Abstract
BackgroundWith regards to the global strategy towards eliminating viral hepatitis, reliable surveillance systems are essential to assess the national response for eliminating hepatitis C virus (HCV).AimWe aimed to assess the completeness of the two national registries with data on acute HCV infection in people with HIV, and estimated the number of acute HCV infections among adults (aged ≥ 18 years) with HIV in the Netherlands.MethodsIn this observational study, cases of HCV infection and reinfection among adults with a positive or unknown HIV-serostatus were identified from 2003 to 2016 in two national registries: the ATHENA cohort and the National Registry for Notifiable Diseases. For 2013–2016, cases were linked, and two-way capture–recapture analysis was carried out.ResultsDuring 2013–2016, there were an estimated 282 (95% confidence interval (CI): 264–301) acute HCV infections among adults with HIV. The addition of cases with an unknown HIV-serostatus increased the matches (from n = 107 to n = 129), and subsequently increased the estimated total: 330 (95%CI: 309–351). Under-reporting was estimated at 14–20%.ConclusionUnder-reporting of acute HCV infection among people with HIV could partially be explained by an unknown HIV-serostatus, or by differences in HCV stage (acute or chronic) at first diagnosis. Surveillance data should ideally include both acute and chronic HCV infections, and enable to distinguish these as well as initial- and re-infections. National surveillance of acute HCV can be improved by increased notification of infections.
Highlights
In 2016, the World Health Organization (WHO) set global targets to eliminate viral hepatitis as a major public health threat by 2030 [1]
We initially described the annual number of reported cases by hepatitis C virus (HCV)/human immunodeficiency virus (HIV) transmission risk group and HIV serostatus for the period 2003–2016, using descriptive statistics
In the period of 2003–2016, 556 acute HCV infections were diagnosed among 501 HIV positive people: 452 were acute primary HCV infections and 104 were HCV reinfections
Summary
In 2016, the World Health Organization (WHO) set global targets to eliminate viral hepatitis as a major public health threat by 2030 [1]. Diagnosis and registration of acute HCV infections are crucial to measure trends in the epidemic and to plan appropriate public health and clinical interventions, such as prevention programmes for those at risk, targeted testing, increasing treatment uptake, and contact tracing to reduce subsequent transmission. Aim: We aimed to assess the completeness of the two national registries with data on acute HCV infection in people with HIV, and estimated the number of acute HCV infections among adults (aged ≥ 18 years) with HIV in the Netherlands. Conclusion: Under-reporting of acute HCV infection among people with HIV could partially be explained by an unknown HIV-serostatus, or by differences in HCV stage (acute or chronic) at first diagnosis. National surveillance of acute HCV can be improved by increased notification of infections
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