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Hepatitis C Virus Epidemiology in Lithuania: Situation before Introduction of the National Screening Programme
Egle Ciupkeviciene1, Janina Petkeviciene1, Jolanta Sumskiene2
1Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, LT47181 Kaunas, Lithuania.
Insights
Lithuanian primary care centers screened nearly 5000 individuals for hepatitis C virus (HCV) infection, finding a 1.7% prevalence. This highlights the effectiveness of integrating HCV screening into routine healthcare, especially for at-risk populations.
Area of Science:
- Hepatology
- Public Health
- Infectious Diseases
Background:
- Lithuania implemented a national strategy in 2022 for hepatitis C virus (HCV) screening, including general practitioners and at-risk groups.
- HCV infection remains a significant global health concern, necessitating effective screening and management strategies.
Purpose of the Study:
- To evaluate HCV-related mortality trends in Lithuania from 2010-2020.
- To determine the prevalence of HCV infection among patients with liver diseases.
- To assess the feasibility and yield of HCV screening in a primary healthcare setting.
Main Methods:
- Age-standardized mortality rates for chronic hepatitis C and liver diseases were calculated.
- HCV infection data were collected from patients with liver cirrhosis, cancer, and transplant recipients at Kauno Klinikos.
- A pilot HCV screening program was conducted at a primary healthcare center in Klaipeda, assessing anti-HCV prevalence and risk factors.
Main Results:
- No consistent trend in HCV-related mortality was observed between 2010 and 2020.
- High HCV prevalence was found in patients with liver diseases: 40.5% with cirrhosis, 49.7% with cancer, and 36.9% post-transplant.
- The pilot screening identified a 1.7% anti-HCV prevalence (2.1% in men, 1.3% in women) among 4867 participants.
- Risk factors for HCV infection included blood transfusions, prior blood donation (pre-1993), and tattoos.
Conclusions:
- HCV screening in primary care settings is effective, demonstrating active patient participation.
- Integrating HCV screening into primary care is crucial for identifying infections, particularly among individuals with liver diseases and those with specific risk factors.
- The study underscores the importance of continued efforts in HCV detection and management within the Lithuanian healthcare system.
Abstract:
In 2022, the Lithuanian health authorities decided to pay general practitioners a fee for performing serological tests for hepatitis C virus (HCV) antibodies in the population born from 1945 to 1994 once per life and annual HCV testing for PWID and HIV infected patients. This study aimed to assess trends in HCV-related mortality in the country and the prevalence of HCV infection among patients with liver diseases and evaluate possibilities of screening for HCV infection at a primary health care center. Age-standardized mortality rates in 2010-2020 were calculated for deaths caused by chronic hepatitis C and some liver diseases. Data on HCV infection among patients with liver cirrhosis, cancer and transplant patients were collected from the tertiary care hospital Kauno Klinikos. The prevalence of anti-HCV and risk factors of HCV infection was assessed among patients registered with the health care center in Klaipeda, where a pilot study of screening was performed. No steady trend in mortality was observed. Analysis of medical documentation showed that 40.5% of patients with liver cirrhosis, 49.7% with cancers and 36.9% of transplant patients were HCV infected. Over the year, 4867 patients were screened in the primary health care center. Positive anti-HCV prevalence was 1.7% (2.1% in men and 1.3% in women). Blood transfusion and being a blood donor before 1993 also having tattoos were associated with higher odds of HCV infection. The study revealed the active participation of individuals in HCV screening.
