Significant decrease in the prevalence of hepatitis C infection after the introduction of direct acting antivirals.
Administration, Oral
Adult
Age Factors
Aged
Aged, 80 and over
Antiviral Agents
/ administration & dosage
Biomarkers
/ blood
Female
Hepatitis B
/ diagnosis
Hepatitis B Surface Antigens
/ blood
Hepatitis C
/ diagnosis
Hepatitis C Antibodies
/ blood
Humans
Male
Middle Aged
Point-of-Care Testing
Prevalence
Risk Factors
Spain
/ epidemiology
Surveys and Questionnaires
Hepatitis C
hepatitis B
point-of-care testing
prevalence
risk factors
Journal
Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
01
08
2019
revised:
20
12
2019
accepted:
11
01
2020
pubmed:
21
1
2020
medline:
5
11
2020
entrez:
21
1
2020
Statut:
ppublish
Résumé
Accurate information on the epidemiology of hepatitis C and B infection is mandatory to establish a national/regional plan. We aim to update the prevalence of hepatitis C and B infection in Catalonia using point-of-care tests to analyze the risk factors related and to implement a linkage-to-care circuit. This is a community-based study. A random list of adult individuals was retrieved from censuses of primary care centers. Point-of-care tests for anti-hepatitis C virus (HCV) and HBV surface antigen (HBsAg) and a questionnaire for risk factor assessment were performed. Positive results were validated and a circuit for linkage-to-care was established. A total of 3328 individuals were included. The anti-HCV and HBsAg overall prevalence were lower than expected [1.02%, 95% confidence interval (CI) 0.65-1.39; and 0.52%, 95% CI 0.26-0.77, respectively]. Anti-HCV positive subjects were mostly (88%) autochthonous. The prevalence increased with age; only 12% were under age 40. The associated risk factors were drug use, blood transfusion, relative with HCV, and diabetes. Notably, the prevalence of active infection was only 0.49% (95% CI 0.23-0.74), 40% less than previously reported, reflecting the impact of direct acting antiviral therapy. Differently, HBsAg positive subjects were mostly foreign migrants (53%) with no other risk factors. Despite the implementation of a linkage-to-care circuit, one third of HBsAg positive subjects were lost. The prevalence of HCV infection was lower than previously reported, showing a strong impact of direct acting antiviral therapy in the last years. Because of hepatitis B universal vaccination, HBV infection in Catalonia is mainly associated with migrant population. Linkage-to-care in patients with hepatitis B was challenging and warrants additional efforts.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Accurate information on the epidemiology of hepatitis C and B infection is mandatory to establish a national/regional plan. We aim to update the prevalence of hepatitis C and B infection in Catalonia using point-of-care tests to analyze the risk factors related and to implement a linkage-to-care circuit.
METHODS
METHODS
This is a community-based study. A random list of adult individuals was retrieved from censuses of primary care centers. Point-of-care tests for anti-hepatitis C virus (HCV) and HBV surface antigen (HBsAg) and a questionnaire for risk factor assessment were performed. Positive results were validated and a circuit for linkage-to-care was established.
RESULTS
RESULTS
A total of 3328 individuals were included. The anti-HCV and HBsAg overall prevalence were lower than expected [1.02%, 95% confidence interval (CI) 0.65-1.39; and 0.52%, 95% CI 0.26-0.77, respectively]. Anti-HCV positive subjects were mostly (88%) autochthonous. The prevalence increased with age; only 12% were under age 40. The associated risk factors were drug use, blood transfusion, relative with HCV, and diabetes. Notably, the prevalence of active infection was only 0.49% (95% CI 0.23-0.74), 40% less than previously reported, reflecting the impact of direct acting antiviral therapy. Differently, HBsAg positive subjects were mostly foreign migrants (53%) with no other risk factors. Despite the implementation of a linkage-to-care circuit, one third of HBsAg positive subjects were lost.
CONCLUSIONS
CONCLUSIONS
The prevalence of HCV infection was lower than previously reported, showing a strong impact of direct acting antiviral therapy in the last years. Because of hepatitis B universal vaccination, HBV infection in Catalonia is mainly associated with migrant population. Linkage-to-care in patients with hepatitis B was challenging and warrants additional efforts.
Substances chimiques
Antiviral Agents
0
Biomarkers
0
Hepatitis B Surface Antigens
0
Hepatitis C Antibodies
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1570-1578Subventions
Organisme : Fellowship Program Gilead 2015
ID : GLD15/00274
Organisme : Instituto de Salud Carlos III
ID : PI18/00079
Organisme : Instituto de Salud Carlos III, Rio Ortega program
ID : CM17/00015
Organisme : Secretaria d' Universitats i Recerca del Departament d' Economia I Coneixement
ID : Grant 2017/SGR 1342
Organisme : Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement
ID : grant 2017 SGR 1753
Informations de copyright
© 2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
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