hepatitis c in the who european region -  · hepatitis c data in the who european region «space...

Antons Mozalevskis

WHO Regional Office for Europe

Hepatitis C in the WHO

European Region

Drug-related infectious disease (DRID) annual exper t meeting15–16 June 2015, EMCDDA – Lisbon

• Estimated number of people living with infection1:

– Hepatitis C - 14 million

– Over 60% infected live in eastern European and central Asian countries (EECA)

• Estimated number of deaths due to viral hepatitis2:

– 84 000 deaths due to Hep C annually

– Absolute majority due to sequelae (cirrhosis, HCC)

Burden of viral hepatitis C in the

WHO European Region

1 V.D. Hope et al. Epidemiol. Infect (2013) 1-172 Global Disease Burden Estimate

Hepatitis C among “most affected population groups”

in the WHO European Region, 2012

44%

4%

11%

2%

0%

10%

20%

30%

40%

50%

People whoinject drugs

Men who havesex with men

Sex workers Generalpopulation

Hepatitis C

V.D. Hope et al. Epidemiol. Infect (2013) 1-17

Geographical/epidemiological division of the

WHO European Region

Estimated Anti-HCV and HCV-RNA prevalence

in general population (WHO-EURO)

1 Gower E. Et al. Global epidemiology and genotype distribution of the hepatitis C virus. J Hepatology 2014; 61 (suppl 1)

Anti-HCV prevalence

HCV-RNA prevalence

Viraemic rate

2013 population (millions)

Anti-HCV infected (millions)

HCV-RNA infected (millions)

Central Europe 1.3% 1.0% 80% 119 1.5 1.2

Eastern Europe 3.3% 2.3% 69% 207 6.8 4.7

Western Europe 0.9% 0.6% 70% 425 3.7 2.6

Estimated Anti-HCV prevalence in general adult

population (WHO-EURO, 20121)

1 V.D. Hope et al. Epidemiol. Infect (2013) 1-17

Estimated Anti-HCV prevalence in people who

inject drugs (WHO-EURO, 20121)

1 V.D. Hope et al. Epidemiol. Infect (2013) 1-17

Objectives:

• to provide a standardised, timely and completepicture of the epidemiology of important infectious diseases;

• to allow sharing of data at the subnational level to identify specific geographic areas of risk and risk groups by age and gender;

Content:

• WHO/Europe infectious disease data set, compiled from reports submitted by Member States

WHO-EURO Centralised information

system for infectious disease (CISID)

• National focal point reporting on the yearly bases (March – May)

• Data sent in Excel (Section 1 & 3) or Word (Section 2) format

Section 1 – vaccine preventable diseases

Section 2 – sexually transmitted infections

Section 3 – other infections including viral hepatitis

• Data entered by the information management team or by relevant programme staff

CISID data from Joint Reporting Form (JRF)

CISID data from JRF

Hepatitis C - Number of cases

JRF data on hepatitis C from 2014

(as of 11.06.14)

• Out of 53 WHO-EURO Member States – reports from 40 MS

• Andorra – zero cases

• France, Germany, San Marino and Spain – no data on hepatitis C

• Reported cases of viral hepatitis from 35 MS

– 20 EU/EEA Member States

– 15 non-EU/EEA Member States

n=93 737

Reported HCV cases (n=93 737)

WHO-EURO, 2014

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Reported HCV cases (n=93 737)

WHO-EURO, 2014

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[PERCENTAGE]

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Reported HCV cases outside EU/EEA (n=72 456)

Reporting non EU/EEA countries PWID unknown total

Albania 0 44

Armenia 169 51

Azerbaijan 1 688 709

Belarus 2789

Bosnia and Herzegovina 0 120 121

Georgia 0 2647 2647

Kazakhstan 175 2076 3157

Montenegro 0 15 15

Republic of Moldova 2 798 826

Russian Federation 59690 59690

Serbia 213 335 577

Switzerland 390 1220 1675

Tajikistan 0 71 71

The former Yugoslav Republic of Macedonia 0 82 82

Turkmenistan 2

Total 781 67911 72456

Hepatitis C data in the WHO European Region

«Space for imrovement» – I

• ECDC enhanced viral hepatitis surveillance

– Standartised case definitions (gradually adopted by EU/EEA

Member States)

– Data completness is poor but improving

– Case reporting should be complemented by serosurveys

and data on chronic hepatitis disease sequelae

Hepatitis C data in the WHO European Region

«Space for imrovement» – II

• WHO-EURO «Joint Reporting Form»

– Case definition harmonisation (ECDC case definition?)

– Ways to get rid of double reporting (ECDC and WHO-EURO)

– Data verification and analysis

Hepatitis C data in the WHO European Region

«Space for imrovement» – III

• Linking with EMCDDA DRID data?

• Updated review of published seroprevalence study data?

• Enhancing the network of the national viral hepatitis focal

points

WHO Regional Office for Europe

• Contact:

– Antons Mozalevskis, WHO-EURO focal point for

viral hepatitis: antons.mozalevskis@regionh.dk

– Martin Donoghoe, WHO-EURO regional advisor

on HIV/AIDS & hepatitis: mdo@euro.who.int

Thank you