Surveillance data on hepatitis B and C show evidence of on-going transmission of viral hepatitis in Europe with 29 307 newly diagnosed cases of acute and chronic hepatitis B (HBV) and 33 860 cases of hepatitis C (HCV) reported in 2016. What is more, these figures do not provide a true picture of the epidemiological burden, as ECDC estimates that around 9 million Europeans live with chronic HBV or HCV, including many with undiagnosed infection.
Understanding viral hepatitis better
ECDC coordinates the enhanced surveillance for hepatitis A, B and C to help countries define epidemiological trends or transmission patterns among newly diagnosed cases. The surveillance data for 2016 show that across the European Union and European Economic Area, chronic infections with HBV and/or HCV dominate the notification trends. Chronic viral hepatitis can result in serious liver disease such as cirrhosis and cancer. Unlike acute infections, chronic hepatitis is typically asymptomatic and those infected are often unaware of it.
This in turn means that the notification data on HBV and HCV diagnoses mostly reflect local testing practices rather than giving an accurate insight into the true burden of viral hepatitis across Europe. ECDC has been expanding the sources of data on these infections and provides prevalence data as an additional source that allows for a clearer picture of the actual burden of disease – and helps to better inform national prevention and control programmes.
Adding more insight: the ECDC prevalence database
On the occasion of World Hepatitis Day, ECDC will launch a prevalence database for hepatitis B and C which includes data mainly based on peer-reviewed cross sectional studies from 2006 onwards. The database includes studies on men who have sex with men, prisoners, pregnant women, migrants and the general population. Data on first-time blood donors are also included. The database is interactive and the user can select which countries and years to view.
Prevalence data may be used to determine if there is a need to:
- target and expand testing for chronic HBV and HCV infection to certain risk groups,
- estimate the size of the chronically infected population who may be in need of treatment.
- In future, possibly pick up certain trends that may require specific interventions.
At present, available evidence suggests that reaching, testing and linkage to care of those at risk of hepatitis infection is a major challenge across most of Europe – and a barrier to the elimination of viral hepatitis as public health threat by 2030 as outlined in the global viral hepatitis elimination strategy.
In order to interrupt transmission chains and to prevent further hepatitis infections, European countries need to strengthen local prevention and control practices as outlined in the World Health Organization’s European Action plan for the health sector response to viral hepatitis . The information from the ECDC prevalence database helps to focus on the key population groups and areas of high prevalence where efforts should be targeted.
ECDC is currently working in collaboration with the WHO Regional Office for Europe and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) to develop a framework to support EU/EEA countries monitor implementation of programmes to tackle hepatitis B and C. This system will be rolled out later in 2018 in an attempt to provide a comprehensive and much needed overview of the progress in tackling these infections.
World Hepatitis Day is marked on 28 July each year to increase the awareness and understanding of viral hepatitis. The five known hepatitis viruses are types A, B, C, D and E.
See the databases