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. 2024 Jun;193(3):1257-1260.
doi: 10.1007/s11845-023-03604-2. Epub 2024 Jan 29.

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

P Aiden McCormick  1 , Marie O'Grady  2 , Cillian F De Gascun  3 , John S Lambert  4 , Orla Crosbie  5 , Susan McKiernan  6 , Maeve Skelly  7 , Paul Holder  3 , Garry Courtney  8 , Brian Hennessy  9 , Kevin Walsh  10 , Roisin Twohig  3 , Kate Browne  3 , Tessa O'Gorman  11 , Vivion Crowley  12 , Seán J Costelloe  13 , Roz O'Byrne  14 , Elizabeth Whitney  8 , Orla Gildea  9 , Noreen Montgomery  10
Affiliations

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

P Aiden McCormick et al. Ir J Med Sci. 2024 Jun.

Abstract

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.

Keywords: Birth cohort; Cirrhosis; Direct acting antiviral agents DAA’s; Epidemiology; Hepatitis C.

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Figures

Fig. 1
Fig. 1
Geographical distribution of hospitals and the number of samples provided for the studies. SVUH, St Vincent’s University Hospital
See this image and copyright information in PMC

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