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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2013

Open Access 01-12-2013 | Research article

Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening

Authors: Susan JM Hahné, Irene K Veldhuijzen, Lucas Wiessing, Tek-Ang Lim, Mika Salminen, Marita van de Laar

Published in: BMC Infectious Diseases | Issue 1/2013

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Abstract

Background

Treatment for chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is improving but not benefiting individuals unaware to be infected. To inform screening policies we assessed (1) the hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus antibody (anti-HCV-Ab) prevalence for 34 European countries; and (2) the cost-effectiveness of screening for chronic HBV and HCV infection.

Methods

We searched peer-reviewed literature for data on HBsAg and anti-HCV-Ab prevalence and cost-effectiveness of screening of the general population and five subgroups, and used data for people who inject drugs (PWID) and blood donors from two European organizations. Of 1759 and 468 papers found in the prevalence and cost-effectiveness searches respectively, we included 124 and 29 papers after assessing their quality. We used decision rules to calculate weighted prevalence estimates by country.

Results

The HBsAg and anti-HCV-Ab prevalence in the general population ranged from 0.1%-5.6% and 0.4%-5.2% respectively, by country. For PWID, men who have sex with men and migrants, the prevalence of HBsAg and anti-HCV-Ab was higher than the prevalence in the general population in all but 3 countries. There is evidence that HCV screening of PWID and HBsAg screening of pregnant women and migrants is cost-effective.

Conclusion

The prevalence of chronic HBV and HCV infection varies widely between European countries. Anti-HCV-Ab screening of PWID and HBsAg screening of pregnant women and migrants have European public health priority. Cost-effectiveness analyses may need to take effect of antiviral treatment on preventing HBV and HCV transmission into account.
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Metadata
Title
Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening
Authors
Susan JM Hahné
Irene K Veldhuijzen
Lucas Wiessing
Tek-Ang Lim
Mika Salminen
Marita van de Laar
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2013
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-13-181

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