Viral hepatitis B and C: focus efforts on screening

Screening efforts of infection by hepatitis C virus (HCV) should be continued and screening for infection with hepatitis B virus (HBV) promoted to propose an appropriate care, suggest the results of a survey conducted by the Institute of Health whose publication was distributed to the press.
A national survey of the prevalence (total number of cases per year) of hepatitis B and C in France, conducted with a sample of 14,416 people aged 18 to 80 years, was initiated by the Institute of Health Surveillance (VS ), in partnership with the National Health Insurance Fund for employees and the support and training of health examination centers Technical Centre. The preliminary results of this study were made public.

For hepatitis C, the overall prevalence of anti-HCV was 0.84%, affecting 367,055 people including 221,386 with a chronic form.

Among them, 57% knew their positive vis-à-vis HCV status.

HCV prevalence among women is higher than among men (1.02% against 0.84%) and 45-49 years (both sexes) the most affected with 2.28% (against 0 04% of youth aged 18 to 24 years).

This prevalence is particularly high in Ile-de-France (1.10%) in contrast to the northwest quarter (0.35%) and three times higher for people in precarious situations (2.49% versus 0.74 %). Several risk factors have been significantly associated with the presence of anti-HCV antibodies: use of intravenous drugs, nasal, blood transfusion performed before 1992, tattoo and country of birth prevalence of anti- HCV is already high.

About hepatitis B, the prevalence of HBsAg, signing a chronic infection, reached 0.65% and affects 280,821 people. Among them, 45% knew their HIV status vis-à-vis HBV. Men are about five times more affected by HBV than women (prevalence of 1.10% against 0.21%).

The prevalence is higher among people in precarious situations (1.80% versus 0.57%).

It is in the north-east quarter of France that carrier prevalence of HBsAg (chronic HBV infection) is the highest (1.12%) and the lowest northwest quarter (0 , 20%). The factors associated with anti-HBc (control contact with HBV, the infection is chronic or is healed) are the use of intravenous drugs, homosexuality, precariousness, a education below bachelor, living at least three months institution, country of birth prevalence of HBsAg is high and a residence located in the northeast quarter, southeast or Ile-de-France.

The objective of this survey was to provide national and regional estimates of the prevalence of HCV-related markers and HBV infections.

As for evolution, it appears that between 20 and 59 years, the prevalence of anti-HCV antibodies was lower in 2004 (0.71%) than in 1994 (1.05%).

In contrast, the prevalence of carriage of HBsAg (0.65%) is superior to the figures proposed in the 1990s (0.2% and 0.4%).

"Efforts to screen for HCV infection should therefore be pursued and screening for HBV infection promoted to propose an appropriate care. Access to screening and care for people in precarious situations should also be ensured, "the authors conclude.