Abstract

Background

A national strategy against hepatitis C virus (HCV) was implemented in Spain in 2015 with the aim of reducing associated morbidity and mortality. In order to improve our understanding of the epidemiology of HCV, we analysed the prevalence of HCV antibodies and active infection overall and by age and sex in the general population aged 20–80 years. We also aimed to report the undiagnosed fraction.

Methods

A national population-based seroprevalence survey was conducted in 2017–2018. A representative sample from the general population was selected using two-stage sampling. The prevalence of total HCV antibodies and of HCV RNA was calculated using inverse probability weighting based on bootstrapping.

Results

Overall, we approached 17 496 persons; 9103 agreed to participate and met the eligibility criteria and 7675 were aged 20–80. We obtained a prevalence of HCV antibodies of 0.85% [95% confidence interval (CI): 0.64–1.08%] and of active infection of 0.22% (95% CI: 0.12–0.32%). The prevalence of active HCV infection was highest in men aged 50–59 (0.86%; 95% CI: 0.28–1.57%) and in men aged 60–69 years (0.72%; 95% CI: 0.27–1.28%). Prevalence was below 0.20% in the remaining age groups. The undiagnosed fraction for active HCV infection was 29.4%.

Conclusion

This study shows that prevalence of HCV in the general population in Spain is low and reflects the impact of scaling up treatment with direct acting antivirals, together with other prevention strategies, from 2015 onwards. The data reported can guide subsequent public health actions.

中文翻译：

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西班牙 2018 年丙型肝炎感染的患病率和未确诊比例：基于全国人口的调查结果

摘要

背景

西班牙于 2015 年实施了一项针对丙型肝炎病毒 (HCV) 的国家战略，旨在降低相关的发病率和死亡率。为了提高我们对 HCV 流行病学的了解，我们分析了 20-80 岁普通人群中 HCV 抗体和活动性感染的总体患病率以及年龄和性别。我们还旨在报告未确诊的部分。

方法

2017-2018 年进行了一项全国人口的血清阳性率调查。使用两阶段抽样从一般人群中选择具有代表性的样本。使用基于自举的逆概率加权计算总 HCV 抗体和 HCV RNA 的流行率。

结果

总体而言，我们接触了 17 496 人；9103 人同意参加并符合资格标准，7675 人年龄在 20-80 岁之间。我们获得了 0.85% [95% 置信区间 (CI): 0.64–1.08%] 的 HCV 抗体流行率和 0.22% (95% CI: 0.12–0.32%) 的活动性感染。50-59 岁男性（0.86%；95% CI：0.28-1.57%）和 60-69 岁男性（0.72%；95% CI：0.27-1.28%）的活动性 HCV 感染率最高。其余年龄组的患病率低于 0.20%。未确诊的活动性 HCV 感染率为 29.4%。

结论

这项研究表明，西班牙普通人群中的 HCV 患病率很低，这反映了从 2015 年起扩大直接作用抗病毒药物治疗以及其他预防策略的影响。报告的数据可以指导后续的公共卫生行动。