…”

“…27 Finally, HIV infection was significantly associated with HCV positivity, highlighting the complexity of health needs of the incarcerated population, as reported also elsewhere. 4,30 On the contrary, prevalence of HBV chronic infection, if higher in comparison with general population, 5 From a public health stance, our approach has the intrinsic added value of addressing and responding to the health needs of those population groups who are mostly deprived and less inclined to access specialized services when in the community. 32 In particular, fast-tracking treatment for people in prison could be an effective strategy to address the larger and less easily identifiable population of PWID.…”

“…haemophilic, patients with advanced liver disease, HIV-positive people) as well as people in prison, people with current/previous history of drug use, selected migrant communities based on epidemiological context of country of origin and men who have sex with men. 3 In EU/EEA countries, the prevalence of HCV infection among people in prison is considerably higher than in the general population, 4 ranging from 4.9% to 86.3% against a prevalence from 0.1% to 5.9%. 4,5 Such difference reflects the synergic effect of multiple and overlapping risk factors in the prison population 4,6 : people with a history of injecting drug use, psychiatric patients and other vulnerable populations who have often reduced access to health care are overrepresented in prison.…”

Hepatitis C Virus among Female Sex Workers: A Cross-Sectional Study Conducted along Rivers and Highways in the Amazon Region

“…Sexual transmission of HCV is well known in high-risk groups, such as MSM, PWID, and human immunodeficiency virus (HIV)-infected individuals [47][48][49][50][51]. The sexual transmission of HCV is supported by the isolation of HCV RNA from semen and cervical smears [33,[52][53][54], and also by the investigation and genetic identification of the same HCV strain in some cases of infected persons who had unprotected sex [32,33,[55][56][57].…”