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A Seroprevalence Study of Hepatitis B and C Virus Infections in a Hospitalized Population in Romania, an Opportunity for a Better National Prevention and Control Strategy

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Odette Popovici1,2, Geza B. Molnar1, Florin Popovici1, Denisa Janţă1, Adriana Pistol1, Doina Azoicăi3

1) The National Institute of Public Health (NIPH), Bucharest;
2) PhD student and
3) PhD supervisor, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.251.hbc


Background & Aims: The most recent prevalence data for jepatitis B virus (HBV) infection in Romania came from an ESEN 2 study (2002), and from a Romanian population-based study performed in 2008. Most of the previous studies were regional and performed in specific groups (blood donors, pregnant women, institutionalized people, etc) and had limited representativeness at the national level, both for HBV and hepatitis C virus (HCV) infection. The scarcity of prevalence data for HBV and HCV infection coming from the routine surveillance was also considered.

The aim of our study was to obtain overall and age group specific estimates of the prevalence of HBV and HCN infections markers in Romania, in order to recommend evidence-based public health interventions. The main outcome was the proportion of persons with HBV, HCV and HBV+HCV infection markers, overall and by age group and gender.

Methods: Our seroprevalence study ensured national representativeness for the targeted hospitalized population. A prospective collection of serum samples in hospital laboratories was completed between September and November 2013, using a systematic sampling. The study respected the confidentiality of personal data. We calculated the sample size using EpiInfo7 and used Z test – Two-tailed probability for statistical significance.

Results: The overall prevalence data estimated in our study were HBc Ab 28%, HBs Ag 4.2%, HBs Ab regardless of titer 64.1%, HBs Ab in titer of at least 10mUI/ml and negative HBc Ab 17.5%; HCV Ab 5.6%; HBc Ab and HCV Ab 2.8%, as markers of double infection.

Conclusion: The overall prevalence data estimated in our study for HBs Ag (4.2%) and HCV Ab (5.6%) correspond to a medium endemicity based on the WHO criteria. The estimated prevalence of HBV and HCV infection markers in the study population should represent an opportunity for a better national prevention and control strategy.

Key words: Hepatitis B virus – Hepatitis C virus – sero-prevalence – evidence-based – public health interventions – strategy.

Abbrevations: ECDC: European Centre for Disease Prevention and Control; ESEN: European Seroepidemiology Network; HBcAb: Hepatitis B-core antibodies; HBsAg: Hepatitis B surface antigen; HBV: Hepatitis B virus; HCVAb: Hepatitis C virus antibodies; HCV: Hepatitis C virus; NIPH: The National Institute of Public Health.