BACKGROUND AND AIM Decisions on public health issues are dependent on reliable epidemiological data. A comprehensive review of the literature was used to gather country-specific data on risk factors, prevalence, number of diagnosed individuals and genotype distribution of the hepatitis C virus (HCV) infection in selected European countries, Canada and Israel. METHODOLOGY Data references were identified through indexed journals and non-indexed sources. In this work, 13,000 articles were reviewed and 860 were selected based on their relevance. RESULTS Differences in prevalence were explained by local and regional variances in transmission routes or different public health measures. The lowest HCV prevalence (â?¤ 0.5%) estimates were from northern European countries and the highest (â?¥ 3%) were from Romania and rural areas in Greece, Italy and Russia. The main risk for HCV transmission in countries with well-established HCV screening programmes and lower HCV prevalence was injection drug use, which was associated with younger age at the time of infection and a higher infection rate among males. In other regions, contaminated glass syringes and nosocomial infections continue to play an important role in new infections. Immigration from endemic countries was another factor impacting the total number of infections and the genotype distribution. Approximately 70% of cases in Israel, 37% in Germany and 33% in Switzerland were not born in the country. In summary, HCV epidemiology shows a high variability across Europe, Canada and Israel. CONCLUSION Despite the eradication of transmission by blood products, HCV infection continues to be one of the leading blood-borne infections in the region.

https://onlinelibrary.wiley.com:443/doi/pdf/10.1111/j.1478-3231.2011.02539.x

A systematic review of hepatitis C virus epidemiology in Europe, Canada and Israel.

Background: Hepatitis C virus (HCV) infection is associated with chronic progressiveliver disease. Its global epidemiology is still not well ascertained and its impact will beconfrontedwithahigher burden inthenextdecade. Aim: The goalofthisstudywastodevelop a tool that can be used to predict the future prevalence of the disease indifferent countries and, more importantly, to understand the cause and effect relation-ship between the key assumptions and future trends. Methods: A system approach wasused to build a simulation model where each population was modeled with theappropriate inﬂows and outﬂows. Sensitivity analysis was used to identify the keydrivers of future prevalence. Results: The total HCV-infected population in the USwasestimated to decline 24% from 3.15 million in 2005 to 2.47 million in 2021, whilediseaseburdenwillincreaseastheremaininginfectedpopulationages.Duringthesameperiod, the mortality rate was forecasted to increase from 2.1 to 3.1%. The diagnosedpopulation was 50% of the total infections, while less than 2% of the total infectionswere treated. Conclusion: We have created a framework to evaluate the HCV-infectedpopulations in countries around the world. This model may help assess the impact ofpoliciestomeetthechallengespredictedbytheevolutionofHCVinfectionanddisease.This prediction tool may help to target new public health strategies.Hepatitis C virus (HCV) infection is associated with chronic,progressive liverdisease. Chronic hepatitis C is a leading cause ofcirrhosis and hepatocellular carcinoma (HCC) (1, 2), and thelatter two are a major indication for liver transplantation (3). Abetterunderstandingof HCVinfectionprevalence anditsmodel-ling can help medical communities and government agenciesmanage the disease burden and develop treatment strategies inlight of the emergence of several potentanti-HCV therapies.Considerable work has been undertaken to forecast theepidemiology of hepatitis C and numerous authors have devel-oped Markov models to estimate the disease burden (4–16).However, these models have limitations resulting from theassumption that the studied cohorts remain homogeneous andtraverse through different statesat a ﬁxed rate over time when, inreality, populations are very heterogeneous (17). Other investiga-tors have developed multicohortnaturalhistory models (17), butallforecastsarecomplicatedbyavailabilityanduncertaintyofkeyinputs, especially outside a few well-studied countries.We addressed this problem by using a system approach tobuildasimulationmodel.Inthismethod,eachpopulationgroup

The global health burden of hepatitis C virus infection

BackgroundPeople 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.AimWe conducted a systematic review in order to find prevalence and incidence estimates in these populations in the European Union/European Economic Area (EU/EEA).MethodsOriginal research articles published between January 2005 and February 2017 were retrieved from PubMed and Embase in February 2017.ResultsFifty-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.ConclusionsPLHIV, 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.

/pdf/hepatitis-b-and-c-prevalence-and-incidence-in-key-population-54wbxl3c7l.pdf

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

https://doi.org/10.1016/s2468-1253(23)00018-3

Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis.

Monitoring infections and risk in people who inject drugs (PWID) is important for informing public health responses. In 2011, a novel hepatitis C antibody (anti-HCV) avidity-testing algorithm to identify samples compatible with recent primary infection was introduced into a national surveillance survey. PWID are recruited annually, through >60 needle-and-syringe programmes and prescribing services. Of the 980 individuals that could have been at risk of HCV infection, there were 20 (2%) samples that were compatible with recent primary infection. These were more common among: those imprisoned ⩾5 times [8/213; adjusted odds ratio (aOR) 8·7, 95% confidence interval (CI) 2·04-37·03]; women (8/230; aOR 3·8, 95% CI 1·41-10·38); and those ever-infected with hepatitis B (5/56; aOR 6·25, 95% CI 2·12-18·43). This study is the first to apply this algorithm and to examine the risk factors associated with recently acquired HCV infection in a national sample of PWID in the UK. These findings highlight underlying risks and suggest targeted interventions are needed.

Factors associated with recently acquired hepatitis C virus infection in people who inject drugs in England, Wales and Northern Ireland: new findings from an unlinked anonymous monitoring survey.

(Accepted 7 November 2008; ﬁrst published online 23 December 2008)SUMMARYSurveillance reports and prevalence studies have indicated that injecting drug users (IDUs)contribute more to the hepatitis C epidemic in the United Kingdom than any other risk group.Information on both the prevalence and incidence of hepatitis C in IDUs is therefore essential tounderstanding the epidemiology of this infection. The prevalence of hepatitis C in specimens fromthe Unlinked Anonymous Prevalence Monitoring Programme collected in 1995, 1996, 1998, 1999,2000, and 2001 was determined using residual syphilis serology specimens from IDUs attending15 genitourinary medicine (GUM) clinics in and outside London. These specimens were tested forantibodies to hepatitis C virus (anti-HCV). Using this cross-sectional design, anti-HCV-negativespecimens were tested for HCV RNA to identify incident infections during the ‘window’ period ofinfection, and thus to estimate HCV incidence. Results of the multivariable analysis showed thatthere was marked variation in prevalence by clinic (P<0.0001) and age (P<0.0001). Overall themajority of infections were in males and the overall prevalence in injectors declined over the studyperiod from 36.9%to28.7%. The annual incidence in these injectors was estimated as being 3.01%(95% CI 1.25–6.73). Over the study period HCV incidence decreased by 1.2% per year. Genotypingof the incident infections identiﬁed the most common genotype as type 1 with type 3 being morefrequently seen after 1998. Of the prevalent infections, genotype 1 was the most common. The studyhas conﬁrmed a higher prevalence of anti-HCV in IDUs in the London area compared to thoseoutside London. How representative of the current injecting drug user population are IDUsattending GUM clinics is unclear. Even so, such studies allow prevalence and incidence to beestimated in individuals who have ever injected drugs and inform ongoing public health surveillance.Key words: Genotype, hepatitis C virus, incidence, injecting drug users, prevalence, windowperiod infections.INTRODUCTIONNational surveillance indicates that most diagnosedhepatitis C virus (HCV) infections in England andWales are in current or ex-injecting drug users (IDUs)[1, 2]. It is therefore important to obtain accurateestimates of the incidence and prevalence of HCVinfection in IDUs. A number of studies in IDUs inthe United Kingdom, have found evidence of HCVinfection in 30–60% of injectors [3–5]. There are,however, no proven laboratory markers of recently

Prevalence and incidence of hepatitis C in injecting drug users attending genitourinary medicine clinics.

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Prevalence and incidence of hepatitis C in injecting drug users attending genitourinary medicine clinics.