Studies on the epidemiology of hepatitis B and C virus infections are still needed

Abstract

Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major public health problems. Approximately 350–400 million people worldwide are chronic hepatitis B surface antigen (HBsAg) carriers, and HBV is a leading cause of cirrhosis and associated liver failure, hepatocellular carcinoma (HCC) and death. Indeed, one half to one million deaths are estimated to be related to HBV every year [1]. HCV infects an estimated 130–170 million persons worldwide and is responsible for 350,000–500,000 deaths per year [2,3]. In Europe, where an estimated 7.3–8.8 million people are infected with HCV, the overall prevalence of the infection is 1.1–1.3%, ranging from 0.6% in Germany to 4% in Italy [4,5]. Chronic hepatitis C is one of the main causes of HCC and the most common indication for liver transplantation in many European countries. Great progress has been made in the management of chronic hepatitis B and C at the individual level. Thanks to recent therapeutic advances, current treatments are able to control HBV replication and to eradicate HCV in almost all cases. Thus, further improvements in the management of HBV and HCV infections will be possible mainly by focusing on treatment impact at a population level. In this field, attention should be given to the dynamics of infection, natural history, screening, and therapeutic access which influence the impact of antiviral therapy on morbidity and mortality [4,5]. The epidemics of HBV and HCV are continuously evolving, mainly because of increased safety of blood donations, improvements in health care conditions, continuous expansion of intravenous drug use, and immigration to Europe from endemic areas. Thanks to vaccination programs and blood donor testing, the incidence of HBV infection has decreased significantly in Europe and the United States (US) during the past two decades [6]. However, this has not translated into a reduced HBV burden, since the absolute number of HBsAg-positive persons continues to increase [6,7]. Regarding HCV infection, despite a marked