ECDC publish hepatitis B and hepatitis C annual epidemiological reports for 2019

On 28 July 2021, the European Centre for Disease Prevention and Control (ECDC) published 2019 epidemiological reports for hepatitis B and hepatitis C.

In key findings from the hepatitis B report: 

• In 2019, 30 EU or EEA member states reported 29,996 cases of hepatitis B virus (HBV) infection. When the five countries that only reported acute cases are excluded, the number is 29,518, which corresponds to a crude rate of 7.4 cases per 100,000 of the population. 
• Of all cases, 6% were reported as acute, 48% as chronic, 38% as unknown and 7% could not be classified. The highest rate of acute infections was observed among 35 to 44-year-olds, with the highest rate of chronic infections was among 25 to 34-year-olds. 
• The rate of acute cases has continued to decline over the last few years, which is in accordance with global trends and likely reflects the impact of national vaccination programmes. 
• Among acute cases with complete information, heterosexual transmission was most commonly reported (27%), followed by nosocomial transmission (17%) and transmission due to sex between men (13%). 
• Among chronic cases, mother-to-child transmission and nosocomial transmission were the most common routes of transmission reported, recorded at 36% and 20% respectively.

In key findings from the hepatitis C report: 

• In 2019, 37,733 cases of hepatitis C were reported in 29 EU or EEA member states. When the countries which only reported acute cases are excluded, the number is 37,660, which corresponds to a crude rate of 8.9 cases per 100,000 of the population. 
• Of the cases reported, 6% were classified as acute, 22% as chronic and 69% as unknown. 
• Hepatitis C was more commonly reported among men than women, with a male-to-female ratio of 2.1 to 1. 
• The most affected age group among both males and females was 25 to 34-year-olds. 
• The mode of transmission was reported for just 21% of cases, with the most commonly reported mode being injecting drug use, which accounted for 45% of cases with complete information on transmission status.

The ECDC report finds interpretation of hepatitis C notification data across countries remains problematic, with ongoing differences in surveillance systems and difficulties in defining reported cases as acute or chronic. With hepatitis C, a largely asymptomatic disease until its late stages, surveillance based on notification data is challenging, with data reflecting testing practices rather than true occurrence of disease.

Sources: ECDC, 28 July 2021 and ECDC, 28 July 2021