• Ir J Med Sci · Jun 2024

    Hepatitis C community prevalence is over-estimated: a prospective, birth cohort study.

    • McCormickP AidenPA0000-0002-5994-6023National Hepatitis C Treatment Program HSE, Liver Unit, St. Vincent's University Hospital and UCD, Elm Park, Donnybrook, Dublin 4, DO4 T6F4, Ireland. a.mccormick@ucd.ie., Marie O'Grady, Cillian F De Gascun, John S Lambert, Orla Crosbie, Susan McKiernan, Maeve Skelly, Paul Holder, Garry Courtney, Brian Hennessy, Kevin Walsh, Roisin Twohig, Kate Browne, Tessa O'Gorman, Vivion Crowley, Seán J Costelloe, Roz O'Byrne, Elizabeth Whitney, Orla Gildea, and Noreen Montgomery.
    • National Hepatitis C Treatment Program HSE, Liver Unit, St. Vincent's University Hospital and UCD, Elm Park, Donnybrook, Dublin 4, DO4 T6F4, Ireland. a.mccormick@ucd.ie.
    • Ir J Med Sci. 2024 Jun 1; 193 (3): 125712601257-1260.

    BackgroundHepatitis C virus infection is often asymptomatic, and many patients may be unaware they are infected. Community-based, birth cohort screening has been advocated to identify these patients. It has been estimated that 0.7-1% of individuals born between 1965 and 1985 in Ireland are infected. The cost-effectiveness of screening is critically dependent on the population prevalence.AimsThe aim is to determine the community prevalence of hepatitis C virus infection in the birth cohort 1965-1985.MethodsResidual serum samples from blood tests ordered by community general practitioners were anonymised and analysed for the presence of hepatitis C antibody ± antigen. Twelve large general hospitals throughout the country participated.ResultsA total of 14,320 samples were tested, 9347 of which were from the birth cohort 1965-1985. Seventy-two samples were positive for hepatitis C antibody of which 12 were positive for hepatitis C antigen (17%). The overall prevalence of hepatitis C antigen in the birth cohort was 0.09%. A higher prevalence (0.39%) was identified in males in two urban areas of Dublin.ConclusionsHepatitis C virus seroprevalence was much lower than previously estimated. The proportion of antibody positive patients with hepatitis C antigen was also lower than expected suggesting the effects of treatment and/or high spontaneous viral clearance. Universal birth cohort screening is unlikely to be cost-effective. Targeted birth cohort screening in high prevalence areas could be considered.© 2024. The Author(s).

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