Epidemiology of hepatitis C in Croatia in the European context

Abstract

We analyzed prevalence, risk factors and hepatitis C virus (HCV) genotype distribution in different population groups in Croatia in the context of HCV epidemiology in Europe, with the aim to gather all existing information on HCV infection in Croatia which will be used to advise upon preventive measures. It is estimated that 35000-45000 of the Croatian population is chronically infected with HCV. Like in other European countries, there have been changes in the HCV epidemiology in Croatia over the past few decades. In some risk groups (polytransfused and hemodialysis patients), a significant decrease in the HCV prevalence was observed after the introduction of routine HCV screening of blood/blood products in 1992. Injecting drug users (IDUs) still represent a group with the highest risk for HCV infection with prevalence ranging from 29% to 65%. Compared to the prevalence in the Croatian general population (0.9%), higher prevalence rates were found in prison populations (8.3%-44%), human immunodeficiency virus-infected patients (15%), persons with high-risk sexual behavior (4.6%) and alcohol abusers (2.4%). Low/very low prevalence was reported in children and adolescents (0.3%) as well as in blood donors (0%-0.009%). In addition, distribution of HCV genotypes has changed due to different routes of transmission. In the general population, genotypes 1 and 3 are most widely distributed (60.4%-79.8% and 12.9%-47.9%, respectively). The similar genotype distribution is found in groups with high-risk sexual behavior. Genotype 3 is predominant in Croatian IDUs (60.5%-83.9%) while in the prison population genotypes 3 and 1 are equally distributed (52.4% and 47.6%). Data on HCV prevalence and risk factors for transmission are useful for implementation of preventive measures and HCV screening.

High Prevalence of Q80K Among NS3 Resistance-Associated Substitutions in Subtype 1a Patients with Chronic Hepatitis C Prior to Treatment with Direct Acting Antivirals: The Croatian Data

“…Croatia is a country with a population of 4 284 889 with the 0.9% prevalence of anti-HCV in individuals undergoing routine check-ups prior to surgical or medically-assisted reproduction procedures, 0.5% in pregnant women, and 0.1% in voluntary blood donors (15,16). The highest burden of disease is attributed to polytransfused patients and plasma product recipients prior to 1992 (75.9%) as well as intravenous drug users (29% -65%) (16).…”

“…The highest burden of disease is attributed to polytransfused patients and plasma product recipients prior to 1992 (75.9%) as well as intravenous drug users (29% -65%) (16). A 10-year retrospective national study on the molecular epidemiology of HCV infection that included 1,163 patients reported 58.8% of genotype 1 infections and 35.6% of genotype 3 infections (genotypes 2 and 4 were rare).…”

Hepatitis C infection among pregnant women in central Poland: Significance of epidemiological anamnesis and impact of screening tests to detect infection

“…Knowledge of the epidemiology of HCV infection specific to the given population and appropriately conducted interviews by the general practitioner were likely to increase the detection of HCV infection. 8,9 Events that could carry a risk of HCV infection in the respondents' histories are presented in Table 1.…”

New Epidemiologic Data Regarding Hepatitis C Virus Infection in Romania

“…In Europe the prevalence of the infection increases with age, with a peak in 55-64-year old patients [17]. Not only the prevalence varies around the world, but also the GTs have a certain distribution: in Europe the most common is subtype 1b, on the American continent it is subtype 1a, in North and Central Africa and in the Middle East GT 4 is prevalent and in Asia GT 3 [18][19][20][21]. The acute HCV infection is rarely diagnosed because there are no symptoms or the symptoms are mild.…”