Up to 98% of hepatitis C in Europe goes undiagnosed
1 October 2007
A report (1) released today by the Eurasian Harm
Reduction Network (EHRN) highlights the significant inconsistencies that
exist in hepatitis C (HCV) diagnosis and treatment across Europe and beyond.
In recognition of World Hepatitis Awareness Day, patient groups around the
globe are united in their call for action.
In some European countries it
is estimated that more than 90% of people who are infected with HCV have not
been diagnosed (Germany 90%; Poland 98%) (ii). Not only does this put many
people at risk of long-term liver damage, it also means that they may
unknowingly transmit the virus to others.
"It is alarming that in the
twenty-first century there are European countries where up to 98% of people
with chronic hepatitis C may not even know they are infected", says Nadine
Piorkowsky, President of the European Liver Patients Association (ELPA).
"The peak of hepatitis C related mortality is still to come. If we want to
flatten it, policymakers in Europe will have to act now. We are therefore
calling on the EU and national governments to urgently recognise hepatitis C
as a major public health threat."
Stephen Hughes, Member of European
Parliament, agrees: "The European Union has a crucial role in identifying
best practice with regard to hepatitis C screening in order to address
existing health inequalities."
Hepatitis C and, specifically, the
under-diagnosis of HCV infection are a global health issue. In fact, HCV is
much more common than HIV, the virus that causes AIDS, with more than four
times as many people living with hepatitis C than with HIV.(2) According to
the World Health Organization (WHO), an estimated 53,700 deaths globally
each year are directly attributable to HCV. The WHO also reports that more
than 308,000 deaths annually are likely to be due to liver cancer caused by
HCV and associated with a significant proportion of the 785,000 deaths due
to cirrhosis.(3) This suggests that, globally, HCV may cause up to 500,000
deaths a year, and possibly even more. With many undiagnosed cases of HCV,
it is likely these numbers will rise in the near future.
"The EHRN report
on HCV prevalence in Europe highlights the need for more in-depth studies in
order to increase awareness and ensure an evidence-based approach to this
disease", says Jeffrey Lazarus, World Health Organization Regional Office
The report shows that the availability and quality of
national, regional and global HCV reporting, resourcing and screening varies
dramatically from country to country. For example, even the official data
from the United Kingdom illustrates that almost two-thirds of estimated HCV
cases are undiagnosed (88,337 diagnosed, 192,663 undiagnosed), which is a
significantly better rate of diagnosis to undiagnosis than most countries.
In contrast, in Poland the estimated number of cases in the general
population is 750,000, while only 20,000, or 2%, of cases have been
Ms Piorkowsky recognises the importance of awareness campaigns:
"Today, on World Hepatitis Awareness Day, we draw attention to the ongoing
needs in the hepatitis C battle globally, and call on people who may be at
risk to get tested!"
France is a clear example of the positive impact
public awareness campaigns can have. Due to government-led campaigns,
hepatitis awareness in that country has increased substantially. Currently,
an estimated 56% of those infected know that they have the infection,
compared with 24% in 1994. In contrast, the EHRN report indicates that in
northern Spain, only 16% of people who tested positive for HCV were aware of
Globally, 180 million people are infected with hepatitis C;
many others are infected and do not know it.(4)
The risk factors for Hepatitis C are
- tattoos or body piercings;
- blood transfusion before screening was introduced (in most
countries, before 1992);
- shared equipment for injecting drugs or cocaine straws/bank notes;
- had medical or dental interventions in countries where equipment is
not adequately sterilised;
- had needle-stick injuries (especially emergency services and
- shared a toothbrush or a razor (very low to medium risk).
About World Hepatitis Awareness Day
Now in its fourth year,
World Hepatitis Awareness Day, which takes place on 1 October 2007, aims to
increase awareness about hepatitis B and C. This year, ELPA and other
international patient organisations are working together to promote this
important educational initiative and encourage those at risk to get tested.
Further information about hepatitis can be found on:
(1). Eurasian Harm Reduction Network (EHRN).
Comparative analysis of HCV prevalence across selected countries of Europe
and the Mediterranean area; 1 October 2007.
(2). World Health
Organization. AIDS Epidemic Update. 2006. (Accessed February 27, 2007, at
Health Organization. Department of Measurement and Health Information.
(4). World Health Organization. Initiative for Vaccine
Research, Viral Cancers, Hepatitis C. 2006. (Accessed July 24, 2006, at
(i) EHRN: Formerly known as the Central and
Eastern European Harm Reduction Network (CEEHRN).
(ii) EHRN data:
Percentage calculated by subtracting diagnosed cases from estimated number
of cases in general population.
Source: European Liver Patients
Save this page on del.icio.us