The Epidemiology of Chronic Hepatitis C: Where We Are Now
Abstract
:1. Global Chronic HCV Epidemiology
2. Epidemiology of Chronic HCV in Europe
3. The Chronic HCV Burden in Italy
4. An Overview of Chronic HCV in Tuscany
- activation of an information campaign aimed at the target population;
- organization of an HCV program;
- consolidation of the linkage to the care system for subjects with active HCV (HCV RNA positive);
- computerization of data from screening activities through the use of platforms already operational in the region.
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- World Health Organization. Global Health Sector Strategy on Viral Hepatitis 2016–2021. Towards Ending Viral Hepatitis. 2016. Available online: https://www.who.int/publications/i/item/WHO-HIV-2016.06 (accessed on 17 May 2016).
- World Health Organization. Hepatitis C. 2023. Available online: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c (accessed on 18 July 2023).
- Salari, N.; Kazeminia, M.; Hemati, N.; Ammari-Allahyari, M.; Mohammadi, M.; Shohaimi, S. Global prevalence of hepatitis C in general population: A systematic review and meta-analysis. Travel Med. Infect. Dis. 2022, 46, 102255. [Google Scholar] [CrossRef]
- World Health Organization. WHO Publishes Updated Guidance on Hepatitis C Infection—With New Recommendations on Treatment of Adolescents and Children, Simplified Service Delivery and Diagnostics. 2022. Available online: https://www.who.int/news/item/24-06-2022-WHO-publishes-updated-guidance-on-hepatitis-C-infection (accessed on 24 June 2022).
- World Health Organization. World Hepatitis Summit 2022 Urges Action to Eliminate Viral Hepatitis as Unexplained Hepatitis Cases in Children Rise Globally. 2022. Available online: https://www.who.int/news/item/07-06-2022-world-hepatitis-summit-2022-urges-action-to-eliminate-viral-hepatitis-as-unexplained-hepatitis-cases-in-children-rise-globally (accessed on 7 June 2022).
- World Health Organization. Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis and Sexually Transmitted Infections for the Period 2022–2030. 2022. Available online: https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/full-final-who-ghss-hiv-vh-sti_1-june2022.pdf?sfvrsn=7c074b36_9 (accessed on 1 June 2022).
- Moore, K.J.; Gauri, A.; Koru-Sengul, T. Prevalence and sociodemographic disparities of Hepatitis C in Baby Boomers and the US adult population. J. Infect. Public Health 2019, 12, 32–36. [Google Scholar] [CrossRef]
- Viejo, L.G.-E.; Herola, A.G.; Lloret, I.S.; Ruano, F.S.; Paulino, I.C.; Ivorra, C.Q.; Saavedra, I.A.; Pérez, D.M.; de la Osa, J.V. Screening of hepatitis C virus infection in adult general population in Spain. Eur. J. Gastroenterol. Hepatol. 2018, 30, 1077–1081. [Google Scholar] [CrossRef]
- Andriulli, A.; Stroffolini, T.; Mariano, A.; Valvano, M.R.; Grattagliano, I.; Ippolito, A.M.; Grossi, A.; Brancaccio, G.; Coco, C.; Russello, M.; et al. Declining prevalence and increasing awareness of HCV infection in Italy: A population-based survey in five metropolitan areas. Eur. J. Intern. Med. 2018, 53, 79–84. [Google Scholar] [CrossRef]
- Platt, L.; Easterbrook, P.; Gower, E.; McDonald, B.; Sabin, K.; McGowan, C.; Yanny, I.; Razavi, H.; Vickerman, P. Prevalence and burden of HCV co-infection in people living with HIV: A global systematic review and meta-analysis. Lancet Infect. Dis. 2016, 16, 797–808. [Google Scholar] [CrossRef]
- Nelson, P.K.; Mathers, B.M.; Cowie, B.; Hagan, H.; Jarlais, D.D.; Horyniak, D.; Degenhardt, L. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: Results of systematic reviews. Lancet 2011, 378, 571–583. [Google Scholar] [CrossRef]
- Gharaei, H.A.; Fararouei, M.; Mirzazadeh, A.; Sharifnia, G.; Rohani-Rasaf, M.; Bastam, D.; Rahimi, J.; Kouhestani, M.; Rezaian, S.; Dianatinasab, M. The global and regional prevalence of hepatitis C and B co-infections among prisoners living with HIV: A systematic review and meta-analysis. Infect. Dis. Poverty 2021, 10, 93. [Google Scholar] [CrossRef]
- Kim, H.N.; Corcorran, M.A. Treatment of HCV in Persons with HIV Coinfection. Available online: https://www.hepatitisc.uw.edu/go/key-populations-situations/treatment-hiv-coinfection/core-concept/all (accessed on 24 January 2024).
- Frankova, S.; Jandova, Z.; Jinochova, G.; Kreidlova, M.; Merta, D.; Sperl, J. Therapy of chronic hepatitis C in people who inject drugs: Focus on adherence. Harm Reduct. J. 2021, 18, 69. [Google Scholar] [CrossRef]
- Hariri, S.; Sharafi, H.; Sheikh, M.; Merat, S.; Hashemi, F.; Azimian, F.; Tamadoni, B.; Ramazani, R.; Gouya, M.M.; Abbasi, B.; et al. Continuum of hepatitis C care cascade in prison and following release in the direct-acting antivirals era. Harm Reduct. J. 2020, 17, 80. [Google Scholar] [CrossRef]
- Dai, C.-Y.; Chuang, W.-L.; Yu, M.-L. EASL recommendations on treatment of hepatitis C: Final update of the series—Some issues. J. Hepatol. 2021, 74, 473–474. [Google Scholar] [CrossRef]
- European Centre for Disease Prevention and Control. Available online: https://www.ecdc.europa.eu/sites/default/files/documents/AER-HEP-C-2021.pdf (accessed on 1 December 2022).
- 30/3/2023-Epatiti virali: I dati al 31 Dicembre 2022. Available online: https://www.epicentro.iss.it/epatite/aggiornamenti (accessed on 30 March 2023).
- Artenie, A.; Stone, J.; Fraser, H.; Stewart, D.; Arum, C.; Lim, A.G.; McNaughton, A.L.; Trickey, A.; Ward, Z.; Abramovitz, D.; et al. Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: A global systematic review and meta-analysis. Lancet Gastroenterol. Hepatol. 2023, 8, 533–552. [Google Scholar] [CrossRef]
- Spada, E.; Rezza, G.; Garbuglia, A.R.; Lombardo, F.L.; Zuccaro, O.; Menniti Ippolito, F.; Cupellaro, E.; Capone, S.; Capobianchi, M.R.; Nicosia, A.; et al. Incidence and Risk Factors for Hepatitis C Virus Infection among Illicit Drug Users in Italy. J. Urban Health 2018, 95, 99–110. [Google Scholar] [CrossRef]
- Polarys CDA Foundation. Available online: https://cdafound.org/polaris-regions-dashboard (accessed on 23 March 2023).
- Kondili, L.A.; Andreoni, M.; Aghemo, A.; Mastroianni, C.M.; Merolla, R.; Gallinaro, V.; Craxì, A. Prevalence of hepatitis C virus estimates of undiagnosed individuals in different Italian regions: A mathematical modelling approach by route of transmission and fibrosis progression with results up to January 2021. New Microbiol. 2022, 45, 249–259. [Google Scholar]
- Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2021–Data Slides. Available online: http://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/who_ghss_global_report_2021_ppt.pdf?sfvrsn=386417bb_20 (accessed on 15 July 2021).
- Monforte, A.D.; Tavelli, A.; Rossotti, R.; Gagliardini, R.; Saracino, A.; Caputo, S.L.; Sala, M.; Quiros-Roldan, E.; Mussini, C.; Girardi, E.; et al. Is HCV elimination among persons living with HIV feasible? Data from the NoCo study in the setting of the ICONA cohort. Liver Int. 2023, 43, 2130–2141. [Google Scholar] [CrossRef]
- Degenhardt, L.; Peacock, A.; Colledge, S.; Leung, J.; Grebely, J.; Vickerman, P.; Stone, J.; Cunningham, E.B.; Trickey, A.; Dumchev, K.; et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: A multistage systematic review. Lancet Glob. Health 2017, 5, e1192–e1207. [Google Scholar] [CrossRef]
- Viral Hepatitis Elimination Barometer among People Who Inject Drugs in Europe. Available online: https://www.emcdda.europa.eu/publications/data-factsheet/viral-hepatitis-elimination-barometer-among-people-who-inject-drugs-in-europe_en (accessed on 1 November 2023).
- Stasi, C.; Silvestri, C.; Berni, R.; Brunetto, M.R.; Zignego, A.L.; Orsini, C.; Milani, S.; Ricciardi, L.; De Luca, A.; Blanc, P.; et al. Epidemiological, demographic and clinical data on chronic viral hepatitis C in Tuscany. Curr. Med. Res. Opin. 2019, 35, 661–666. [Google Scholar] [CrossRef]
- Shiffman, M.L. The next wave of hepatitis C virus: The epidemic of intravenous drug use. Liver Int. 2018, 38, 34–39. [Google Scholar] [CrossRef]
- Valerio, H.; Alavi, M.; Conway, A.; Silk, D.; Treloar, C.; Martinello, M.; Milat, A.; Dunlop, A.; Murray, C.; Henderson, C.; et al. Declining prevalence of current HCV infection and increased treatment uptake among people who inject drugs: The ETHOS Engage study. Int. J. Drug Policy 2022, 105, 103706. [Google Scholar] [CrossRef]
- Salari, N.; Darvishi, N.; Hemmati, M.; Shohaimi, S.; Ghyasi, Y.; Hossaini, F.; Bazrafshan, M.-R.; Akbari, H.; Mohammadi, M. Global prevalence of hepatitis C in prisoners: A comprehensive systematic review and meta-analysis. Arch. Virol. 2022, 167, 1025–1039. [Google Scholar] [CrossRef]
- American Association for the Study of Liver Diseases. Infectious Diseases Society of America. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C. Available online: https://www.hcvguidelines.org/ (accessed on 27 August 2020).
- US Preventive Services Task Force; Owens, D.K.; Davidson, K.W.; Krist, A.H.; Barry, M.J.; Cabana, M.; Caughey, A.B.; Donahue, K.; Doubeni, C.A.; Epling, J.W.; et al. Screening for Hepatitis C Virus Infection in Adolescents and Adults. JAMA 2020, 323, 970–975. [Google Scholar] [CrossRef]
- European Centre for Disease Prevention and Control. Prevention of Hepatitis B and C in the EU/EEA. 2022. Available online: https://www.ecdc.europa.eu/en/publications-data/prevention-hepatitis-b-and-c-eueea (accessed on 1 December 2022).
- GBD 2019 Europe Hepatitis B & C Collaborators. Hepatitis B and C in Europe: An update from the Global Burden of Disease Study 2019. Lancet Public Health 2023, 8, e701–e716. [Google Scholar] [CrossRef]
- Polaris Observatory. The Authoritative Resource for Epidemiological Data, Modeling Tools, Training, and Decision Analytics to Support Global Elimination of Hepatitis B and C by 2030. Available online: http://www.hepbunited.org/assets/Webinar-Slides/8b54a78215/POLARIS-Brief-181217.pdf (accessed on 1 June 2022).
- World Health Organization. Hepatitis C in the WHO European Region. Fact Sheet–July 2018. Available online: http://www.euro.who.int/__data/assets/pdf_file/0009/377253/fact-sheet-hepatitis-c-eng.pdf?ua=1 (accessed on 1 July 2018).
- Agenzia Italiana del Farmaco. Registri AIFA per il Monitoraggio dei Farmaci Anti-HCV. Available online: https://www.aifa.gov.it/aggiornamento-epatite-c (accessed on 18 March 2023).
- Stasi, C.; Silvestri, C.; Bravi, S.; Aquilini, D.; Casprini, P.; Epifani, C.; Voller, F.; Cipriani, F. Hepatitis B and C epidemiology in an urban cohort in Tuscany (Italy). Clin. Res. Hepatol. Gastroenterol. 2015, 39, e13–e15. [Google Scholar] [CrossRef]
- Agenzia Regionale di Sanità della Toscana, 2023. La Sorveglianza Epidemiologica delle Malattie Infettive in Toscana 2022. Rapporti ARS, n. 5. Available online: https://www.ars.toscana.it/images/pubblicazioni/Rapporti/2023/Rapporto_malattie_infettive_2022_def.pdf (accessed on 24 November 2022).
- REGIONE TOSCANA. Programma per l’ Eradicazione del Virus dell’ Epatite Cronica “C” nella Popolazione Toscana. Available online: https://www301.regione.toscana.it/bancadati/atti/Contenuto.xml?id=5100188&nomeFile=Delibera_n.647_del_18-05-2015 (accessed on 18 May 2015).
- Regione Toscana Progetto per la Realizzazione di un Programma per il Controllo Dell’epatite Cronica c in Toscana. Available online: http://www301.regione.toscana.it/bancadati/atti/Contenuto.xml?id=5177892&nomeFile=Delibera_n.397_del_09-04-2018 (accessed on 9 April 2018).
- Ministero della Salute. DECRETO 14 Maggio 2021. Esecuzione dello Screening Nazionale per L’eliminazione del Virus dell’HCV. (21A04075) (GU Serie Generale n.162 del 08-07-2021). Available online: https://www.gazzettaufficiale.it/eli/id/2021/07/08/21A04075/sg (accessed on 8 July 2021).
- REGIONE TOSCANA. Avvio di un Programma di Screening Gratuito per Prevenire, Eliminare ed Eradicare il Virus Dell’epatite C, in Attuazione Dell’art. 25-Sexies del D.L.n. 162/2019. Available online: http://www301.regione.toscana.it/bancadati/atti/Contenuto.xml?id=5355950&nomeFile=Delibera_n.1538_del_27-12-2022 (accessed on 31 December 2022).
- OPT HEPAC. Optimisation of Diagnosis and Care Pathways for Chronic HCV in Tuscany. Available online: https://www.unipi.it/index.php/risultati-e-prodotti/item/18717-opt-heaps (accessed on 31 July 2020).
- Ceccarelli, L.; Stasi, C.; Bartolacci, S.; Lazzeretti, M.; Tavoschi, L.; Silvestri, C. DAA Treatment Uptake and Impact over 2015–2020 in Tuscany, Italy. 2021. Available online: https://elibrary.escmid.org/?search%5Bquery%5D=%22Luca+Ceccarelli%22 (accessed on 9 July 2022).
- Stasi, C.; Silvestri, C.; Fanti, E.; Di Fiandra, T.; Voller, F. Prevalence and features of chronic viral hepatitis and HIV coinfection in Italian prisons. Eur. J. Intern. Med. 2016, 34, e21–e22. [Google Scholar] [CrossRef]
- Silvestri, C.; Stasi, C.; Lazzeretti, M.; Voller, F. Substance Abuse Disorder and Viral Infections (Hepatitis, HIV): A Multicenter Study in Tuscan Prisons. J. Correct. Health Care 2021, 27, 161–166. [Google Scholar] [CrossRef]
- Puglia, M.; Stasi, C.; Da Frè, M.; Voller, F. Prevalence and characteristics of HIV/HBV and HIV/HCV coinfections in Tuscany. Braz. J. Infect. Dis. 2016, 20, 330–334. [Google Scholar] [CrossRef]
Key strategic and operational actions required to eliminate viral hepatitis | Promote greater public and political awareness of the importance of prevention, diagnosis, and treatment of hepatitis B and C. |
Greater financial resources, including in the area of prevention; | |
improve diagnosis and treatment of hepatitis; | |
provide universal access to hepatitis B vaccines at birth; improve screening procedures for pregnant women aimed at preventing vertical transmission (mother-child); | |
invest in primary prevention, particularly in people at risk; | |
increase access to testing for subjects infected with chronic hepatitis B and C viruses; | |
improve access to care; | |
promote simplified service delivery models; | |
overcome the barriers encountered by the most affected and at-risk populations; | |
strengthen collaborations aimed at the prevention, diagnosis, and treatment of viral hepatitis. | |
Targets | Goals of 90–80% hepatitis B or C patients diagnosed and treated; |
90% administration of the first dose of hepatitis B vaccine at birth to prevent vertical transmission (from mother with hepatitis B infection to child); | |
90% vaccination coverage in children (administration of the third dose); | |
distribution of 300 sterile needles and syringes to people who inject drugs; | |
100% blood units screened and 100% safe injections. |
Globally | Europe | Italy | |||
---|---|---|---|---|---|
Incidence | HCV * | 1.5 million [2] | 1019 [17] | 55 [18] | |
Incidence | HCV in PWID | 12.1/100 person years [19] | 12.8/100 person years [19] | 5.83/100 person years [20] | |
Prevalence | HCV | 50,688,000 [21] | 6,271,000 [21] | 398,610 [22] | |
HIV/HCV | 2.3 million [23] | 66,800 [10] | 27.3% HCV-Ab positive; of those tested for HCV-RNA 39.3% were positive [24] | ||
HCV in PWID | 52.3% are HCV Ab positive [25] | 60.64% average of HCVAb positive in 11 countries with recent data [26] | 54.1–71% HCV Ab positive [26] |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Stasi, C.; Milli, C.; Voller, F.; Silvestri, C. The Epidemiology of Chronic Hepatitis C: Where We Are Now. Livers 2024, 4, 172-181. https://doi.org/10.3390/livers4020013
Stasi C, Milli C, Voller F, Silvestri C. The Epidemiology of Chronic Hepatitis C: Where We Are Now. Livers. 2024; 4(2):172-181. https://doi.org/10.3390/livers4020013
Chicago/Turabian StyleStasi, Cristina, Caterina Milli, Fabio Voller, and Caterina Silvestri. 2024. "The Epidemiology of Chronic Hepatitis C: Where We Are Now" Livers 4, no. 2: 172-181. https://doi.org/10.3390/livers4020013