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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

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



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.


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.


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.


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.


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

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