Screening for hepatitis C in a general adult population in a low-prevalence area: the Tromsø study.
Epidemiology
Hepatitis C
Norway
Population surveys
Prevalence
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
26 Feb 2019
26 Feb 2019
Historique:
received:
31
10
2018
accepted:
19
02
2019
entrez:
28
2
2019
pubmed:
28
2
2019
medline:
30
5
2019
Statut:
epublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 30808290
doi: 10.1186/s12879-019-3832-7
pii: 10.1186/s12879-019-3832-7
pmc: PMC6390317
doi:
Substances chimiques
Hepatitis C Antibodies
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
189Subventions
Organisme : Helse Nord RHF
ID : N.a.
Organisme : AbbVie AS Norway
ID : N.a.
Organisme : UiT The Arctic University of Norway
ID : N.a.
Références
Am J Epidemiol. 2001 Nov 15;154(10):891-4
pubmed: 11700242
Scand J Gastroenterol. 2003 Aug;38(8):864-70
pubmed: 12940441
Gastroenterology. 2005 Feb;128(2):343-50
pubmed: 15685546
Hepatology. 2007 Jul;46(1):32-6
pubmed: 17567829
J Viral Hepat. 2008 Apr;15(4):250-4
pubmed: 18086182
Eur J Public Health. 2009 Jun;19(3):245-53
pubmed: 19196737
Liver Int. 2009 Jan;29 Suppl 1:89-99
pubmed: 19207971
Transfusion. 2009 Jul;49(7):1296-305
pubmed: 19222816
Transfusion. 2009 Jul;49(7):1306-13
pubmed: 19309471
Drug Alcohol Rev. 2009 Nov;28(6):648-57
pubmed: 19930019
Epidemiol Infect. 2012 Jan;140(1):58-69
pubmed: 21324216
Int J Epidemiol. 2012 Aug;41(4):961-7
pubmed: 21422063
Lancet. 2011 Aug 13;378(9791):571-83
pubmed: 21802134
J Public Health (Oxf). 2012 Mar;34(1):14-23
pubmed: 22138489
Hepatology. 2012 Jun;55(6):1652-61
pubmed: 22213025
Transfusion. 2012 Sep;52(9):1940-8
pubmed: 22304422
Dig Liver Dis. 2012 Jun;44(6):497-503
pubmed: 22342471
BMC Infect Dis. 2012 Aug 06;12:178
pubmed: 22866925
Clin Infect Dis. 2012 Oct;55(8):1047-55
pubmed: 22875876
Ann Intern Med. 2012 Dec 4;157(11):817-22
pubmed: 22910836
BMJ. 2012 Oct 03;345:e6525
pubmed: 23034845
Ann Intern Med. 2013 Jan 15;158(2):101-8
pubmed: 23183613
Scand J Public Health. 2013 Feb;41(1):65-80
pubmed: 23341355
BMC Public Health. 2014 Jan 22;14:66
pubmed: 24450797
J Viral Hepat. 2014 May;21 Suppl 1:60-89
pubmed: 24713006
PLoS One. 2014 May 19;9(5):e97317
pubmed: 24842841
J Viral Hepat. 2015 Jan;22 Suppl 1:26-45
pubmed: 25560840
J Viral Hepat. 2015 Jan;22 Suppl 1:46-73
pubmed: 25560841
Lancet. 2016 Sep 10;388(10049):1081-1088
pubmed: 27394647
Scand J Gastroenterol. 2017 Jan;52(1):61-68
pubmed: 27598393
BMJ Open. 2016 Sep 06;6(9):e011821
pubmed: 27601496
PLoS One. 2016 Nov 15;11(11):e0166451
pubmed: 27846264
J Med Virol. 2017 Aug;89(8):1435-1441
pubmed: 28165155
J Clin Virol. 2017 Apr;89:1-4
pubmed: 28171829
Lancet Gastroenterol Hepatol. 2017 May;2(5):325-336
pubmed: 28397696
Lancet Gastroenterol Hepatol. 2017 Mar;2(3):161-176
pubmed: 28404132
BMC Infect Dis. 2017 Aug 3;17(1):541
pubmed: 28774261
Curr Epidemiol Rep. 2017 Jun;4(2):174-185
pubmed: 28785531
BMC Infect Dis. 2017 Sep 16;17(1):624
pubmed: 28915795
Lancet Glob Health. 2017 Dec;5(12):e1192-e1207
pubmed: 29074409
Gut. 2018 Nov;67(11):2017-2024
pubmed: 29615488
Eur J Gastroenterol Hepatol. 2018 Sep;30(9):1077-1081
pubmed: 29939868
J Hepatol. 2018 Oct;69(4):785-792
pubmed: 30227916
Hepatol Int. 2019 Jan;13(1):58-65
pubmed: 30377928
PLoS One. 2018 Nov 28;13(11):e0208036
pubmed: 30485377
Lancet. 1997 Mar 22;349(9055):825-32
pubmed: 9121257