Prevalence of hepatitis C infection among the general population and high-risk groups in the EU/EEA: A systematic review update

Abstract

Background: Although significant improvement in efficacy measured by a sustained virological response, the high acquisition costs of direct-acting antivirals limit the access for patients and influence the costs of healthcare resource utilisation in hepatitis C. It is important to have the latest estimates of prevalence, especially in high-risk groups, for cost of illness, cost-effectiveness and budget impact studies. Methods: Original studies on the estimates of the prevalence among general and high-risk populations in the European Union/European Economic Area (EU/EEA) were retrieved from Medline and Embase for the period from 2015 to 2018. All included studies were evaluated for risk of selection bias and summarised together in a narrative form. Results from previous reviews and updated searches were compared per country among different populations, respectively. Results: Among the 3871 studies identified, 46 studies were included: 20 studies were used for the estimate of the general population; 3 for men who have sex with men (MSM); 6 for prisoners; and 17 for people who inject drugs (PWID). Compared with the results reported in previous systematic reviews, the updated estimates were lower than previously in most available countries. Anti-HCV general population prevalence estimates ranged from 0.54% to 1.50% by country. The highest prevalence of anti-HCV was found among PWID (range of 7.90% - 82.00%), followed by prisoners (7.00% - 41.00%), HIV-positive MSM (1.80% - 7.10%), HIV-negative MSM (0.20% - 1.80%), pregnant women (0.10% - 1.32%) and first-time blood donors (0.03% - 0.09%). Conclusions: Our study highlights the heterogeneity in anti-HCV prevalence across different population groups in EU/EEA. The prevalence also varies widely between European countries. There are many countries that are not represented in our results, highlighting the need for the development of robust epidemiological studies.

Infection with hepatitis C virus in hemodialysis patients: An overview of the diagnosis and prevention rules within a hemodialysis center (Review)

“…Among patients with cirrhosis, there is: 1-5% annual risk of hepatocellular carcinoma and 3-6% annual risk of hepatic decompensation, for which the risk of death in the following year is 15-20% (20)(21)(22). It is estimated that worldwide 71 million individuals are infected with HCV, a great number of patients dying each year of HCV-related complications (23). HCV infection becomes chronic in a considerable proportion of patients (~75% of cases) (23).…”

“…HCV infection becomes chronic in a considerable proportion of patients (~75% of cases) (23). Among these, 27% are diagnosed with liver cirrhosis and 25% with liver carcinoma, 20 years after acquiring the infection (23,24).…”

Uptake and predictors of direct-acting antiviral treatment for hepatitis C among people receiving opioid agonist therapy in Sweden and Norway: a drug utilization study from 2014 to 2017

“…The differences between Sweden and Norway are interesting and relevant for other settings. Prevalence of anti-HCV among PWIDs seems consistently higher in Sweden compared to Norway [35,36]. Coverage of OAT is higher in Norway than Sweden.…”

SeXY chromosomes and the immune system: reflections after a comparative study

“…Men and women differ in their susceptibility to infectious diseases [1][2][3][4], response to vaccines [5], and autoimmune diseases [6,7]. Though behavioural differences partly explain sex bias in infection susceptibility [8], sex differences in the immune response in animal models under controlled laboratory conditions indicate the role of biological differences [9]. Thus, a sex bias in the immune system seems at least as important.…”