Prevalence of HCV among people who inject drugs in Brussels—a respondent-driven sampling survey

Abstract

Background: In Belgium, people who inject drugs (PWID) are at a high risk of being infected by hepatitis C (HCV) as injecting drug use is the main mode for transmission of HCV in Europe. Estimates about the number of people living with HCV in Belgium are rare and even less is known about the prevalence of HCV among PWID. Method: Between 1 February 2019 and 26 April 2019, PWID and high-risk opiate users (HROU) were recruited in Brussels through respondent-driven sampling (RDS). They were invited to a questionnaire and underwent a rapid HCV test. Results: A total of 253 respondents participated in the study, of which 168 were PWID and 238 were HROU, with 153 respondents belonging to both categories. The overall unweighted sample average for HCV antibodies was 41.1%. The weighted population estimates were 43.7% (95% CI 30.6-56.8%) for RDS-II and 43.4% (95% CI 28.9-58.0%) for RDS-SS. Conclusions: This prevalence is lower than the prevalence estimates reported elsewhere in Europe. However, the data still suggest that serious efforts are needed to reach the goal set by the WHO to reduce HCV by 2030 with 90%.

Identification and treatment of viral hepatitis C in persons who use drugs: a prospective, multicenter outreach study in Flanders, Belgium

“…The HCV Ab prevalence in our cohort (14.8%) was many times higher than in the general Belgian population (0.12%) [ 5 ]. If we only focus on the PWID in our population, the prevalence is comparable to a Belgian study in PWID and high-risk opiate users (39.2% vs.41.1%) [ 10 ]. Looking at the entire screened cohort, 6% were not aware of potential exposure to HCV infection.…”

“…In this study, an estimated HCV Ab prevalence of 30% was used. This is less than the estimated prevalence of HCV Ab in PWID [ 10 , 11 ], but we chose this conservative estimate, as we also included non-PWID. With a confidence interval (CI) of 95%, z is 1.96.…”

“…In Ireland and Madrid (Spain), 50% and 33% of the PWUD were exposed to an HCV infection [ 8 , 9 ]. A recent study estimated the HCV antibody (Ab) prevalence in Belgian people injecting drugs (PWID), a subpopulation of PWUD, at 41.1% [ 10 ]. However, no data on HCV Ab prevalence in the more general PWUD population are available for Belgium [ 11 ].…”

Snowball Sampling vs. Respondent Driven Sampling in Regional Research. Comparing the use of the Methods to Study Migrants Working in Elderly Care

“…The RDS method was used, among others, in the survey of jazz musicians (Heckathorn & Jeffri, 2001), drug addicts (Heckathorn et al, 2002), (Lisa G Johnston, Chen, Silva-Santisteban, & Raymond, 2013;Van Baelen, Plettinckx, Antoine, & Gremeaux, 2020), homosexuals (Khatib et al, 2017;Michaels, Pineau, Reimer, Ganesh, & Dennis, 2019), carriers of infectious diseases (Raymond et al, 2019), people taking the ecstasy pill (Wang et al, 2005), prostitutes (Simic et al, 2006;Carrillo, Rivera, & Braunstein, 2020;Hakim et al, 2020;Lisa Grazina Johnston, Sabin, Hien, & Huong, 2006) the homeless (Dankova, Bernard, & Vasat, 2019), women undergoing abortion (Gerdts et al, 2019), as well as among young people to estimate the risk associated with their participation in a car accident (Oscos-Sanchez et al, 2019).…”

Hepatitis C virus prevalence in Belgium

“…WHO defines HCV prevalence as the number and proportion of people living with a chronic HCV infection (HCV RNA positive or HCV antigen positive). In Belgium, the existing data on HCV prevalence focus on specific subpopulations (Van Baelen et al, 2020), are outdated (Beutels et al, 1997), limited to specific geographic areas (Beutels et al, 1997), or not representative because of the sampling method (Litzroth et al, 2019). In 2019, a metaanalysis of HCV prevalence studies performed between 2013 and 2019 estimated the HCV seroprevalence at 1.01% (95% CI 0.64-1.42%) and the viremic prevalence at 0.33% (95% CI 0.21-0.47%) (Muyldermans et al, 2019).…”