Hepatitis C community prevalence is over-estimated: a prospective, birth cohort study

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2024年1月29日

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P. Aiden McCormick,
Marie O’Grady,
Cillian F. De Gascun,
John S. Lambert,
Orla Crosbie,
Susan McKiernan,
Maeve Skelly,
Paul Holder,
Garry Courtney,
Brian Hennessy,
Kevin Walsh,
Roisin Twohig,
Kate Browne,
Tessa O’Gorman,
Vivion Crowley,
Seán J. Costelloe,
Roz O’Byrne,
Elizabeth Whitney,
Orla Gildea,
Noreen Montgomery

摘要

Background

Hepatitis C virus infection is often asymptomatic, and many patients may be unaware they are infected. Community-based, birth cohort screening has been advocated to identify these patients. It has been estimated that 0.7–1% of individuals born between 1965 and 1985 in Ireland are infected. The cost-effectiveness of screening is critically dependent on the population prevalence.

Aims

The aim is to determine the community prevalence of hepatitis C virus infection in the birth cohort 1965–1985.

Methods

Residual serum samples from blood tests ordered by community general practitioners were anonymised and analysed for the presence of hepatitis C antibody ± antigen. Twelve large general hospitals throughout the country participated.

Results

A total of 14,320 samples were tested, 9347 of which were from the birth cohort 1965–1985. Seventy-two samples were positive for hepatitis C antibody of which 12 were positive for hepatitis C antigen (17%). The overall prevalence of hepatitis C antigen in the birth cohort was 0.09%. A higher prevalence (0.39%) was identified in males in two urban areas of Dublin.

Conclusions

Hepatitis C virus seroprevalence was much lower than previously estimated. The proportion of antibody positive patients with hepatitis C antigen was also lower than expected suggesting the effects of treatment and/or high spontaneous viral clearance. Universal birth cohort screening is unlikely to be cost-effective. Targeted birth cohort screening in high prevalence areas could be considered.