Estimating the global prevalence of hepatitis C infection

2017 - 08 - 24

Estimating the global prevalence of hepatitis C infection

Scientists from LIH contributed to a worldwide and a European study on hepatitis C prevalence conducted by large consortia. The prevalence of hepatitis C was estimated to 1.0% worldwide, a percentage which is lower than in previous less precise estimations, and to 0.63% in Europe.

Hepatitis C is a disease of viral origin that is characterised by an inflammation of the liver. The hepatitis C virus (HCV) can cause both acute and chronic hepatitis. The severity of the disease can range from mild symptoms lasting a few weeks to a serious, long-lasting illness. It can develop into chronic cirrhosis and liver cancer if not diagnosed early and treated adequately. The virus can be transmitted by the exposure to small quantities of blood, the population group being most at risk are drug users with unsafe drug injection practices.

A strategy was presented in 2016 at the World Health Assembly about the care and management of hepatitis infection. The targets of the World Health Organisation (WHO) are a 65% reduction in liver-related deaths, a 90% reduction of new hepatitis infections, and 90% of patients with hepatitis infections being diagnosed by 2030.

The global study conducted by a large consortium, the Polaris Observatory HCV Collaborators, included data from 100 countries representing more than 85% of the world’s population. The data was collected from a systemic review of the literature on prevalence and genotype after the year 2013, complemented with interviews with 400 country expert (Delphi process) to identify missing inputs and approve data. The combination of all the data allowed to estimate the prevalence of viraemic HCV to 0.1% in 2015, which corresponds to 71.1 million people. HCV genotypes 1 and 3 were found to be the most common cause of infection. This study is of high relevance for the development of strategies at country and regional level to control the hepatitis burden by 2030.

The European study led by the European Union HCV Collaborators assessed the burden of HCV infection in the 28 EU members states and evaluated the level of intervention required to achieve the WHO goals. A similar methodology was employed as for the global study. The prevalence for HCV was estimated to 0.63% in 2015, corresponding to 3.2 million infections. The authors claim that the WHO targets are achievable in Europe with a united effort.

Dr Carole Devaux from the Department of Infection and Immunity and Daniel Struck from the Department of Population Health at LIH provided the data sets for Luxembourg in both studies and validated and optimised the input of the modelling as local HCV experts, with Dr Vic Arendt from the National Service for Infectious Diseases of the “Centre Hospitalier de Luxembourg”, Dr Joël Mossong from the “Laboratoire national de santé” and Patrick Hoffmann from the Ministry of Health. The Polaris Observatory in which the LIH scientists are part was created in 2015 to monitor and forecast the disease burden for hepatitis B and C and provide decision analytics to support the worldwide elimination of hepatitis.

Both publications appeared in the journal “The Lancet Gastroenterology & Hepatology” in the issues of March and May 2017.

Links to publications:

Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study

Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: a modelling study