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Abstract

Introduction

A national study from 2006 to 2008 showed a high antibody prevalence of 3.2% against hepatitis C virus (HCV) in Romania, but more recent epidemiological data on hepatitis C prevalence are lacking.

Aim

We aimed to estimate the current prevalence of HCV antibodies (anti-HCV) and chronic HCV infection in the general adult population in Romania, as a crucial element in monitoring progress towards eliminating hepatitis C.

Methods

We used anonymised leftover sera from a SARS-CoV-2 survey conducted between July and October 2020 (n = 2,100), supplemented with sera collected prospectively between July 2022 and March 2023 (n = 574). These included sera collected from adults visiting laboratories for routine medical check-ups. Sera were tested for anti-HCV and HCV core antigen and classified according to anti-HCV and chronic infection status.

Results

Of the total 2,674 specimens tested, 44 were anti-HCV-positive with a weighted anti-HCV prevalence of 1.4% (95% CI: 1.0–1.9), and 29 were HCV core antigen-positive with a weighted prevalence of chronic infection of 0.9% (95% CI: 0.5–1.2). The prevalence of chronic infection did not differ significantly between men and women. It was higher in persons 60 years and older (2.0%; 95% CI: 1.1–3.0) and in specimens from the North-East region (2.2%; 95% CI: 0.8–3.7).

Conclusion

Although the overall HCV prevalence in Romania is currently low, targeted screening, prevention measures and treatment scale-up are needed especially for the population 60 years and older and in the north-eastern part of the country to achieve the goal of ending the hepatitis C epidemic.

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2024-07-25
2024-10-31
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.30.2300663
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References

  1. World Health Organization (WHO). Implementing the global health sector strategies on HIV, viral hepatitis and sexually transmitted infections, 2022–2030. Report on progress and gaps 2024. Geneva: WHO; 2024. Available from: https://iris.who.int/bitstream/handle/10665/376814/9789240094925-eng.pdf
  2. Manns MP, Buti M, Gane E, Pawlotsky JM, Razavi H, Terrault N, et al. Hepatitis C virus infection. Nat Rev Dis Primers. 2017;3(1):17006.  https://doi.org/10.1038/nrdp.2017.6  PMID: 28252637 
  3. Stanaway JD, Flaxman AD, Naghavi M, Fitzmaurice C, Vos T, Abubakar I, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet. 2016;388(10049):1081-8.  https://doi.org/10.1016/S0140-6736(16)30579-7  PMID: 27394647 
  4. World Health Organization (WHO). Hepatitis C. Geneva: WHO. [Accessed: 24 Jan 2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c
  5. Nijmeijer BM, Koopsen J, Schinkel J, Prins M, Geijtenbeek TB. Sexually transmitted hepatitis C virus infections: current trends, and recent advances in understanding the spread in men who have sex with men. J Int AIDS Soc. 2019;22(Suppl) Suppl 6;e25348.  https://doi.org/10.1002/jia2.25348  PMID: 31468692 
  6. Negro F, Weis N, Lazarus J. EASL policy statement on hepatitis C elimination. Geneva: European Association for the Study of the Liver; 2019. Available from: https://easl.eu/wp-content/uploads/2019/07/EASL-Policy-Statement-on-Hepatitis-C-Elimination_June2019.pdf
  7. World Health Organization (WHO). Global health sector strategy on viral hepatitis 2016-2021. Towards ending viral hepatitis. Report No.: WHO/HIV/2016.06. Geneva: WHO; 2016. Available from: https://apps.who.int/iris/handle/10665/246177
  8. National Institute of Statistics Romania (INS). TEMPO online. Bucharest: INS. [Accessed: 15 Sep 2023]. Available from: http://statistici.insse.ro:8077/tempo-online/#/pages/tables/insse-table
  9. Gheorghe L, Csiki IE, Iacob S, Gheorghe C, Smira G, Regep L. The prevalence and risk factors of hepatitis C virus infection in adult population in Romania: a nationwide survey 2006 - 2008. J Gastrointestin Liver Dis. 2010;19(4):373-9. PMID: 21188327 
  10. Voiculescu M, Iliescu L, Ionescu C, Micu L, Ismail G, Zilisteanu D, et al. A cross-sectional epidemiological study of HBV, HCV, HDV and HEV prevalence in the SubCarpathian and south-eastern regions of Romania. J Gastrointestin Liver Dis. 2010;19(1):43-8. PMID: 20361074 
  11. Huiban L, Stanciu C, Muzica CM, Cuciureanu T, Chiriac S, Zenovia S, et al. Hepatitis C virus prevalence and risk factors in a village in northeastern Romania-A population-based screening-the first step to viral micro-elimination. Healthcare (Basel). 2021;9(6):651. . https://doi.org/10.3390/healthcare9060651  PMID: 34072635 
  12. World Health Organization (WHO). Monitoring and evaluation for viral hepatitis B and C: recommended indicators and framework. Geneva: WHO; 2016. Available from: https://iris.who.int/handle/10665/204790
  13. European Centre for Disease Prevention and Control (ECDC). Systematic review on hepatitis B and C prevalence in the EU/EEA. Stockholm: ECDC; 2016. Available from: https://www.ecdc.europa.eu/en/publications-data/systematic-review-hepatitis-b-and-c-prevalence-eueea
  14. 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
  15. Pistol A, Nicolescu O, Leustean M, Chifiriuc MC, Cucu IA, Furtunescu FL, et al. The seroprevalence of SARS-CoV-2 antibodies in Romania - first prevalence survey. BJSTR. 2021;39(1):30902-8.
  16. Blach S, Zeuzem S, Manns M, Altraif I, Duberg A-S, Muljono DH, et al. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017;2(3):161-76.  https://doi.org/10.1016/S2468-1253(16)30181-9  PMID: 28404132 
  17. Fina S, Heider B, Raț C. Unequal Romania: Regional socio-economic disparities in Romania. Bucharest: Friedrich-Ebert-Stiftung Romania; 2021. Available from: https://library.fes.de/pdf-files/bueros/bukarest/18052-20210623.pdf
  18. Raoofi S, Pashazadeh Kan F, Rafiei S, Hosseinipalangi Z, Noorani Mejareh Z, Khani S, et al. Global prevalence of nosocomial infection: A systematic review and meta-analysis. PLoS One. 2023;18(1):e0274248.  https://doi.org/10.1371/journal.pone.0274248  PMID: 36706112 
  19. Popovici O, Molnar GB, Popovici F, Janţă D, Pistol A, Azoicăi D. A seroprevalence study of hepatitis B and C virus infections in a hospitalized population in Romania, an opportunity for a better national prevention and control strategy. J Gastrointestin Liver Dis. 2016;25(1):25-32.  https://doi.org/10.15403/jgld.2014.1121.251.hbc  PMID: 27014751 
  20. Gheorghe L, Iacob S, Csiki IE, Huiban L, Cojocaru M, Cojocariu C, et al. The prevalence of HCV infection and risk factors in a hospital- based population screening, a first step to the micro-elimination of HCV infection in medical institutions from Romania - results of the HepC ALERT study. J Gastrointestin Liver Dis. 2020;29(4):587-93.  https://doi.org/10.15403/jgld-3084  PMID: 33331354 
  21. Lopes H, Baptista-Leite R, Franco D, Eclemea I, Bratu EC, Furtunescu FL, et al. Modeling the puzzle of hepatitis C epidemiology in Romania: a pathway to control. J Gastrointestin Liver Dis. 2020;29(3):377-84.  https://doi.org/10.15403/jgld-643  PMID: 32830821 
  22. Coalition for Global Hepatitis Elimination. The National Framework Plan for the viral hepatitis control in Romania, 2019-2030, coordinated by the Ministry of Health Romania (National Program). [Accessed: 28 Aug 2023]. Available from: https://www.globalhep.org/about/partner-programs/national-framework-plan-viral-hepatitis-control-romania-2019-2030
  23. Micallef JM, Kaldor JM, Dore GJ. Spontaneous viral clearance following acute hepatitis C infection: a systematic review of longitudinal studies. J Viral Hepat. 2006;13(1):34-41.  https://doi.org/10.1111/j.1365-2893.2005.00651.x  PMID: 16364080 
  24. Manuc M, Preda CM, Popescu CP, Baicuș C, Voiosu T, Pop CS, et al. New epidemiologic data regarding hepatitis C virus infection in Romania. J Gastrointestin Liver Dis. 2017;26(4):381-6.  https://doi.org/10.15403/jgld.2014.1121.264.cvr  PMID: 29253053 
  25. 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
  26. Institutul Național de Sănătate Publică. Analiza date supraveghere. [Surveillance data analysis]. Bucharest: Institutul Național de Sănătate Publică. [Accessed: 29 May 2024]. Available from: https://insp.gov.ro/centrul-national-de-supraveghere-si-control-al-bolilor-transmisibile-cnscbt/analiza-date-supraveghere
  27. United Nations Office on Drugs and Crime (UNODC). World drug report 2017. Vienna: ONODC. [Accessed: 28 May 2024]. Available from: https://www.unodc.org/wdr2017
  28. Cozzolongo R, Osella AR, Elba S, Petruzzi J, Buongiorno G, Giannuzzi V, et al. Epidemiology of HCV infection in the general population: a survey in a southern Italian town. Am J Gastroenterol. 2009;104(11):2740-6.  https://doi.org/10.1038/ajg.2009.428  PMID: 19638964 
  29. Litzroth A, Suin V, Wyndham-Thomas C, Quoilin S, Muyldermans G, Vanwolleghem T, et al. Low hepatitis C prevalence in Belgium: implications for treatment reimbursement and scale up. BMC Public Health. 2019;19(1):39.  https://doi.org/10.1186/s12889-018-6347-z  PMID: 30621662 
  30. Abdel-Aziz F, Habib M, Mohamed MK, Abdel-Hamid M, Gamil F, Madkour S, et al. Hepatitis C virus (HCV) infection in a community in the Nile Delta: population description and HCV prevalence. Hepatology. 2000;32(1):111-5.  https://doi.org/10.1053/jhep.2000.8438  PMID: 10869297 
  31. 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 
  32. World Health Organization (WHO). Guidelines on hepatitis B and C testing. Geneva: WHO; 2017. Available from: https://www.who.int/publications-detail-redirect/9789241549981
  33. European Union Drugs Agency (EUDA). Viral hepatitis elimination barometer among people who inject drugs in Europe. Lisbon: EUDA. [Accessed: 15 Nov 2023]. Available from: https://www.emcdda.europa.eu/publications/data-factsheet/viral-hepatitis-elimination-barometer-among-people-who-inject-drugs-in-europe_en
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