Infection with hepatitis C (HCV) or hepatitis B virus (HBV) is a significant cause of liver disease-related morbidity and mortality in the European Union/European Economic Area (EU/EEA). With advent of direct-acting antivirals (cure rates >90%), elimination of chronic viral hepatitis is a possibility. An effective elimination strategy requires identification of patients at high risk for infection. A systematic review published in journal BMC Infectious Disease, provides estimates of HBV/HCV prevalence in EU/EAA among 3 high-risk groups: men who have sex with men (MSM), people who inject drugs (PWID) and people in prison.
Sixty-eight HBV/HCV prevalence estimates from 23 EU/EEA countries were evaluated. Among MSM, HBV prevalence estimates ranged from 0.0%-0.1% in Estonia and the UK to 1.4% in France. HCV estimates ranged between 4.7%-1.8%, 2.5%-2.9%, 0.7%-1.3% and 2.2%-1.6% for Estonia, Croatia, the Netherlands and the UK, respectively. HBV prevalence in the prison population ranged from 10% for Croatia, France, Germany and Hungary to >80% for Luxembourg. HBV prevalence in PWID ranged from 0.5% in Croatia, Hungary and Ireland, to >6% in Hungary and Portugal while HCV prevalence ranged between ≥30% and ≥50%.
Overall, HBV prevalence was highest among people in prison (range, 0.3%-25.2%) followed by PWID (0.5%-6.1%) and MSM (0.0%-1.4%). The highest prevalence of HCV was also found among people in prison (4.3%-86.3%) and PWID (13.8%-84.3%) followed by MSM (0.0%-4.7%).
Authors commented: “PWID and the prison population should be prioritised as the key populations for HBV/HCV screening and treatment.” They further added, “Our data does not support MSM as a high-risk group for chronic hepatitis B infection but it should still be considered as a key population for targeted action.”