Slide 1

Report
A population-based surveillance study
on the prevalence and treatment of
hepatitis C in Estonia
Kairi Mansberg
PhD student
University of Tartu, Department of Internal Medicine
background
• hepatitis C infection is a significant public health
problem and a leading cause of chronic liver disease
in Estonia
• Estonian Society of Gastroenterology
• multi-center, open-label study
• study cohort of consecutive patients with acute
hepatitis C, chronic hepatitis C, C-related cirrhosis,
C-related hepatocellular carcinoma
represents of the real-life situation
aim
• characterize the patients with hepatitis C
• analyse a real-life hepatitis C cohort of patients
• describe the risk factors of hepatitis C
• analyse antiviral treatment in real-life situation
material and methods (1)
• patients consecutively referred as in-patients and outpatients were recruited in 7 divisions of 5 hospitals by
37 gastroenterologists / infectious disease doctors
• patients were required to meet the criteria of acute
hepatitis C, chronic hepatitis C, C-related cirrhosis or
C-related hepatocellular carcinoma
• patients were included during a one-year recruitment
period, 01.02.09-31.01.10 and followed till 31.07.11
• informed consent was obtained from all patients
• Ethics Review Committee on Human Research of the
University of Tartu approval was obtained
material and methods (2)
• web-based eCase Report Form is used for data
registration
• data are entered into an eCRF by doctor
• in the course of the study, the study monitor make
site visits to verify eCRFs against source
documentation
• monitoring is conducted in each study center 4 times
per year
• data were analysed using descriptive statistics
program Stata 10,0
results: 518 patients were included
47%
male(n=271)
female(n=247)
53%
results: distribution by gender and age
80
70
60
50
male
40
female
30
20
10
0
-29
30-39
40-49
50-59
60-69
70-
results: distribution of risk factors
IVDU, 12%
unknown cause of infection,
40%
Risk due to a profession, 3%
blood transfusion before
1994 , 28%
haemodialysis, 0%
Piercing, 2%
Tattoo, 8%
Acupuncture, 0%
blood transfusion after
1994 , 3%
Sexual contact with HCV pt,
4%
results: age and risk factors
45
40
35
30
25
20
15
10
5
0
-29
30-39
40-49
50-59
60-60
IVDU
Risk due to a profession
blood transfusion before 1994
blood transfusion after 1994
Sexual contact with HCV pt
Tattoo
acupuncture
Piercing
haemodialysis
70-
results: distribution of diagnosis
hepatocellular
carcinoma
1%
acute hepatitis C
1%
C-chirrosis
12%
chronic hepatitis C
86%
results: distribution of diagnosis
results: c-chirrosis
34% of patsients visit a doctor at the stage of cirrhosis
34%
66%
.
results: distribution by genotypes
G3
25%
G2
6%
G1
69%
HCV genotypes in Estonia
results: age and genotypes
100
90
80
70
60
GT 1
50
GT 2
GT 3
40
30
20
10
0
-29
30-39
40-49
50-59
60-69
70-
G1 starts from the age of 40, but in younger age groups the increasing importance G3
results: genotypes and risk factors
160
IVDU
140
Risk due to a profession
120
blood transfusion before 1994
100
blood transfusion after 1994
80
Sexual contact with HCV pt
60
Tattoo
Acupuncture
40
Piercing
20
haemodialysis
0
G1
G2
G3
results: gender, age and genotypes
70
60
50
40
GT 1
GT 2
30
GT 3
20
10
0
-29
30-39
40-49
50-59
male
60-69
70-
-29
30-39
40-49
50-59
60-69
female
G1 is most prevalent among male pt aged 40-49 and female pt aged 50-59.
G3 is common in younger age groups of men and women
70-
conclusions (1)
• study cohort of consecutive 518 patients is
representative of the real-life situation
• prevailing genotype in Estonia is 1B, but our data
indicate the increasing importance of genotype 3
• in many patients HCV liver disease is diagnosed too
late – in HCV-related cirrhosis stage
conclusions (2)
• 265 patients started antiviral treatment during the
study period, which makes up 79% of all Estonian
patients in whom treatment was started during the
same period
Plans for the future
• to analyse antiviral treatment results in real-life
situation
– RVR, pEVR, cEVR, SVR
– relapsers, nonresponders
• to analyse adverse events during antiviral treatment in
real-life situation
• potential cooperation with Department of
Microbiology of University of Tartu
Acknowledgements
Estonian Society of Gastroenterology
Roche Estonia OÜ
Tartu University Hospital
Riina Salupere, Karin Kull, Katrin Labotkin, Hele Remmel,
Seren Kivi, Leana Sits, Tiina Prükk, Rita Pihlak, Svetlana Proškina, Külliki
Ainsalu
West Tallinn Central Hospital
Külliki Suurmaa, Vadim Brjalin, Anu Mäelt, Marina Levitševa, Kristi Ott, Nele
Rasmann,Tiiu Aug, Dagmar Mägi
East Talinn Central Hospital
Triin Remmel, Maie Aua, Asta Kolde, Ene Halling, Benno Margus, Toomas Kariis,
Peeter Kõiva
Pärnu Hospital
Krista Jaago, Kadi Kenk, Urve Mardna
East Viru Central Hospital
Jelena Šmidt, Svetlana Semjonova

similar documents