Cent Eur J Public Health 2008, 16(3):106-110 | DOI: 10.21101/cejph.a3482

Addressing HCV Infection in Europe: Reported, Estimated and Undiagnosed Cases

Simona Merkinaite¹, Jeffrey V. Lazarus², Charles Gore^3,4

¹ Eurasian Harm Reduction Network, Vilnius, Lithuania

² World Health Organization Regional Of ce for Europe, Copenhagen, Denmark

³ The Hepatitis C Trust, London, United Kingdom

⁴ World Hepatitis Alliance, London, United Kingdom

The hepatitis C virus (HCV) is a major public health problem due to its high prevalence, high rate of onward transmission and health complications. As many as 85% of people infected with HCV may go on to become chronic carriers of the disease with the risk of developing liver cancer or cirrhosis. At present, it is the most common cause of chronic liver disease and liver transplantation in a number of countries, with an estimated 250,000 people dying annually from HCV-related causes.
Despite the magnitude of the problem, the virus does not receive adequate attention from either the general public or from health policy-makers. This study assesses HCV prevalence from both estimated totals and undiagnosed cases in selected European countries. Secondary sources were assessed and experts in 17 European countries were interviewed about HCV prevalence, reporting strategies and transmission.
Available data suggest that only between 10% and 40% of people with HCV in Europe are aware of their infection (up to 90% of the prevalent pool are undiagnosed in such countries as Germany or Poland). Though the virus affects people of all ages, races and backgrounds, in Europe, between 20% and 90% of new HCV cases have been identified among past or current injecting drug users (IDUs). It is of the utmost importance to improve both public awareness and access to early testing and counselling, with the goal of prevention of further infections, maintenance of health and provision of treatment to avoid cirrhosis and liver cancer.
Additionally, as previous studies in central and eastern Europe show, evidence-based measures to prevent and manage HCV among IDUs, where most current transmission is concentrated, remain limited. Therefore, there is a strong need for intensified advocacy to put HCV higher on both public health and harm reduction agendas.

Keywords: health policy, hepatitis C - prevalence, drug use, central and eastern Europe, Europe

Received: February 15, 2008; Revised: June 20, 2008; Accepted: June 20, 2008; Published: September 1, 2008  Show citation