Quick Search: Hepatitis B | Hepatitis C | Interferons
Hepatitis C is a significant global problem with a wide-ranging impact on patients, their families, healthcare systems, society and the economy. Globally, an estimated 170 million people, approximately 3% of the world’s population, are infected with the hepatitis C virus (HCV) (WHO, 1999), with 3 to 4 million people being newly infected each year. Rates of HCV prevalence vary geographically (Table 1-1) (WHO, 2000) with the virus being most prevalent in South-East Asia and the Western Pacific and also in certain patient populations, such as patients which received blood before the early 90s, intravenous drug users and haemophiliacs.
| WHO region | Total population (Milions) | Hepatitis C prevalence rate (%) | Infected population (Milions) |
|---|---|---|---|
| Africa | 602 | 5.3 | 31.9 |
| Americas | 785 | 1.7 | 13.1 |
| Eastern Mediteranean | 466 | 4.6 | 21.3 |
| Europe | 858 | 1.03 | 8.91 |
| South-East Asia | 1500 | 2.15 | 32.3 |
| Western Pacific | 1600 | 3.9 | 62.2 |
| Total | 5811 | 2.9 | 169.7 |
In the USA, antibodies to HCV are found in 0.1–1.8% of the general population (Memon and Memon, 2002). The frequency of serum anti-HCV found in samples of the general population in Latin American countries ranges from 0.5–2.8% in Argentina; 0.8–3.4% in Brazil; 0.1–1.5% in Mexico; and 0.6–1.2% in Venezuela (Schinazi et al, 1998). The estimated rates of diagnosing HCV vary considerably around the world, ranging for example from 5% in the UK, to 40% in France and 50% in Canada. Current estimates also indicate evidence of HCV infection in 10–20% of dialysis patients, with substantial geographical and individual variability between haemodialysis centres (Carithers, 1999; Pereira, 1999).
Despite the burden of the disease there is a lack of uniform HCV surveillance systems, hence the real prevalence and incidence is not known in most countries.
Co-infection with HIV
Over the past few years HIV–HCV co-infection has emerged as a major public health concern. Globally, approximately 30% of patients with HIV also have HCV infection, although there is considerable variation in the prevalence of HIV–HCV co-infection, depending on both geographic region and the predominant modes of transmission. Patients infected with HIV and HCV have a more aggressive disease course and respond to therapy less well than those monoinfected with HCV. The diagnosis and treatment of HIV infection have greatly improved in most countries. With the introduction of highly active antiretroviral therapy for treatment of HIV, liver disease caused by chronic hepatitis C virus infection has now become an increasingly important cause of morbidity and mortality among HIV-infected patients.
Co-infection with HBV and HCV
Co-infection with hepatitis B virus (HBV) and HCV leads to more aggressive liver disease with the two viruses interacting (in poorly defined ways) to increase the rate of hepatic fibrosis (Cropley and Main, 2000). The presence of co-existent HBV infection may be under-diagnosed in patients with chronic hepatitis C (CHC) (Tanaka et al, 2004).