1887
Research Open Access
Like 0

Abstract

Introduction

Obtaining epidemiological data on chronic hepatitis C virus (HCV) infection is essential to monitor progress towards the hepatitis C elimination targets.

Aim

We aimed to estimate the prevalence of chronic HCV and the seroprevalence of HCV in the adult general population in Estonia.

Methods

This cross-sectional study, conducted between 12 July and 6 December 2022, included anonymised residual sera collected prospectively from patients 18 years and older visiting a general practitioner in all counties of Estonia. Specimens were considered HCV-seropositive if they tested positive for HCV antibodies by enzyme-linked immunoassay, confirmed by line-immunoblot assay. Chronic HCV infection was determined by positive RT-qPCR.

Results

We tested a total of 4,217 specimens. The estimated HCV seroprevalence and prevalence of chronic HCV infection were 1.8% (95% CI: 1.4–2.2) and 0.8% (95% CI: 0.5–1.1), respectively, with ca 8,100 persons estimated to have chronic HCV infection in the general adult population of Estonia. No statistically significant differences in the prevalence of chronic HCV infection were observed between sexes, counties or age groups, with the highest prevalence rates observed in men (sex ratio: 1.7), Ida-Virumaa County (1.8%; 95% CI: 0.8–3.6) and the age group 40–49 years (1.7%; 95% CI: 0.9–2.9).

Conclusion

This study found an overall low prevalence of chronic HCV infection in Estonia. Continued efforts should be made for the targeted screening, diagnosis and treatment of individuals with chronic HCV infection to achieve hepatitis elimination targets.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2024.29.30.2300651
2024-07-25
2024-12-21
/content/10.2807/1560-7917.ES.2024.29.30.2300651
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/29/30/eurosurv-29-30-6.html?itemId=/content/10.2807/1560-7917.ES.2024.29.30.2300651&mimeType=html&fmt=ahah

References

  1. Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61(1) Suppl;S58-68. https://doi.org/10.1016/j.jhep.2014.07.012  PMID: 25443346 
  2. World Health Organization (WHO). Hepatitis C. Geneva: WHO. [Accessed: 24 Jan 2024]. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c
  3. World Health Organization (WHO). Global health sector strategy on viral hepatitis 2016-2021. Geneva: WHO; 2016. Available from: https://apps.who.int/iris/bitstream/handle/10665/246177/WHO-HIV-2016.06-eng.pdf
  4. Seifert LL, Perumpail RB, Ahmed A. Update on hepatitis C: Direct-acting antivirals. World J Hepatol. 2015;7(28):2829-33. https://doi.org/10.4254/wjh.v7.i28.2829  PMID: 26668694 
  5. Hepatitis C. only a step away from elimination? Lancet. 2015;385(9973):1045. https://doi.org/10.1016/S0140-6736(15)60584-0  PMID: 25797543 
  6. Salari N, Kazeminia M, Hemati N, Ammari-Allahyari M, Mohammadi M, Shohaimi S. Global prevalence of hepatitis C in general population: A systematic review and meta-analysis. Travel Med Infect Dis. 2022;46:102255.  https://doi.org/10.1016/j.tmaid.2022.102255  PMID: 35007756 
  7. Cornberg M, Razavi HA, Alberti A, Bernasconi E, Buti M, Cooper C, et al. A systematic review of hepatitis C virus epidemiology in Europe, Canada and Israel. Liver Int. 2011;31(s2) Suppl 2;30-60.  https://doi.org/10.1111/j.1478-3231.2011.02539.x  PMID: 21651702 
  8. Worldometer. Estonia population (live). [Accessed: 25 Jan 2023]. Available from: https://www.worldometers.info/world-population/estonia-population
  9. Liakina V, Hamid S, Tanaka J, Olafsson S, Sharara AI, Alavian SM, et al. Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 3. J Viral Hepat. 2015;22(S4) Suppl 4;4-20.  https://doi.org/10.1111/jvh.12475  PMID: 26513445 
  10. Mansberg K, Kull K, Salupere R, Prükk T, Margus B, Kariis T, et al. A population-based surveillance study on the epidemiology of hepatitis c in Estonia. Medicina (Kaunas). 2018;54(1):9.  https://doi.org/10.3390/medicina54010009  PMID: 30344240 
  11. European Centre for Disease Prevention and Control (ECDC). Toolkit to support the generation of robust estimates of hepatitis C prevalence. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/toolkit-support-generation-robust-estimates-hepatitis-c-prevalence
  12. Kender E, Käbin M. “Kodulähedaste analüüside” projekti rakendamiseks vajalik proovivõtupunktide analüüs. [Evaluation of the sites taking samples for the "close-to-home analyses" project]. Tallinn: Poliitikauuringute Keskus Praxis; 2023. Estonian. Available from: https://www.praxis.ee/wp-content/uploads/2023/01/Raport_Kodulahedased_analuusid_Praxis.pdf
  13. Statistics Estonia. Statistical database. Tallin: Statistics Estonia. [Accessed: 13 Jul 2023]. Available from: https://andmed.stat.ee/en/stat
  14. Sibley A, Han KH, Abourached A, Lesmana LA, Makara M, Jafri W, et al. The present and future disease burden of hepatitis C virus infections with today’s treatment paradigm - volume 3. J Viral Hepat. 2015;22(S4) Suppl 4;21-41.  https://doi.org/10.1111/jvh.12476 
  15. Uusküla A, Rajaleid K, Talu A, Abel-Ollo K, Des Jarlais DC. A decline in the prevalence of injecting drug users in Estonia, 2005-2009. Int J Drug Policy. 2013;24(4):312-8.  https://doi.org/10.1016/j.drugpo.2012.11.002  PMID: 23290632 
  16. Raag M, Vorobjov S, Uusküla A. Prevalence of injecting drug use in Estonia 2010-2015: a capture-recapture study. Harm Reduct J. 2019;16(1):19. https://doi.org/10.1186/s12954-019-0289-3  PMID: 30871554 
  17. Kase K, Avi R, Toompere K, Rajasaar H, Pauskar M, Soodla P, et al. Dynamics of hepatitis C epidemic among people living with HIV in Estonia based on Estonian HIV cohort study. BMC Infect Dis. 2021;21(1):792.  https://doi.org/10.1186/s12879-021-06521-w  PMID: 34376170 
  18. Tolmane I, Rozentale B, Keiss J, Arsa F, Brigis G, Zvaigzne A. The prevalence of viral hepatitis C in Latvia: a population-based study. Medicina (Kaunas). 2011;47(10):532-5. https://doi.org/10.3390/medicina47100076  PMID: 22186116 
  19. Garvey P, O’Grady B, Franzoni G, Bolger M, Irwin Crosby K, Connell J, et al. Hepatitis C virus seroprevalence and prevalence of chronic infection in the adult population in Ireland: a study of residual sera, April 2014 to February 2016. Euro Surveill. 2017;22(30):30579. https://doi.org/10.2807/1560-7917.ES.2017.22.30.30579  PMID: 28797323 
  20. European Centre for Disease Prevention and Control (ECDC). Hepatitis C - Annual epidemiological report for 2021. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/hepatitis-c-annual-epidemiological-report-2021
  21. Centers for Disease Control and Prevention (CDC). Surveillance for viral hepatitis – United States, 2017. Atlanta: CDC; 2019. Available from: https://www.cdc.gov/hepatitis/statistics/2017surveillance/index.htm
  22. United Nations Development Programme (UNDP). Estonian human development report 2000. New York: UNDP; 2000. Available from: https://hdr.undp.org/system/files/documents/2000nhdrestonia.pdf
  23. National Institute on Drug Abuse (NIDA). Substance Use in Women Research Report. Sex and gender differences in substance use. Gaithersburg: NIDA. [Accessed: 2023 Mar 28]. Available from: https://nida.nih.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use
  24. Uusküla A, Talu A, Vorobjov S, Salekešin M, Rannap J, Lemsalu L, et al. The fentanyl epidemic in Estonia: factors in its evolution and opportunities for a comprehensive public health response, a scoping review. Int J Drug Policy. 2020;81:102757. https://doi.org/10.1016/j.drugpo.2020.102757  PMID: 32416523 
  25. Uusküla A, Kalikova A, Zilmer K, Tammai L, DeHovitz J. The role of injection drug use in the emergence of Human Immunodeficiency Virus infection in Estonia. Int J Infect Dis. 2002;6(1):23-7. https://doi.org/10.1016/S1201-9712(02)90131-1  PMID: 12044297 
  26. Uusküla A, Rajaleid K, Talu A, Abel K, Rüütel K, Hay G. Estimating injection drug use prevalence using state wide administrative data sources: Estonia, 2004. Addict Res Theory. 2007;15(4):411-24. https://doi.org/10.1080/16066350701417533 
  27. Eek A, Lutsar K, Salupere R, Kase K, Kiivet RA. C-hepatiidi ravi kulutõhusus. [Cost-effectiveness of hepatitis C treatment]. Tartu: Tartu Ülikooli peremeditsiini ja rahvatervishoiu instituut; 2020. Estonian. Available from: https://tervis.ut.ee/sites/default/files/2022-04/TTH39_C-hepatiit_ravi.pdf
  28. Grebely J, Page K, Sacks-Davis R, van der Loeff MS, Rice TM, Bruneau J, et al. The effects of female sex, viral genotype, and IL28B genotype on spontaneous clearance of acute hepatitis C virus infection. Hepatology. 2014;59(1):109-20. https://doi.org/10.1002/hep.26639  PMID: 23908124 
  29. Estonian Health Insurance Fund. Estonian health care system. Tallin: Tervisekassa. [Accessed: 18 Jul 2023]. Available from: https://www.tervisekassa.ee/en/people/health-care-services/estonian-health-care-system
/content/10.2807/1560-7917.ES.2024.29.30.2300651
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error