Sergio Rodríguez-Tajes1,2, Ángela Domínguez3, Jose Antonio Carrión2,4, María Buti2,5, Joan Carles Quer2,6, Rosa M Morillas2,7, Carme López2,8, Xavier Torras2,9, Carme Baliellas2,10, Merche Vergara2,11, Montse Forner2,12, Natividad Zaragoza2,13, Joan Salò2,14, Joaquim Rigau2,15, Llorenç Caballeria2,16, Zoe Mariño1,2, Mireia Janè17, Joan Colom17, Xavier Forns1,2, Sabela Lens1,2. 1. Liver Unit, Hospital Clínic, IDIBAPS and CIBEREHD, University of Barcelona, Barcelona, Spain. 2. Societat Catalana de Digestologia, Barcelona, Spain. 3. Medicine Department, University of Barcelona and CIBERESP, Barcelona, Spain. 4. Liver Unit, Hospital del Mar, Barcelona, Spain. 5. Liver Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron and CIBEREHD, Barcelona, Spain. 6. Liver Unit, Hospital Universitario Joan XXIII, Tarragona, Spain. 7. Liver Unit, Hospital Germans Trias i Pujol, IGTP, CIBEREHD, Autonomous University of Barcelona, Barcelona, Spain. 8. Liver Unit, Hospital Josep Trueta, Girona, Spain. 9. Liver Unit, Hospital Santa Creu iSant Pau and CIBEREHD, Barcelona, Spain. 10. Liver Unit, Hospital Bellvitge, Barcelona, Spain. 11. Liver Unit, Hospital Parc Taulí, Sabadell, Spain. 12. Liver Unit, Hospital Mutua de Terrassa, Terrassa, Spain. 13. Liver Unit, Hospital Arnau Vilanova, Lleida, Spain. 14. Liver Unit, Hospital de Vic, Vic, Spain. 15. Liver Unit, Hospital Granollers, Granollers, Spain. 16. Unidad de Apoyo a la Investigación (USR) Metropolitana Nord, Instituto Universitario de Investigación en Atención Primaria (IDIAP) Jordi Gol, Mataró, Spain. 17. Program for the Prevention, Control and Care of HIV, Sexually Transmitted Infections and Viral Hepatitis, Public Health Agency of Catalonia, Barcelona, Spain.
Abstract
BACKGROUND AND AIM: 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: 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: 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: 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.
BACKGROUND AND AIM: 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: 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: 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: 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.
Authors: Laura Huiban; Carol Stanciu; Cristina Maria Muzica; Tudor Cuciureanu; Stefan Chiriac; Sebastian Zenovia; Vladut Mirel Burduloi; Oana Petrea; Ana Maria Sîngeap; Irina Gîrleanu; Cătălin Sfarti; Camelia Cojocariu; Anca Trifan Journal: Healthcare (Basel) Date: 2021-05-31
Authors: David Chromy; David J M Bauer; Benedikt Simbrunner; Matthias Jachs; Lukas Hartl; Philipp Schwabl; Caroline Schwarz; Armin Rieger; Katharina Grabmeier-Pfistershammer; Michael Trauner; Peter Ferenci; Mattias Mandorfer; Michael Gschwantler; Thomas Reiberger Journal: J Viral Hepat Date: 2022-03-15 Impact factor: 3.517