Current prevalence of chronic hepatitis B and C virus infection in the general population, blood donors and pregnant women in the EU/EEA: a systematic review

Hofstraat, Sanne Henrietta Ina; Falla, Abby; Duffell, Erika; Hahné, Susan; Amato‐Gauci, Andrew J.; Veldhuijzen, Irene; Tavoschi, Lara

doi:10.1017/s0950268817001947

Cited by 114 publications

(140 citation statements)

References 32 publications

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“…A recently published article reported a similar prevalence (1.1%) of anti-HCV relative to that reported here. 31 However, in that study, the viraemia was not measured but was assumed to be 70%. When compared with the 25.9% reported here, this discrepancy indicates that epidemiological studies based on seroprevalence alone are obsolete, overestimating the burden of disease by including those who have cleared the infection after treatment or spontaneously.…”

Section: Discussionmentioning

confidence: 94%

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Epidemiology of hepatitis C virus infection in a country with universal access to direct‐acting antiviral agents: Data for designing a cost‐effective elimination policy in Spain

Crespo

Cuadrado

Perelló

et al. 2019

Journal of Viral Hepatitis

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Accurate HCV prevalence estimates are necessary for guiding elimination policies. Our aim was to determine the HCV prevalence and assess the cost‐effectiveness of a screen‐and‐treat strategy in the Spanish population. A population‐based, cross‐sectional study (PREVHEP‐ETHON Cohort, Epidemiological sTudy of Hepatic infectiONs; NCT02749864) was performed from July 2015‐April 2017. Participants from three Spanish regions were selected using two‐stage conglomerate sampling, and stratified by age, with randomized subject selection. Anthropometric and demographic data were collected, and blood samples were taken to detect anti‐HCV antibodies/quantify HCV RNA. The cost‐effectiveness of the screening strategies and treatment were analysed using a Markov model. Among 12 246 participants aged 20‐74 (58.4% females), the overall anti‐HCV prevalence was 1.2% (95% CI 1.0‐1.4), whereas the detectable HCV‐RNA prevalence was 0.3% (0.2‐0.4). Infection rates were highest in subjects aged 50‐74 years [anti‐HCV 1.6% (1.3‐1.9), HCV RNA 0.4% (0.3‐0.6]. Among the 147 anti‐HCV + subjects, 38 (25.9%) had active infections while 109 (74.1%) had been cleared of infection; 44 (40.4%) had cleared after antiviral treatment, whereas 65 (59.6%) had cleared spontaneously. Overall, 59.8% of the anti‐HCV + participants were aware of their serological status. Considering a cost of treatment of €7000/patient, implementing screening programmes is cost‐effective across all age cohorts, particularly in patients aged 50‐54 (negative incremental cost‐effectiveness ratio which indicates a cost‐saving strategy). The current HCV burden is lower than previously estimated, with approximately 25% of anti‐HCV + individuals having an active infection. A strategy of screening and treatment at current treatment prices in Spain is cost‐effective across all age cohorts.

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Section: Discussionmentioning

confidence: 94%

“…A recently published article reported a similar prevalence (1.1%) of anti‐HCV relative to that reported here . However, in that study, the viraemia was not measured but was assumed to be 70%.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of hepatitis C virus infection in a country with universal access to direct‐acting antiviral agents: Data for designing a cost‐effective elimination policy in Spain

Crespo

Cuadrado

Perelló

et al. 2019

Journal of Viral Hepatitis

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“…[1][2][3] The overall prevalence of CHB in Europe is estimated to be nearly 0.9%, or 4.7 million. 4 Based on an analysis in 2010, CHB resulted in nearly 800,000 deaths worldwide due to subsequent liver-related diseases such as hepatocellular carcinoma and cirrhosis. 6 It was ranked among the Correspondence: Fraence Hardtstock Ingress-Health HWM GmbH, Alter Holzhafen 19, Wismar 23966, Germany Tel +49-3841-758-1024 Fax +49-3841-7581011 Email fraence.hardtstock@ingresshealth.com top 20 most common causes of death worldwide and considered as a major global health problem.…”

Section: Introductionmentioning

confidence: 99%

<p>Preferences of Patients with Chronic Hepatitis B – A Discrete Choice Experiment on the Acceptability of Functional Cure</p>

Hardtstock

Sbarigia

Kocaata

et al. 2020

PPA

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Background: Current antiviral therapies for chronic hepatitis B (CHB) rarely achieve functional cure, thus often requiring lifelong therapy. A therapy achieving functional cure in a significant percentage of patients could change the treatment landscape substantially. However, the acceptability of functional cure by patients is unknown, especially if associated with additional treatment burden. Methods: A Discrete Choice Experiment (DCE) including patients with CHB was performed between 2018 and 2019 in Germany. Patient inclusion criteria were confirmed CHB; age of at least 18 years; no history of hepatocellular carcinoma; no HIV or HCV/HDV coinfection. The final DCE included the following attributes: route of administration (oral administration by tablets; subcutaneous injection + tablets; intramuscular electroporation + tablets), side effect frequency (0/1/3 days per month), functional cure (1%/30%/50% of patients), frequency of physician visits (monthly, half-yearly) and travel time to treating physician (15/45 min). Results: The main analysis sample consisted of 108 patients with CHB (mean age: 49.1 years, female: 37.0%, average time since CHB diagnosis: 14.0 years, 52.8% with Hepatitis B surface antigen (HBsAg) chronic HBV infection). High efficacy was found to be the main driver of decisions for/against the presented treatment options (impacted 57% of patients' decisions), followed by therapy regimen (17%), safety profile (12%) and number of physician visits (11%). Latent class analysis revealed first insights into different decision patterns, with age, gender and previous side-effect experience affecting patients' decisions. Conclusion: In comparison to all other treatment-related attributes such as therapy regimen or safety profile, patients with CHB showed a strong preference towards a scenario where a substantial number of patients benefit from sustained disease remission, which mimics functional cure.

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“…While the majority of infections among adults in many settings are linked to injection drug use, the most important source of paediatric HCV infection is vertical transmission of the virus, responsible for approximately 60% of paediatric HCV cases globally . Among pregnant women, estimates of HCV prevalence have ranged from 0.1% to 8% from different countries and settings …”

Section: Introductionmentioning

confidence: 99%

Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child

Freriksen

Seyen²,

Judd

et al. 2019

Aliment Pharmacol Ther

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Summary Background With the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct‐acting antivirals (DAAs) in pregnancy is generally lacking, treatment of HCV infection during pregnancy is not currently recommended. Aim To provide an overview of current knowledge regarding maternal exposure, placental handling and safety of DAAs during pregnancy and lactation Methods A literature search was performed focusing on the effect of pregnancy on maternal exposure to DAAs, the placental handling of DAAs, the safety of DAAs for mother and child during pregnancy and the safety of DAAs during lactation. Results Exposure to all DAAs studied is likely to be altered during pregnancy, mostly related to pregnancy‐induced effects on drug absorption and metabolism. Although animal studies show that most DAAs are reported to cross the placenta and transfer into breast milk, most DAA combinations show a favourable safety profile. Because of the rapid viral decline after treatment initiation, and to avoid the critical period of organogenesis, treatment may be started at the end of the second trimester or early third trimester. Conclusions Treatment of HCV infection during pregnancy is realistic, as DAAs are highly effective and treatment duration is relatively short. There is an urgent need to study DAAs during pregnancy and lactation to contribute to the goal of HCV elimination.

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Current prevalence of chronic hepatitis B and C virus infection in the general population, blood donors and pregnant women in the EU/EEA: a systematic review

Cited by 114 publications

References 32 publications

Epidemiology of hepatitis C virus infection in a country with universal access to direct‐acting antiviral agents: Data for designing a cost‐effective elimination policy in Spain

Epidemiology of hepatitis C virus infection in a country with universal access to direct‐acting antiviral agents: Data for designing a cost‐effective elimination policy in Spain

<p>Preferences of Patients with Chronic Hepatitis B – A Discrete Choice Experiment on the Acceptability of Functional Cure</p>

Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child

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