John C Martin Foundation.

Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. Clinical care for patients with HCV-related liver disease has advanced considerably thanks to an enhanced understanding of the pathophysiology of the disease, as well as developments in diagnostic procedures and improvements in therapy and prevention. These therapies make it possible to eliminate hepatitis C as a major public health threat, as per the World Health Organization target, although the timeline and feasibility vary from region to region. These European Association for the Study of the Liver recommendations on treatment of hepatitis C describe the optimal management of patients with recently acquired and chronic HCV infections in 2020 and onwards.

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 ( 0.5%) estimates were from northern European countries and the highest (Z3%) were from Romania and rural areas in Greece, Italy and Russia. The main risk for HCV transmission in countries with wellestablished 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 Keywords diagnosis -epidemiology -HCV -hepatitis C -incidence -mortality -prevalence Conclusion: Despite the eradication of transmission by blood products, HCV infection continues to be one of the leading blood-borne infections in the region.Chronic hepatitis C (CHC) is a major health burden in Europe. Recent data suggest that patients with CHC have a higher overall morbidity and mortality (1, 2). A significant portion of liver transplantation in Europe is attributable to cirrhosis and hepatocellular carcinoma because of CHC (3). The socioeconomic impact of hepatitis C virus (HCV) infection is tremendous. The incidence of complications of CHC will not decline over the next 10 years despite improved efficacy of antiviral therapy because most patients with CHC remain undiagnosed (4). Prevention of new infections, HCV screening and early treatment have the potential to reduce the overall morbidity and mortality. However, the cost-effectiveness of HCV screening may depend on the HCV prevalence (5). Decisions on public health issues such as HCV screening and prevention measures are dependent on reliable epidemiological data regarding HCV prevalence and transmission routes. The epidemiological status in Europe is continuously evolving and may vary significantly among the different regions throughout Europe (6). Thus, different countries may need different strategies to reduce the overall burden of HCV infection.Because epidemiological data are the basis for the development of preventive measures, we aimed to systematically identify, review and characterize HCV epidemiology throughout Europe. We included Canada and Israel in our analysis because their healthcare systems and the epidemiological situation are similar to many European countries. MethodsA comprehensive review of the literature was used to gather country-specific data on risk factors, prevalence, number of diagnosed...

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