Hepatitis B and C prevalence in Portugal: disparity between the general population and high-risk groups

Eur J Gastroenterol Hepatol. 2016 Jun;28(6):640-4. doi: 10.1097/MEG.0000000000000608.

Abstract

Background and aims: The prevalence of anti-HCV and HBsAg in Portugal has been shown to be elevated in high-risk groups, such as intravenous drug-users and incarcerated individuals. However, in the general population, prevalence remains largely unknown. The aims of this study were to estimate the prevalence of anti-HCV and HBsAg in the general Portuguese population and identify associated risk factors.

Materials and methods: We carried out a nationwide, population-based cross-sectional study of adults resident in mainland Portugal. Serology for HBsAg, anti-HBc, anti-HBs, and anti-HCV was performed. Anti-HCV-positive individuals were tested for HCV RNA by PCR.

Results: Of 1685 participants, 50.6% were men, mean age 50.2±18.3 years. In terms of hepatitis C, the prevalence of anti-HCV was 0.54% [95% confidence interval (CI): 0.2-0.9] and 0.12% (95% CI: 0.0-0.3) were viremic, with peak prevalence among individuals 35-64 years of age (0.8%), men (0.8%), and individuals from Lisbon and Tagus Valley region (1.9%).In terms of hepatitis B, the estimated prevalence of HBsAg was 1.45% (95% CI: 0.9-2.0). A higher prevalence was found in individuals who were 35-64 years old (2.2%), in men (2.5%), and in the Northern region (2.6%).The presence of positive serological markers of hepatitis C virus and hepatitis B virus infection did not correlate with elevated aminotransferases, race, place of birth, and alcohol consumption.

Conclusion: These results suggest a low endemicity for both hepatitis B and hepatitis C in the general population, in contrast to a very high prevalence in risk groups, thus suggesting that targeted screening to high-risk groups may be more cost-effective than general population screening.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Cross-Sectional Studies
  • Female
  • Health Status Disparities
  • Hepatitis B Antibodies / immunology
  • Hepatitis B Core Antigens / immunology
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B, Chronic / blood
  • Hepatitis B, Chronic / epidemiology*
  • Hepatitis B, Chronic / immunology
  • Hepatitis C Antibodies / immunology
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / epidemiology*
  • Hepatitis C, Chronic / immunology
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Portugal / epidemiology
  • Prevalence
  • RNA, Viral / blood
  • Risk Factors
  • Sex Distribution
  • Viremia / epidemiology*
  • Young Adult
  • gamma-Glutamyltransferase / blood

Substances

  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Hepatitis B Surface Antigens
  • Hepatitis C Antibodies
  • RNA, Viral
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase