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BMC Infect Dis. 2018 Jan 16;18(1):42. doi: 10.1186/s12879-017-2908-5.

Estimating the scale of chronic hepatitis C virus infection in the EU/EEA: a focus on migrants from anti-HCV endemic countries.

Author information

1
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. am.falla@rotterdam.nl.
2
Division of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, PO Box 70032, 3000, LP, Rotterdam, The Netherlands. am.falla@rotterdam.nl.
3
Department of Health Sciences, Hamburg University of Applied Sciences, Faculty Life Sciences / Public Health Research, Ulmenliet 20, 21033, Hamburg, Germany.
4
Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246, Hamburg, Germany.
5
European Centre for Disease Prevention and Control, Granits väg 8, 171 65, Solna, Sweden.
6
Division of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, PO Box 70032, 3000, LP, Rotterdam, The Netherlands.
7
Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

Abstract

BACKGROUND:

Increasing the proportion diagnosed with and on treatment for chronic hepatitis C (CHC) is key to the elimination of hepatitis C in Europe. This study contributes to secondary prevention planning in the European Union/European Economic Area (EU/EEA) by estimating the number of CHC (anti-HCV positive and viraemic) cases among migrants living in the EU/EEA and born in endemic countries, defining the most affected migrant populations, and assessing whether country of birth prevalence is a reliable proxy for migrant prevalence.

METHODS:

Migrant country of birth and population size extracted from statistical databases and anti-HCV prevalence in countries of birth and in EU/EEA countries derived from a systematic literature search were used to estimate caseload among and most affected migrants. Reliability of country of birth prevalence as a proxy for migrant prevalence was assessed via a systematic literature search.

RESULTS:

Approximately 11% of the EU/EEA adult population is foreign-born, 79% of whom were born in endemic (anti-HCV prevalence ≥1%) countries. Anti-HCV/CHC prevalence in migrants from endemic countries residing in the EU/EEA is estimated at 2.3%/1.6%, corresponding to ~580,000 CHC infections or 14% of the CHC disease burden in the EU/EEA. The highest number of cases is found among migrants from Romania and Russia (50-60,000 cases each) and migrants from Italy, Morocco, Pakistan, Poland and Ukraine (25-35,000 cases each). Ten studies reporting prevalence in migrants in Europe were identified; in seven of these estimates, prevalence was comparable with the country of birth prevalence and in three estimates it was lower.

DISCUSSION:

Migrants are disproportionately affected by CHC, account for a considerable number of CHC infections in EU/EEA countries, and are an important population for targeted case finding and treatment. Limited data suggest that country of birth prevalence can be used as a proxy for the prevalence in migrants.

KEYWORDS:

Chronic viral hepatitis; Epidemiology; Europe; Hepatitis C virus (HCV); Migrants

PMID:
29338702
PMCID:
PMC5771208
DOI:
10.1186/s12879-017-2908-5
[Indexed for MEDLINE]
Free PMC Article

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