Hepatitis C Virus Infection in Scotland: Epidemiological Review and Public Health Challenges

Hutchinson, Sharon J.; Roy, K.; Wadd, Sarah; Sm, Bird; Taylor, A; Anderson, Ellen Zambo; Shaw, L.; Codere, G; Goldberg, D.

doi:10.1258/rsmsmj.51.2.8

Cited by 67 publications

(62 citation statements)

References 46 publications

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“…As a result of improved blood transfusion safety serotypes associated with blood transfusions are being replaced by other serotypes especially those related to injecting drug use [44]. Prisoners often have prevalence rates of antibodies to HCV comparable to those of IDUs due to a high proportion of IDUs among this group [46][47][48][49][50][51][52][53][54]. In Germany, Spain and in UK the anti-HCV prevalence in sex workers ranged from 0.7 to 9.0 %; with the lowest estimate in Germany [20,23,24].…”

Section: T a B L E 4 Characteristics Of Hepatitis C Surveillance Systmentioning

confidence: 99%

Surveillance and epidemiology of hepatitis B and C in Europe – a review

2008

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Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are frequent causes of acute and chronic hepatitis worldwide and leading causes for hepatic cirrhosis and cancer. There is a distinct geographical variation in HBV and HCV incidence and prevalence in the European Union (EU) and European Economic Area/European Free Trade Association (EEA/EFTA) member states and neighbouring countries. The HBV carrier prevalence ranges from 0.1 to 8.0% and that of HCV from 0.1 to 6.0%. Within the last few years, the HBV incidence has decreased while the HCV incidence has increased. Both diseases are concentrated in certain subpopulations, such as injecting drug users, with tens of times higher prevalence than in the general population. Most EU and EEA/EFTA countries have a surveillance system for HBV and HCV infections, but due to differences in system structures, reporting practices, data collection methods and case definitions used, the surveillance data are difficult to compare across countries. The harmonisation and strengthening of HBV and HCV surveillance at the European level is of utmost importance to obtain more robust data on these diseases.

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Section: T a B L E 4 Characteristics Of Hepatitis C Surveillance Systmentioning

confidence: 99%

Surveillance and epidemiology of hepatitis B and C in Europe – a review

2008

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“…To date, there is no available vaccine for HCV prevention. Hence, identifying the probable routes of transmission and eliminating them, including dental treatment is an important way to reduce HCV infection [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Is dental extraction a risk factor for contracting HCV infection: Abs, RNA and genotype detection

Al-Kubaisy¹,

Al-Naggar²,

Ibrahim³

et al. 2014

Oral Biol Dent

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Background: The medical risk factor associated with hepatitis C virus (HCV) infection such as blood transfusion and surgery had been intensely studied in many countries. Up to 40% of patients infected with HCV may have non identifiable routes of viral acquisition. Dental extraction may be one of these risk factors. The purpose of the present study was to determine the existence of infection and the predominated HCV genotype among subjects with dental extraction. Material and methods: A case-control study involving pregnant women with and without history of dental extraction (n=776, n=2715, respectively). HCV antibodies (anti-HCV) were tested using subsequently third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia Tek-111). In addition 94 serum samples were subjected to molecular analysis using RT-PCR and DNA enzyme immunoassay (DEIA) method for HCV-RNA and genotypes. Results: Anti-HCV seroprevelance was significantly higher (6.3%) among cases with dental extraction (cases) than their counter control group (control) (2.63%) (p=0.00001). Dental extraction act as a risk factor for HCV infection (OR=2.73; 95% CI=1.8-3.9). HCV-RNA was found to be significantly higher (74.6%) in cases than (38.7%) control group (p=0.0016). No significant association between HCV genotypic and the history of tooth extraction but HCV-1b showed higher rate (90%) among dental extraction cases. Conclusion: Our study showed that dental extraction acts as a risk factor for acquiring HCV. Complete sterilization and cleaning of equipment is necessary.

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“…It is estimated that half of the infected patients in Scotland remain undiagnosed. 2 The treatment for the infection following its discovery in 1991 was initially standard interferon with very poor rates of SVR, which equates to a cure, in the order of 10%. The addition of daily ribavirin to standard interferon improved the SVR rates to around 30% for genotype 1, which is the most difficult genotype to treat.…”

Section: Opinionmentioning

confidence: 99%

Boceprevir for previously treated chronic hepatitis C virus genotype 1 infection

Bathgate¹

2011

J R Coll Physicians Edinb

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sUmmARyThis paper reports the important results of the RESPOND-2 trial and is accompanied in the same issue by the report of the SPRINT-2 trial investigating the use of boceprevir for untreated chronic hepatitis C virus (HCV) genotype 1 infection. The RESPOND-2 trial recruited 403 patients who had either no response to interferon previously or had no circulating virus at the end of treatment but then relapsed within the first 24 weeks of stopping therapy.Following randomisation all patients had a lead-in period of four weeks of pegylated (PEG-) interferon alpha-2b and weight-based ribavirin (800-1,400 mg). After the lead-in period three groups were treated in a 1:2:2 ratio. Group 1 received a further 44 weeks of PEG-interferon and ribavirin plus placebo. Group 2 received response guided therapy with boceprevir 800 mg three times daily plus PEG-interferon and ribavirin for 32 weeks if they had undetectable virus at weeks eight and 12. For individuals with detectable virus at week eight and undetectable virus at week 12, PEG-interferon and ribavirin were given for a further 12 weeks. Group 3 received 44 weeks of boceprevir 800 mg three times daily and PEG-interferon and ribavirin. Any patients with detectable virus at week 12 discontinued treatment.The proportion of relapsers in each group was around 65% with around 20% in each group having significant fibrosis or cirrhosis. The viral load was high in over 80% of patients in all groups. The sustained virological response (SVR) was 21% in group 1, 59% in group 2 and 66% in group 3 which is a highly significant result for comparisons between the boceprevir groups and group 1 (p<0.001). Those with prior relapse had better response rates than those with prior non-response and patients who had a reduction in HCV RNA levels by greater than 1 log at week four (good response) had a substantially better outcome than those with a poor interferon response.Viral breakthrough in the treatment arms, indicating probable resistance, was only 5%. There was an increase in anaemia in the treatment groups compared with group 1 (45% vs 20%). This however resulted in discontinuation in only 3% of group 3 patients. OpINIONChronic hepatitis C infection affects over 200 million people worldwide. It is the leading indication for liver transplantation both in the United States and Europe and has a prevalence in the United Kingdom of around 0.5%. It is estimated that half of the infected patients in Scotland remain undiagnosed. 2The treatment for the infection following its discovery in 1991 was initially standard interferon with very poor rates of SVR, which equates to a cure, in the order of 10%. The addition of daily ribavirin to standard interferon improved the SVR rates to around 30% for genotype 1, which is the most difficult genotype to treat. From early in the last decade the standard of care became PEGinterferon with ribavirin, which increased response rates to over 40% in genotype 1 and over 70% in genotypes 2 and 3.Until this year there has been no real prospect of offering any re...

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Hepatitis C Virus Infection in Scotland: Epidemiological Review and Public Health Challenges

Cited by 67 publications

References 46 publications

Surveillance and epidemiology of hepatitis B and C in Europe – a review

Surveillance and epidemiology of hepatitis B and C in Europe – a review

Is dental extraction a risk factor for contracting HCV infection: Abs, RNA and genotype detection

Boceprevir for previously treated chronic hepatitis C virus genotype 1 infection

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