Abstract
BackgroundAlthough significant improvement in efficacy measured by a sustained virological response, the high acquisition costs of direct-acting antivirals limit the access for patients and influence the costs of healthcare resource utilisation in hepatitis C. It is important to have the latest estimates of prevalence, especially in high-risk groups, for cost of illness, cost-effectiveness and budget impact studies.MethodsOriginal studies on the estimates of the prevalence among general and high-risk groups in the European Union/European Economic Area (EU/EEA) were retrieved from Medline and Embase for the period from 2015 to 2018. All included studies were evaluated for risk of selection bias and summarised together in a narrative form. Results from previous reviews and updated searches were compared per country among different populations, respectively.ResultsAmong the 3871 studies identified, 46 studies were included: 20 studies were used for the estimate of the general population; 3 for men who have sex with men (MSM); 6 for prisoners; and 17 for people who inject drugs (PWID). Compared with the results reported in previous systematic reviews, the updated estimates were lower than previously in most available countries. Anti-HCV general population prevalence estimates ranged from 0.54 to 1.50% by country. The highest prevalence of anti-HCV was found among PWID (range of 7.90–82.00%), followed by prisoners (7.00–41.00%), HIV-positive MSM (1.80–7.10%), HIV-negative MSM (0.20–1.80%), pregnant women (0.10–1.32%) and first-time blood donors (0.03–0.09%).ConclusionsOur study highlights the heterogeneity in anti-HCV prevalence across different population groups in EU/EEA. The prevalence also varies widely between European countries. There are many countries that are not represented in our results, highlighting the need for the development of robust epidemiological studies.
Highlights
Significant improvement in efficacy measured by a sustained virological response, the high acquisition costs of direct-acting antivirals limit the access for patients and influence the costs of healthcare resource utilisation in hepatitis C
Literature search retrievals The search for data on anti-hepatitis C virus (HCV) prevalence in the general population and men who have sex with men (MSM), and people in prison and people who inject drugs (PWID) identified 2790 and 1081 citations, respectively
46 publications were included in the review of prevalence data, with 11 publications used for the estimate of the general population, 7 for pregnant women, 2 for first-time blood donors, 3 for MSM, 6 for prisoners and 17 for PWID (Fig. 1)
Summary
Significant improvement in efficacy measured by a sustained virological response, the high acquisition costs of direct-acting antivirals limit the access for patients and influence the costs of healthcare resource utilisation in hepatitis C. It is important to have the latest estimates of prevalence, especially in high-risk groups, for cost of illness, cost-effectiveness and budget impact studies. Infection with hepatitis C virus (HCV) leads to an asymptomatic acute stage. Approximately 75% of acutely infected patients face a substantial risk of developing chronic HCV infection [1]. During the 2 decades after infection, 27% develop liver cirrhosis, and 25% develop hepatocellular carcinoma (HCC) [2, 3]. An estimated 71 million people were living with chronic HCV. Given to the slow rates of liver disease progression, many countries are yet to experience the full burden of HCV-related disease [5]. Decade-long delays between infection and the expression of chronic liver disease or liver cancer made it difficult to link these diseases to earlier HCV infections.
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