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Asymptomatic hepatitis C prevalence in anti-HCV
positive subjects (population based study)
Valentina Liakina, Arida Buivydiene, Saule
Brasiskiene, Jonas Valantinas
Centre of Hepatology, Gastroenterology and Dietetics
Clinic of Gastroenterology, Nephrourology and Surgery
Faculty of Medicine, Vilnius University
Aims
• To estimate the prevalence of anti-HCV in
various regions of Lithuania
• To assess the amount of HCV carriers
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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Methods
Survey was performed in 2010-2013.
3737 volunteers (age from 18 till 76 years) from healthy population who wanted
to know their ant-HCV status in Vilnius, Kaunas, Klaipeda, Panevezys, Siauliai,
Ignalina, Utena and Zarasai regions of Lithuania were admitted for anonymous
anti-HCV testing.
The study protocol was approved by Lithuanian Ethics Committee.
All participants answered anonymous questionnaire with HCV risk factors.
Financial support – ROCHE-Lietuva
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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Methods
Anti-HCV antibodies were detected by:
2010-2011: rapid lateral flow immunochromatography test from peripheral
capillary blood (Core HCV-WB; Core Diagnostics, Birmingham B2 5HG, UK).
2012-2013: rapid qualitative immunoassay from saliva samples (OraQuick® HCV
Rapid Antibody Tests OraSure Technologies, Inc, Bethlehem PA 18015 USA).
Anti-HCV positive cases were confirmed by 2-step chemiluminescent
microparticle immunoassay on venous blood (Architect System anti-HCV; Abbott,
65205 Wiesbaden, Germany).
HCV RNA qualitative detection was performed with COBAS AMPLICOR Hepatitis
C Virus (HCV) Test, version 2.0 (Roche Diagnostics, Mannheim, Germany).
HCV genotypes detection was performed with VERSANT HCV Genotyping assay
(LiPA) (Siemens)
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
4
Overall 3737, anti-HCV (crude rate) –
85/2,27%
Region
Regional
population,
n
Study cohort,
n/%
Anti-HCV
positive cases,
n
Anti-HCV
positivity, %
Vilnius
632187
1747/0.28
48
2.75
Kaunas
393307
154/0.04
5
3.25
Klaipeda
210155
486/0.23
11
2.26
Siauliai
149218
515/0.35
10
1.94
Panevezys
135210
151/0.11
2
1.32
Ignalina
17568
246/1.4
4
1.63
Utena
41751
262/0.63
2
0.76
Zarasai
17693
176/0.99
3
1.7
Overall
1597089
3737/0.23
85
2.27
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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Anti-HCV prevalence in the European countries
Hahne et al. BMC Infect Dis. 2013 Apr 18;13:181.
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
6
Hahne SJM et all, BMC Infectious Diseases 2013;13:181
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
Hope VD et all, Epidemiol Infec 2014;142:270-286
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N=85
Refuse further testing or
were inaccessible
N=34
Tested for anti-HCV from venous
blood N=51
Anti-HCV negative
N=7/13.7%
Anti-HCV positive
N=44/86.3%
HCV RNA positive
N=29/65.9%
HCV RNA negative
N=15/34.1%
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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HCV carriers
• 1.96% anti-HCV positive 58800 subjects and
65,9% of them are HCV carriers
• 1,29% of population are HCV carriers (38700
subjects)
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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HCV genotypes in asymptomatic carriers
• Genotype 1 – 13/45%
• Genotype 2 – 6/20%
• Genotype 3 – 10/35%
HCV genotypes in chronic hepatitis cohort
• Genotype 1 – 65%
• Genotype 2 – 8.7%
• Genotipas 3 – 26.3%
Liakina V et al. Med Sci Monit, 2009; 15(4): PH17-23
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
11
HCV transmission routes
OR
•
•
•
•
•
•
•
•
Injection drug use
–
HCV infection in family member –
Blood transfussions –
Delivery –
Tattoo –
Open trauma –
Tooth removal/prosthetics –
Multiple and long-lasting hospitalizations –
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
43
11
6
5
4
4
3
3
p
<0,0001
0,0002
0,0002
0,0224
0,0013
0,0009
0,0048
0,0064
12
HCV transmission routes
Esteban JI et al. J of Hepatology 2008;48:148-162
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Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
13
Not confirmed as HCV transmission routes
Blood donations
Hemodialysis
Surgery
Dentistry
Abortions
Risky sexual behavior
Piercing
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Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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Conclusions
 1.96% of Lithuanian population is anti-HCV positive (as confirmed by
venous blood testing) ~ 58800 subjects
 65,9% anti-HCV positive subjects are HCV RNA positive – HCV
carriers ~ 38700 subjects
 The main HCV reservoir is intravenous drug users
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
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Changes in HCV transmission routes and
HCV genotypes distribution
11th Annual Conference of the Baltic
Network Against Life-threatening Viral
Infections 24-27 April 2014 - Vilnius,
Esteban JI et al. J of Hepatology 2008;48:148-162
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