Hepatitis C epidemiology and demographics: Difference between revisions
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==Overview== | |||
[[HCV]] is a worldwide prevalent infection whose incidence rate is difficult to estimate due to its asymptomatic course early in the disease and lack of statistical figures in most countries. While the overall trend is on the decline, several countries still suffer from highly prevalence disease burden. [[Egypt]] is considered the most prevalent country with [[HCV]], [[HCV-associated cirrhosis]], and [[hepatocellular]] carcinoma, whereby the prevalence tends to increase with age, suggesting ongoing new cases of HCV. Approximately one-fourth of all cases of cirrhosis and hepatocellular carcinoma are attributed to HCV worldwide. HCV infects males and females equally. | |||
and | |||
==Epidemiology and Demographics== | |||
===Incidence and Prevalence=== | |||
According to the [[World Health Organization]] (WHO), approximately 3% of the global population are infected with chronic hepatitis C virus (HCV). Figures in individual countries vary greatly: Approximately 2-4 million persons are infected with chronic HCV in USA, 5-10 million in Europe, and more than 10 million in India.<ref name=WHO>{{cite web WHO Hepatitis|url=http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index4.html |title=Hepatitis C |website= World Health Organization |publisher= WHO |accessdate=July 27 2014}}</ref> | |||
Acute HCV infection follows an asymptomatic course, which makes the accurate determination of HCV incidence difficult. Additionally, many countries lack sufficient epidemiological data.<ref name=WHO>{{cite web WHO Hepatitis|url=http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index4.html |title=Hepatitis C |website= World Health Organization |publisher= WHO |accessdate=July 27 2014}}</ref> Nonetheless, it is presumed that approximately 150,000 new cases are reported in USA and Western Europe annually, whereas the incidence in Japan is as high as 350,000 new cases each year. More than 60-80% of patients with HCV infection continue to become chronic carriers of the disease, with an overall number of chronic carriers reaching approximately 170 million patients.<ref name=WHO>{{cite web WHO Hepatitis|url=http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index4.html |title=Hepatitis C |website= World Health Organization |publisher= WHO |accessdate=July 27 2014}}</ref> The trend today is marked by progressive decrease in new HCV infections, demonstrating a remarkable 80% decrease since the infection was first discovered in 1989-1990.<ref name=WHO>{{cite web WHO Hepatitis|url=http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index4.html |title=Hepatitis C |website= World Health Organization |publisher= WHO |accessdate=July 27 2014}}</ref> | |||
Prevalence of HCV rises significantly in specific populations<ref name=WHO>{{cite web WHO Hepatitis|url=http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index4.html |title=Hepatitis C |website= World Health Organization |publisher= WHO |accessdate=July 27 2014}}</ref>: | |||
*[[Intravenous drug users]]: > 70% (Most cases of HCV infection nowadays) | |||
*[[Hemophilia]] patients: > 70% | |||
*[[Hemodialysis]]: 20-30% | |||
Of note, nosocomial sources of HCV infection, such as infected blood and surgical products, have significantly been reduced due to testing of products prior to utilization.<ref name=WHO>{{cite web WHO Hepatitis|url=http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index4.html |title=Hepatitis C |website= World Health Organization |publisher= WHO |accessdate=July 27 2014}}</ref> | |||
===Age=== | |||
Age of infected patients does is unequal in different regions. In USA, Australia, and Western Europe, more than 65% of HCV infections are seen in patients between 30-50 years.<ref name="pmid17552026">{{cite journal| author=Alter MJ| title=Epidemiology of hepatitis C virus infection. | journal=World J Gastroenterol | year= 2007 | volume= 13 | issue= 17 | pages= 2436-41 | pmid=17552026 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17552026 }} </ref> These numbers may suggest that most cases of HCV in these regions took place before 1990. On the other hand, there is an increase of HCV prevalence with age in countries such as Turkey, Spain, Italy, Japan, China, and Egypt. Most patients in these countries are older than 50 years of age.<ref name="pmid17552026">{{cite journal| author=Alter MJ| title=Epidemiology of hepatitis C virus infection. | journal=World J Gastroenterol | year= 2007 | volume= 13 | issue= 17 | pages= 2436-41 | pmid=17552026 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17552026 }} </ref> | |||
===Gender=== | |||
* Patients of both sexes are susceptible to disease.<ref name=WHO>{{cite web WHO Hepatitis|url=http://www.who.int/csr/disease/hepatitis/whocdscsrlyo2003/en/index4.html |title=Hepatitis C |website= World Health Organization |publisher= WHO |accessdate=July 27 2014}}</ref> | |||
===Morbidity and Mortality=== | |||
Approximately 27% of cases of cirrhosis and 25% of hepatocellular carcinoma (HCC) are attributed to chronic HCV infection.<ref name="pmid17552026">{{cite journal| author=Alter MJ| title=Epidemiology of hepatitis C virus infection. | journal=World J Gastroenterol | year= 2007 | volume= 13 | issue= 17 | pages= 2436-41 | pmid=17552026 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17552026 }} </ref> | |||
===Geographic Distribution=== | |||
HCV is a worldwide disease that is virtually present in all regions of the globe. The most endemic region of HCV - especially genotype 4a - is Egypt, due to previous non-hygenic medical and paramedical practices in the country.<ref name="pmid17552026">{{cite journal| author=Alter MJ| title=Epidemiology of hepatitis C virus infection. | journal=World J Gastroenterol | year= 2007 | volume= 13 | issue= 17 | pages= 2436-41 | pmid=17552026 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17552026 }} </ref> As many as 25% of Egyptian blood donors are chronic carriers of HCV infection. On the other hand, the United Kingdom and Scandinavia have low prevalence of HCV compared to other regions.<ref name="pmid17552026">{{cite journal| author=Alter MJ| title=Epidemiology of hepatitis C virus infection. | journal=World J Gastroenterol | year= 2007 | volume= 13 | issue= 17 | pages= 2436-41 | pmid=17552026 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17552026 }} </ref> | |||
In other countries, HCV prevalence is seen in specific regions within countries, rather than the entire country. Such patterns are seen in Italy, China, and Japan.<ref name="pmid17552026">{{cite journal| author=Alter MJ| title=Epidemiology of hepatitis C virus infection. | journal=World J Gastroenterol | year= 2007 | volume= 13 | issue= 17 | pages= 2436-41 | pmid=17552026 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17552026 }} </ref> | |||
==References== | ==References== | ||
Revision as of 02:35, 28 July 2014
Overview
HCV is a worldwide prevalent infection whose incidence rate is difficult to estimate due to its asymptomatic course early in the disease and lack of statistical figures in most countries. While the overall trend is on the decline, several countries still suffer from highly prevalence disease burden. Egypt is considered the most prevalent country with HCV, HCV-associated cirrhosis, and hepatocellular carcinoma, whereby the prevalence tends to increase with age, suggesting ongoing new cases of HCV. Approximately one-fourth of all cases of cirrhosis and hepatocellular carcinoma are attributed to HCV worldwide. HCV infects males and females equally.
Epidemiology and Demographics
Incidence and Prevalence
According to the World Health Organization (WHO), approximately 3% of the global population are infected with chronic hepatitis C virus (HCV). Figures in individual countries vary greatly: Approximately 2-4 million persons are infected with chronic HCV in USA, 5-10 million in Europe, and more than 10 million in India.[1]
Acute HCV infection follows an asymptomatic course, which makes the accurate determination of HCV incidence difficult. Additionally, many countries lack sufficient epidemiological data.[1] Nonetheless, it is presumed that approximately 150,000 new cases are reported in USA and Western Europe annually, whereas the incidence in Japan is as high as 350,000 new cases each year. More than 60-80% of patients with HCV infection continue to become chronic carriers of the disease, with an overall number of chronic carriers reaching approximately 170 million patients.[1] The trend today is marked by progressive decrease in new HCV infections, demonstrating a remarkable 80% decrease since the infection was first discovered in 1989-1990.[1]
Prevalence of HCV rises significantly in specific populations[1]:
- Intravenous drug users: > 70% (Most cases of HCV infection nowadays)
- Hemophilia patients: > 70%
- Hemodialysis: 20-30%
Of note, nosocomial sources of HCV infection, such as infected blood and surgical products, have significantly been reduced due to testing of products prior to utilization.[1]
Age
Age of infected patients does is unequal in different regions. In USA, Australia, and Western Europe, more than 65% of HCV infections are seen in patients between 30-50 years.[2] These numbers may suggest that most cases of HCV in these regions took place before 1990. On the other hand, there is an increase of HCV prevalence with age in countries such as Turkey, Spain, Italy, Japan, China, and Egypt. Most patients in these countries are older than 50 years of age.[2]
Gender
- Patients of both sexes are susceptible to disease.[1]
Morbidity and Mortality
Approximately 27% of cases of cirrhosis and 25% of hepatocellular carcinoma (HCC) are attributed to chronic HCV infection.[2]
Geographic Distribution
HCV is a worldwide disease that is virtually present in all regions of the globe. The most endemic region of HCV - especially genotype 4a - is Egypt, due to previous non-hygenic medical and paramedical practices in the country.[2] As many as 25% of Egyptian blood donors are chronic carriers of HCV infection. On the other hand, the United Kingdom and Scandinavia have low prevalence of HCV compared to other regions.[2]
In other countries, HCV prevalence is seen in specific regions within countries, rather than the entire country. Such patterns are seen in Italy, China, and Japan.[2]