Prevalence and undiagnosed fraction of hepatitis C infection in 2018 in Spain: results from a national population-based survey

Abstract

Background A national strategy against hepatitis C virus (HCV) was implemented in Spain in 2015 with the aim of reducing associated morbidity and mortality. In order to improve our understanding of the epidemiology of HCV, we analysed the prevalence of HCV antibodies and active infection overall and by age and sex in the general population aged 20–80 years. We also aimed to report the undiagnosed fraction. Methods A national population-based seroprevalence survey was conducted in 2017–2018. A representative sample from the general population was selected using two-stage sampling. The prevalence of total HCV antibodies and of HCV RNA was calculated using inverse probability weighting based on bootstrapping. Results Overall, we approached 17 496 persons; 9103 agreed to participate and met the eligibility criteria and 7675 were aged 20–80. We obtained a prevalence of HCV antibodies of 0.85% [95% confidence interval (CI): 0.64–1.08%] and of active infection of 0.22% (95% CI: 0.12–0.32%). The prevalence of active HCV infection was highest in men aged 50–59 (0.86%; 95% CI: 0.28–1.57%) and in men aged 60–69 years (0.72%; 95% CI: 0.27–1.28%). Prevalence was below 0.20% in the remaining age groups. The undiagnosed fraction for active HCV infection was 29.4%. Conclusion This study shows that prevalence of HCV in the general population in Spain is low and reflects the impact of scaling up treatment with direct acting antivirals, together with other prevention strategies, from 2015 onwards. The data reported can guide subsequent public health actions.

Hepatitis C antibody prevalence and active hepatitis C infection in HIV-negative gay, bisexual, and other men who have sex with men in Barcelona and Madrid, Spain (March 2018-March 2021)

“…In Spain, according to the second National Study of HCV seroprevalence (2017-2018) [16] , the prevalence of HCV antibodies among 20-80s is an estimated 0.85% (95% CI: 0.64-1.08%) and the prevalence of active HCV infection is 0.22% (0.12-0.32%). According to the National Centre of Epidemiology [1] , by 2020, 819 cases were notified across Spain (incidence rate of 2.36 per 100.000 citizens) but of those only 7.8% (n = 64) were confirmed as active cases.…”

Pilot hepatitis C micro‐elimination strategy in Pakistani migrants in Catalonia through a community intervention

“…In Spain, over half of the estimated cases of hepatitis C have been treated since the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System was implemented in 2015 4 . However, among people accessing primary care (PC) in 2017–2018, 29.4% of those with viremic HCV infection had not yet been diagnosed 5 . Additionally, during the coronavirus disease 2019 (COVID‐19) pandemic, diagnosis rates have declined causing a delay in antiviral treatment, which could increase liver mortality and disease burden and costs 6 .…”

Prevalence of HCV infection in Europe in the DAA era: Review

“…78 Nine studies were conducted in Spain; only one of them was prospective (Table 4; Table S1; Figure 1). [89][90][91][92][93][94][95][96][97] According to published data, anti-HCV prevalence in Spain ranged between .86% and 1.58%, with most subjects (46%-97%) being already aware of their HCV status. Rates of active infection accounted for 22%-55% of seropositive individuals (Table 4; Table S1; Figure 1).…”