Current prevalence of chronic hepatitis B and C virus infection in the general population, blood donors and pregnant women in the EU/EEA: a systematic review

Abstract

This systematic review aimed at estimating chronic hepatitis B (HBV) and C virus (HCV) prevalence in the European Union (EU) and Economic Area (EEA) countries in the general population, blood donors and pregnant women. We searched PubMed©, Embase© and Cochrane Library databases for reports on HBV and HCV prevalence in the general population and pregnant women in EU/EEA countries published between 2005 and 2015. Council of Europe data were used for HBV and HCV blood donor prevalence. HBV general population estimates were available for 13 countries, ranging from 0·1% to 4·4%. HCV general population estimates were available for 13 countries, ranging from 0·1% to 5·9%. Based on general population and blood donor estimates, the overall HBV prevalence in the EU/EEA is estimated to be 0·9% (95% CI 0·7-1·2), corresponding to almost 4·7 million HBsAg-positive cases; and the overall HCV prevalence to be 1·1% (95% CI 0·9-1·4), equalling 5·6 million anti-HCV-positive cases. We found wide variation in HCV and HBV prevalence across EU/EEA countries for which estimates were available, as well as variability between groups often considered a proxy for the general population. Prevalence estimates are essential to inform policymaking and public health practice. Comparing to other regions globally, HBV and HCV prevalence in the EU/EEA is low.

Keywords: Hepatitis B; hepatitis C; prevalence; systematic review.

Fig. 1.

Flow chart of study selection for the general population and pregnant women; EU/EEA countries, 2005–2015.

Fig. 2.

HBsAg prevalence (left) and anti-HCV prevalence (right) in the adult general population in the EU/EEA, based on studies published between 2005 and 2015.

Fig. 3.

HBsAg prevalence estimates from studies with a lower risk of bias for the general population (study quality score ⩾4) and for pregnant women (study quality score ⩾2), in the EU/EEA, 2005–2015 (legend: country, prevalence estimate (95% CI) and sample size (N), general population estimates represented by diamond data points, pregnant women estimates represented in italics with triangle data points). *Standardized estimates were used for Belgium and Czech Republic. *Pooled estimates were used for Germany, Italy and Spain for the general population and for Denmark, Italy, the Netherlands and the UK for pregnant women.

Fig. 4.

Anti-HCV prevalence estimates from studies with a lower risk of bias for the general population (study quality score ⩾4) and for pregnant women (study quality score ⩾2), in the EU/EEA, 2005–2015 (legend: country, prevalence estimate (95% CI) and sample size (N), general population estimates represented by diamond data points, pregnant women estimates in italics with triangle data points). *Pooled estimates were used for Germany and Italy.