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Europe’s journal on infectious disease epidemiology, prevention and control Special edition: Hepatitis C virus infection December 2017 Featuring • 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 • Towards elimination of hepatitis B and C in European Union and European Economic Area countries: monitoring the World Health Organization’s global health sector strategy core indicators and scaling up key interventions www.eurosurveillance.org Editorial team Editorial advisors Based at the European Centre for Albania: Alban Ylli, Tirana Disease Prevention and Control (ECDC), Austria: Maria Paulke-Korinek, Vienna 171 65 Stockholm, Sweden Belgium: Koen de Schrijver; Tinne Lernout, Antwerp Telephone number Bosnia and Herzegovina: Sanjin Musa, Sarajevo +46 (0)8 58 60 11 38 Bulgaria: Iva Christova, Sofia E-mail Croatia: Sanja Music Milanovic, Zagreb [email protected] Cyprus: Maria Koliou, Nicosia Czech Republic: Jan Kynčl, Prague Editor-in-chief Denmark: Peter Henrik Andersen, Copenhagen Dr Ines Steffens Estonia: Kuulo Kutsar, Tallinn Senior editor Finland: Outi Lyytikäinen, Helsinki Kathrin Hagmaier France: Judith Benrekassa, Paris Germany: Jamela Seedat, Berlin Scientific editors Greece: Rengina Vorou, Athens Janelle Sandberg Hungary: Ágnes Hajdu, Budapest Karen Wilson Iceland: Gudrun Sigmundsdottir, Reykjavík Assistant editors Ireland: Lelia Thornton, Dublin Alina Buzdugan Italy: Paola De Castro, Rome Vilasini Roy Latvia: Dzintars Mozgis, Riga Ingela Rumenius Lithuania: Saulius Čaplinskas, Vilnius Associate editors Luxembourg: Thérèse Staub, Luxembourg Tommi Asikainen, Brussels, Belgium The former Yugoslav Republic of Macedonia: Aziz Pollozhani, Skopje Magnus Boman, Stockholm, Sweden Malta: Tanya Melillo Fenech, Msida Mike Catchpole, Stockholm, Sweden Montenegro: Senad BegiĆ, Podgorica Natasha Crowcroft, Toronto, Canada Netherlands: Barbara Schimmer, Bilthoven Christian Drosten, Bonn, Germany Norway: to be confirmed Karl Ekdahl, Stockholm, Sweden Poland: Malgorzata Sadkowska-Todys, Warsaw Johan Giesecke, Stockholm, Sweden Portugal: Paulo Jorge Nogueira, Lisbon David Heymann, London, United Kingdom Romania: Daniela Pitigoi, Bucharest Irena Klavs, Ljubljana, Slovenia Serbia: Mijomir Pelemis, Belgrade Karl Kristinsson, Reykjavik, Iceland Slovakia: Lukáš Murajda, Bratislava Daniel Lévy-Bruhl, Paris, France Slovenia: Maja Sočan, Ljubljana Jacob Moran-Gilad, Beer-Sheva, Israel Spain: Josefa Masa Calle, Madrid Panayotis T. Tassios, Athens, Greece Sweden: Anders Wallensten, Stockholm Hélène Therre, Paris, France Turkey: Fehminaz Temel, Ankara Henriette de Valk, Paris, France United Kingdom: Nick Phin, London Sylvie van der Werf, Paris, France World Health Organization Regional Office for Europe: Robb Design / Layout Butler, Copenhagen Fabrice Donguy / Dragos Platon Online submission system http://www.editorialmanager.com/eurosurveillance/ www.eurosurveillance.org © Eurosurveillance, 2017 Contents Special edition: Hepatitis C virus infection Research Articles 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 2 Garvey P C et al. Severe liver disease related to chronic hepatitis C virus infection in treatment-naive patients: epidemiological characteristics and associated factors at first expert centre visit, France, 2000 to 2007 and 2010 to 2014 10 Sanna A et al. Development and validation of the HCV-MOSAIC risk score to assist testing for acute hepatitis C virus (HCV) infection in HIV-infected men who have sex with men (MSM) 22 Newsum M et al. Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017 31 Walewska B et al. Perspectives Towards elimination of hepatitis B and C in European Union and European Economic Area countries: monitoring the World Health Organization’s global health sector strategy core indicators and scaling up key interventions 40 Duffel F et al. © Eurosurveillance www.eurosurveillance.org 1 Research article 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 P Garvey 1 2 , B O’Grady ³ , G Franzoni ³ , M Bolger ³ , K Irwin Crosby ³ , J Connell 3 , D Burke ³ , C De Gascun ³ , L Thornton ¹ 1. Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland 2. European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden 3. National Virus Reference Laboratory, University College Dublin, Dublin, Ireland Correspondence: [email protected] Citation style for this article: Garvey P, O’Grady B, Franzoni G, Bolger M, Irwin Crosby K, Connell J, Burke D, De Gascun C, Thornton L. 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):pii=30579. DOI: http://dx.doi. org/10.2807/1560-7917.ES.2017.22.30.30579 Article submitted on 26 October 2016 / accepted on 17 May 2017 / published on 30 July 2017 Robust data on hepatitis C virus (HCV) population prev- prevalence of HCV in some countries in central Asia alence are essential to inform national HCV services. (5.4%), western Africa (5.3%), central Africa (4.2%), In 2016, we undertook a survey to estimate HCV preva- eastern Europe (3.3%), and North Africa/Middle East lence among the adult population in Ireland. We used (3.1%) being higher than countries in North America anonymised residual sera available at the National (1.0%) and western Europe (0.9%) [5]. Within Europe, Virus Reference Laboratory. We selected a random prevalence estimates of 0.4% to 5.2% have been sample comprising persons ≥ 18 years with probability reported, with countries in the north and west of proportional to the general population age-sex distri- Europe having lower estimates (0.9%) than countries bution. Anti-HCV and HCV Ag were determined using in the east of Europe (3.3%) [5,6]. the Architect anti-HCV and HCV Ag assays. Fifty-three of 3,795 specimens were seropositive (age-sex-area Historically, there was limited success in treating HCV, weighted seroprevalence 0.98% (95% confidence but in recent years, treatment with new direct-act- interval (CI): 0.73–1.3%)). Thirty-three specimens ing antivirals (DAAs) that possess high efficacy and were HCV-antigen and antibody-positive (age-sex-area improved safety profiles, has led many to suggest that weighted prevalence of chronic infection 0.57% (95% the elimination of HCV is now possible [7]. Successful CI: 0.40–0.81%)). The prevalence of chronic infection treatment not only benefits the individual by reduc- was higher in men (0.91%; 95% CI: 0.61–1.4%), in ing his or her risk of cirrhosis and other liver-related specimens from the east of the country (1.4%; 95%CI: outcomes, but also benefits the general population by 0.99–2.0%), and among persons aged 30–39 years reducing rates of onward transmission. and 40–49 years (1.1% (95% CI: 0.59–2.0%) and 1.1% (95% CI: 0.64–1.9%) respectively). Ireland ranks at the With the advent of highly potent and curative DAAs, lower end of the spectrum of prevalence of chronic many countries are now developing national strate- HCV infection internationally. Men born between 1965 gies for population screening for HCV infection, and and 1984 from the east of the country have the highest national HCV treatment programmes. Initiatives in rate of chronic HCV infection. Ireland include the formal establishment in 2015 by the Health Service Executive (HSE) of a National Hepatitis C Background Treatment Programme for known HCV-infected individ- Acute hepatitis C virus (HCV) infection is typically uals [8]. Concurrently, a Guideline Development Group asymptomatic or associated with non-specific symp- was convened by the HSE to develop national HCV toms. Studies have indicated, however, that up to 80% screening guidelines to identify HCV-infected individu- of those infected will develop chronic infection, which als who are currently unaware of their HCV status. For can lead, over many decades, to cirrhosis, liver cancer these approaches to be successful, the availability of and death [1,2]. Because of the asymptomatic nature robust data on population HCV seroprevalence is key, of HCV infection, individuals can be infected for many a fact recognised both by the Irish National Hepatitis years before diagnosis. Globally, the World Health C Strategy 2011–2014 [9], and likewise in December Organization (WHO) has estimated that between 130 2015, by the European Centre for Disease Prevention and 150 million people are HCV-infected [3,4], with the and Control (ECDC) [10]. 2 www.eurosurveillance.org Figure 1 Ireland is believed to be a low-prevalence country for Construction of hepatitis C virus study sampling frame, HCV, and prior studies that measured the HCV sero- Ireland, 2014–2016 prevalence in selected high-risk or localised popula- tions, and in antenatal women [11-16], support this view; however, no national HCV prevalence studies in Serological specimens for persons age the general population have been conducted and the ≥18 years received at NVRL with dates of true burden of infection is unknown. We undertook a discard March 2016 to June 2016 national cross-sectional study to estimate HCV sero- N=49,269 prevalence and prevalence
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