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

Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Liver international: official journal of the International Association for the Study of the Liver (Impact Factor: 4.85). 07/2011; 31 Suppl 2(2):30-60. DOI: 10.1111/j.1478-3231.2011.02539.x
Source: PubMed


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.
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.
Differences in prevalence were explained by local and regional variances in transmission routes or different public health measures. The lowest HCV prevalence (≤ 0.5%) estimates were from northern European countries and the highest (≥ 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.
Despite the eradication of transmission by blood products, HCV infection continues to be one of the leading blood-borne infections in the region.

Download full-text


Available from: Homie A Razavi
  • Source
    • "We will discuss some of these shortcomings below. Even more patchy is the evidence concerning the disease burden , although recent studies have tried to fill the gap conducting intensive local surveys and expert interviews [12] [13] [14]. According to the study by Perz et al. [3], from the US Centers of Disease Control and Prevention, the attributable fractions of cirrhosis for HCV are 38% for Western and 34% for Eastern Europe [3], while those for hepatocellular carcinoma are, respectively, 44% and 15%. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The advent of potent and safe direct-acting antivirals against the hepatitis C virus has the potential of fulfilling the dream of eliminating this infection and its impact on global public health. However, even if effective drugs are at hand, most patients remain unaware of their infection, which may be recognized only in late stages when dire complications have occurred. Europe is not spared by this scourge, with its estimated 19,000,000 persons infected, and knowledge of the epidemiology of HCV and its drivers is a critical tool in fighting this virus. A thorough review is provided on the extent of the HCV epidemic across Europe, with a discussion of the most important subgroups affected, and of the risk factors of infection, both traditional and new.
    Preview · Article · Oct 2014 · Digestive and Liver Disease
  • Source
    • "In 2009, the overall HCV infection rate of 8.19 per 100,000 population was reported for 26 EU and EEA/EFTA Member States [20]. In 2011, Cornberg et al. [21] reviewed the prevalence of HCV in several countries and the lowest HCV prevalence estimates were from northern European countries, whilst the highest prevalence estimates were from Romania and rural areas in Greece and Italy, as well as portions of Russia. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Hepatitis C virus (HCV) is endemic worldwide and according to the World Health Organization (WHO), there are about 150 million chronic carriers worldwide. The infection is a leading cause of liver diseases like cirrhosis and hepatocellular carcinoma (HCC); thus, HCV infection constitutes a critical public health problem. There are increasing efforts worldwide in order to reduce the global impact of hepatitis C through the implementation of programmatic actions that may increase the awareness of viral hepatitis and also improve surveillance, prevention, and treatment. In Brazil, about 1,5 million people have been chronically infected with HCV. The country has a vast territory with uneven population density, and hepatitis C incidence rates are variable with the majority of cases concentrated in the most populated areas. Currently, the main priorities of Brazilian Ministry of Health's strategies for viral hepatitis management include the prevention and early diagnosis of viral hepatitis infections; strengthening of the healthcare network and lines of treatment for sexually transmitted diseases, viral hepatitis, and AIDS; improvement and development of surveillance, information, and research; and promotion of universal access to medication. This review aims to summarize the available data on hepatitis C epidemiology and current status of efforts in prevention and infection control around the world and in Brazil.
    Full-text · Article · Jun 2014
  • Source
    • "In Italy HCV infection has a higher prevalence than in other Western countries [39], and IDUs have represented the highest risk group for HIV for at least 2 decades, thus the number of co-infected individuals should be quite high [39,40]. The HCV genotype distribution gives an indirect confirmation to this hypothesis: while in Italian population genotypes 1 and 2 appear the most represented [39], in our study genotype 2 was almost absent and genotype 4, mainly transmitted by parenteral routes and linked to drug injection [39,40], is rare in other settings, while it was observed in 18% of patients from the present study. "
    [Show abstract] [Hide abstract]
    ABSTRACT: A good correlation between HCV core antigen (HCVAg) and different HCV-RNA assays has been described, but little data are available in HCV/HIV co-infection. We aimed to evaluate HCVAg in comparison with HCV-RNA and to determine their kinetics during antiviral treatment in selected HCV/HIV co-infected patients. 355 samples from 286 HCV/HIV co-infected subjects for whom HCV-RNA (Abbott RealTime) was requested were analysed also for HCVAg (Abbott ARCHITECT) in order to evaluate the correlation between the two parameters both in patients treated or untreated for chronic hepatitis C and according to different HCV genotypes. The differences between percentages were evaluated by chi square or Fisher's exact test, while mean and median values were compared by Student's t test or the Mann-Whitney test, respectively. All differences were considered significant for a p value <0.05. HCVAg was detectable on 288/315 sera (91.4%) positive for HCV-RNA and in 5 out of40(12.5%) sera with undetectable HCV-RNA for a total concordance of 90.1%. The correlation was fair both in untreated (r = 0.742) and in treated (r = 0.881) patients and stronger for genotypes 1 and 4 than for genotype 3. Both HCV-RNA and HCVAg levels were significantly higher (p = 0.028 and p = 0.0098, respectively) in patients infected by genotype 1 than by genotype 3. The mean ratio of Log values between HCV-RNA (IU/mL) and HCVAg (fmol/liter) was 2.27 + 1.09 in untreated and 2.20 + 0.82 in treated patients (p = n.s.),consistent with a sensitivity of HCVAg corresponding to about 1,000 IU/mL of HCV-RNA, and ranged from 2.21 to 2.32 among HCV genotypes with no significant differences; five samples (1.4%; 2 genotype 1a or 1c, 3 genotype 3a) showed highly divergent values. The analysis of 18 monitoring profiles from patients treated with PEG-IFN and Ribavirin showed similar trends, except in one case in which relapse could be predicted by HCVAg and not by HCV-RNA. These results suggest that HCVAg represents an adequate tool for determining an ongoing HCV infection also in HIV co-infected patients, with lower costs and faster turnaround time that HCV-RNA.
    Full-text · Article · Apr 2014 · BMC Infectious Diseases
Show more