Screening of hepatitis C virus infection in adult general population in Spain

Viejo, Laura Gómez-Escolar; Herola, A. García; Lloret, Isabel Sáez; Ruano, Fernando Sánchez; Paulino, Inmaculada Clemente; Ivorra, Cristina Quílez; Saavedra, Isabel Almenta; Pérez, David Martínez; Osa, Jaime Valverde de la

doi:10.1097/meg.0000000000001190

Cited by 31 publications

(22 citation statements)

References 21 publications

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“…A study on 2637 individuals in Valencia, Spain, found that antibody detection was positive in 30 individuals (1.1%). The study showed that among the anti-HCV-positive cases, 23.3% had tattoos and piercing as a risk factor, as in the present study, although there is no representation regarding the decade of birth 17 . A survey of 2,128 individuals in Suriname found an association between HCV positivity and male sex, advanced age, Javanese ethnicity, and presence of tattoos 22 .…”

Section: Discussionsupporting

confidence: 58%

“…the great epidemic of intravenous drug use in the 1980s in Spain, as well as in Brazil several years later, which was later than that in the USA and other European countries 17 . In the USA, there is a new boom; a majority of patients who were infected after 2009 reported injection drug use (IDU) (40.6%) as their source of infection, which coincides with the recent heroin use epidemic 18 .…”

Section: Discussionmentioning

confidence: 96%

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Epidemiological survey of hepatitis C in a region considered to have high prevalence: the state of Minas Gerais, Brazil

Gomide

Melo

Santos

et al. 2019

Rev. Soc. Bras. Med. Trop.

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Introduction: The prevalence of hepatitis C virus (HCV) infection is affected by demographic, virological, clinical, and lifestylerelated factors and varies in different regions in Brazil or worldwide. The present study aimed to clarify the epidemiological patterns of HCV infection in the interior region of Brazil. Methods: This study was conducted in the Southern Triangle Macro-region of the state of Minas Gerais, Brazil, according to the guidelines of the National Program for the Prevention and Control of Viral Hepatitis. The participants answered a structured questionnaire on social and epidemiological factors.Immunochromatographic rapid tests were used for the qualitative detection of antibodies against HCV in whole blood (Alere HCV® Code 02FK10) in adult subjects by a free-standing method. Results: Of 24,085 tested individuals, 184 (0.76%) were anti-HCV positive. The majority of anti-HCV-positive individuals were born between 1951 and 1980 (n=146 [79.3%]), with 68 women and 116 men. Identified risk factors included syringe and/or needle sharing (p = 0.003), being in prison (p = 0.004), and having tattoos or piercings (p = 0.005) and were significantly associated with the decade of birth. Conclusions: The study shows the importance of testing populations at risk for HCV infection, including incarcerated individuals, those with tattoos or piercings, those who share or have shared syringes or needles, and those in high-risk birth cohorts (1950s, 1960s, and 1970s) in the Southern Triangle Macro-region.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 96%

Epidemiological survey of hepatitis C in a region considered to have high prevalence: the state of Minas Gerais, Brazil

Gomide

Melo

Santos

et al. 2019

Rev. Soc. Bras. Med. Trop.

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“…Similar data regarding hepatitis C prevalence have been reported in two recent studies conducted in other regions in Spain. One in Valencia in 2018 found an HCV seroprevalence of 1.14% and another in Navarra from 2014–2016 obtained an HCV seroprevalence 0.83%. However, the methodology in these studies differed from ours, as the first was performed only in an adult population between 25 and 70 years of age in a small area, and the second was undertaken in patients admitted for elective surgery.…”

Section: Discussionmentioning

confidence: 99%

Significant decrease in the prevalence of hepatitis C infection after the introduction of direct acting antivirals

Rodríguez‐Tajes

Domı́nguez

Carrión

et al. 2020

J of Gastro and Hepatol

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Background and Aim: Accurate information on the epidemiology of hepatitis C and B infection is mandatory to establish a national/regional plan. We aim to update the prevalence of hepatitis C and B infection in Catalonia using point-of-care tests to analyze the risk factors related and to implement a linkage-to-care circuit. Methods: This is a community-based study. A random list of adult individuals was retrieved from censuses of primary care centers. Point-of-care tests for anti-hepatitis C virus (HCV) and HBV surface antigen (HBsAg) and a questionnaire for risk factor assessment were performed. Positive results were validated and a circuit for linkage-to-care was established. Results: A total of 3328 individuals were included. The anti-HCV and HBsAg overall prevalence were lower than expected [1.02%, 95% confidence interval (CI) 0.65-1.39; and 0.52%, 95% CI 0.26-0.77, respectively]. Anti-HCV positive subjects were mostly (88%) autochthonous. The prevalence increased with age; only 12% were under age 40. The associated risk factors were drug use, blood transfusion, relative with HCV, and diabetes. Notably, the prevalence of active infection was only 0.49% (95% CI 0.23-0.74), 40% less than previously reported, reflecting the impact of direct acting antiviral therapy. Differently, HBsAg positive subjects were mostly foreign migrants (53%) with no other risk factors. Despite the implementation of a linkage-to-care circuit, one third of HBsAg positive subjects were lost. Conclusions: The prevalence of HCV infection was lower than previously reported, showing a strong impact of direct acting antiviral therapy in the last years. Because of hepatitis B universal vaccination, HBV infection in Catalonia is mainly associated with migrant population. Linkage-to-care in patients with hepatitis B was challenging and warrants additional efforts. racy or integrity of any part of the article. Financial support: The study received grant support from Gilead and donations from Abbvie and MSD. X. F.: Instituto de Salud Carlos III (PI18/00079), Ministry of de Economy and Competitiveness, co-funded by the European Fund of Regional Development, European Commission. Una manera de hacer Europa. Fellowship Program Gilead 2015 project number GLD15/00274. S. L. was supported by grants from Hospital Clinic and the Fundacion BBVA. CIBEREHD is funded by the Instituto de Salud Carlos III. X. F. received support by the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (grant 2017 SGR 1753) and CERCA Programme/Generalitat de Catalunya. A. D. and M. J. were supported by CIBERESP (funded by the

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“…On the other hand, the study has unmasked several individuals with chronic HCV infection that did not define themselves as belonging to known risk groups. A recent Spanish pilot study for an eventual population-based screening program included the adult population (20-75 years) in a small health area with a participation rate of 46.2% (2637/5706) [39]. HCV RNA was detected in 13 persons (0.5%), of whom five were unaware of the disease.…”

Section: Screening Strategies In a Low-prevalence Area: Whom And How mentioning

confidence: 99%

Screening for hepatitis C in a general adult population in a low-prevalence area: the Tromsø study

et al. 2019

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Background: Chronic hepatitis C virus (HCV) infection can progress to cirrhosis and end-stage liver disease in a substantial proportion of patients. The infection is frequently asymptomatic, leaving many infected individuals unaware of the diagnosis until complications occur. This advocates the screening of healthy individuals. The aim of this study was to estimate the prevalence of HCV infection in the general adult population of the municipality of Tromsø, Norway, and to evaluate the efficiency of such an approach in a presumed low-prevalence area. Methods: The study was part of the seventh survey of the Tromsø Study (Tromsø 7) in 2015-2016. Sera from 20,946 individuals aged 40 years and older were analysed for antibodies to HCV (anti-HCV). A positive anti-HCV test was followed up with a new blood test for HCV RNA, and the result of any previous laboratory HCV data were recorded. Samples positive for anti-HCV and negative for HCV RNA were tested with a recombinant immunoblot assay. All HCV RNA positive individuals were offered clinical evaluation. Results: Among 20,946 participants, HCV RNA was detected in 33 (0.2%; 95% CI: 0.1-0.3), of whom 13 (39.4%; 95% CI: 22.7-56.1) were unaware of their infection. The anti-HCV test was confirmed positive in 134 individuals (0.6%; 95% CI: 0.5-0.7) with the highest prevalence in the age group 50-59 years. Current or treatment-recovered chronic HCV-infection was found in 85 individuals (0.4%; 95% CI: 0.3-0.5) and was associated with an unfavorable psychosocial profile. Conclusion: In this population-based study, the prevalence of viraemic HCV infection was 0.2%. A substantial proportion (39%) of persons with viraemic disease was not aware of their infectious status, which suggests that the current screening strategy of individuals with high risk of infection may be an inadequate approach to identify chronic HCV infection hidden in the general population.

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Screening of hepatitis C virus infection in adult general population in Spain

Abstract: HCV screening strategies applied to the general population are good means to diagnose and treat patients who are not aware of their infection, avoiding new transmissions as well as disease progression.

Cited by 31 publications

References 21 publications

Epidemiological survey of hepatitis C in a region considered to have high prevalence: the state of Minas Gerais, Brazil

Epidemiological survey of hepatitis C in a region considered to have high prevalence: the state of Minas Gerais, Brazil

Significant decrease in the prevalence of hepatitis C infection after the introduction of direct acting antivirals

Screening for hepatitis C in a general adult population in a low-prevalence area: the Tromsø study

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