Validity of hepatitis B and hepatitis C case definitions

Area of Science:

• Public Health
• Epidemiology
• Infectious Diseases

Background:

• Hepatitis B (HBV) and Hepatitis C (HCV) infections affect millions globally, with their full public health impact often underestimated.
• Standardized case definitions are crucial for effective disease surveillance and accurate assessment of infections.

Purpose of the Study:

• To evaluate the sensitivity and specificity of current European Commission (EC) and Centers for Disease Prevention and Control (CDC) case definitions for hepatitis B and C.
• To compare the diagnostic accuracy of different case definitions used in disease surveillance.

Main Methods:

• The study analyzed 150 hospital referrals with suspected hepatitis from Serbia (2014/2015).
• Sensitivity, specificity, positive, and negative predictive values of EC and CDC case definitions for HBV and HCV were assessed.

Main Results:

• Hepatitis B case definitions from EC (2008) and CDC (2012) demonstrated low sensitivity for acute and chronic cases.
• Laboratory confirmation-based definitions provided maximal sensitivity and specificity for both HBV and HCV.
• CDC's chronic HCV definition showed low sensitivity (36.8%) for probable cases, while EC's definitions were optimal for confirmed HCV cases.

Conclusions:

• Syndromic case definitions for hepatitis exhibit low sensitivity, limiting their surveillance utility.
• Laboratory diagnostics are essential, offering maximal accuracy (sensitivity, specificity, predictive values).
• There is a need for universal case definitions focused solely on confirmed cases of hepatitis B and C.