The online version of this article (doi: https://doi.org/10.1186/s12879-017-2908-5) contains supplementary material, which is available to authorized users.
Increasing the proportion diagnosed with and on treatment for chronic hepatitis C (CHC) is key to the elimination of hepatitis C in Europe. This study contributes to secondary prevention planning in the European Union/European Economic Area (EU/EEA) by estimating the number of CHC (anti-HCV positive and viraemic) cases among migrants living in the EU/EEA and born in endemic countries, defining the most affected migrant populations, and assessing whether country of birth prevalence is a reliable proxy for migrant prevalence.
Migrant country of birth and population size extracted from statistical databases and anti-HCV prevalence in countries of birth and in EU/EEA countries derived from a systematic literature search were used to estimate caseload among and most affected migrants. Reliability of country of birth prevalence as a proxy for migrant prevalence was assessed via a systematic literature search.
Approximately 11% of the EU/EEA adult population is foreign-born, 79% of whom were born in endemic (anti-HCV prevalence ≥1%) countries. Anti-HCV/CHC prevalence in migrants from endemic countries residing in the EU/EEA is estimated at 2.3%/1.6%, corresponding to ~580,000 CHC infections or 14% of the CHC disease burden in the EU/EEA.
The highest number of cases is found among migrants from Romania and Russia (50–60,000 cases each) and migrants from Italy, Morocco, Pakistan, Poland and Ukraine (25–35,000 cases each). Ten studies reporting prevalence in migrants in Europe were identified; in seven of these estimates, prevalence was comparable with the country of birth prevalence and in three estimates it was lower.
Migrants are disproportionately affected by CHC, account for a considerable number of CHC infections in EU/EEA countries, and are an important population for targeted case finding and treatment. Limited data suggest that country of birth prevalence can be used as a proxy for the prevalence in migrants.
Additional file 1: Annex 1. Search strategy for systematic reviews and meta-analyses of global/worldwide prevalence studies; Annex 2. PRISMA diagram of systematic search for global HBsAg/anti-HCV sero-prevalence; Annex 3. Description of the search strategy and retrievals for chronic hepatitis B/C prevalence studies among migrants; Annex 4. PRISMA flow diagram of systematic search for HBsAg/anti-HCV sero-prevalence in migrants in the EU/EEA; Annex 5. Inclusion/exclusion criteria for systematic reviews/meta analyses reporting the prevalence worldwide/in various continents/regions; Annex 6. Inclusion/exclusion criteria for studies retrieved by the search for articles reporting the prevalence among migrants; Annex 7. Comparison of anti-HCV estimates from SRs/MAs and rationale for estimate selected for analysis; Annex 8. Anti-HCV prevalence estimates selected from systematic reviews; Annex 9. Chronic Hepatitis C burden country tables: 50 largest migrant populations per EU/EEA country; Annex 10. Countries of birth of foreign-born migrants found amongst the ten migrant groups most affected by chronic hepatitis C in 10 or more of the 31 EU/EEA countries. (DOCX 308 kb)12879_2017_2908_MOESM1_ESM.docx
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- Estimating the scale of chronic hepatitis C virus infection in the EU/EEA: a focus on migrants from anti-HCV endemic countries
A. M. Falla
A. A. Ahmad
I. K. Veldhuijzen
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