The prevalence and the risk factors for hepatitis C virus infection in Serbia.

Nikola Mitrovic,Dragan Delic,Jasmina Simonovic Babic,Ljiljana Markovic Denic,Natasa Nikolic,Aleksandra Barac,Ksenija Bojovic,Branko Brmbolic,Ivana Milosevic,Natasa Katanic

doi:10.3855/jidc.10172

Abstract

The epidemiological characteristics of the hepatitis C virus (HCV) infection in Republic of Serbia have not been studied sufficiently so far. The aim of this study was to estimate the prevalence of anti-HCV positivity in the general population of Serbia and determine the risk factors for this infection. Estimation of the prevalence was done using the median ratio method with data from several regional countries to a previously determined prevalence of anti-HCV positivity among volunteer blood donors of 0.19%. In order to determine the risk factors a matched case-control study was conducted of 106 subjects with confirmed HCV infection from the Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia and the same number of hospital controls matched by sex and age. The estimated prevalence of anti-HCV positivity in the general population of Serbia was 1.13% (95% CI: 1.0-1.26%). The most important predictive risk factors of HCV infection were: intravenous drug use (OR = 31.0; 95% CI: 3.7-259.6), blood transfusions (OR = 3.7; 95% CI: 1.6-8.7), invasive dental treatment (OR = 3.1; 95% CI: 1.4-6.8), and low level of education (OR = 2.2; 95% CI:1.1-4.7). A total of 91.5% of the persons with hepatitis C had at least one of the significant risk factors. The prevalence of anti-HCV positivity ranks Serbia in the range of mid-endemic European countries. Preventive measures should be directed at preventing drug use, on education about getting the infection, creating safe conditions for blood transfusions, and strict adherence to adopted practices in dentistry.

Highlights

The epidemiological characteristics of the hepatitis C virus (HCV) infection in Republic of Serbia have not been studied sufficiently so far
Introduced a system of active HCV infection monitoring. This system envisages the monitoring of the epidemiological characteristics of HCV infection in the European Economic Community countries
The following risk factors were independent predictors for acquiring HCV infection: psychoactive substance usein general (OR = 12.2; 95% confidence interval (95% confidence interval (CI)): 4.6-32.6; p < 0.001),receiving transfusion (OR = 4.4; 95% CI: 1.1-5.1; p = 0.019), invasive dental procedures (OR = 2.4; 95% CI: 1.2-4.8; p = 0.012), body piercing (OR = 8.6; 95% CI: 1.9-38.5; p = 0.001), tattooing (OR = 2.4; 95% CI: 1.2-4.8; p = 0.016), prison stay (OR = 4.2; 95% CI: 1.4-13.1; p = 0.008) and sexual relations with persons at risk of HCV infection (OR = 7.4; 95% CI: 3.3-16.9; p < 0.001)

Summary

Introduction

The epidemiological characteristics of the hepatitis C virus (HCV) infection in Republic of Serbia have not been studied sufficiently so far. The aim of this study was to estimate the prevalence of anti-HCV positivity in the general population of Serbia and determine the risk factors for this infection. The most important predictive risk factors of HCV infection were: intravenous drug use (OR = 31.0; 95% CI: 3.7-259.6), blood transfusions (OR = 3.7; 95% CI: 1.6-8.7), invasive dental treatment (OR = 3.1; 95% CI: 1.4-6.8), and low level of education (OR = 2.2; 95% CI:1.1-4.7). HCV is the most frequent cause of chronic hepatitis, with the frequency of 2550% (depending on the world region), and it is one of the most significant risk factor of hepatocellular carcinoma, found among approximately some 60% of those afflicted by this malignancy [2]. This system envisages the monitoring of the epidemiological characteristics of HCV infection (prevalence, incidence, routes of transmission, assets invested in controlling it, effectiveness of recommended measures, etc.) in the European Economic Community countries (the European Union member states with Norway, Iceland and Lichtenstein)

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