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Estimation du nombre de personnes non diagnostiquées pour une hépatite C chronique en France en 2014. Implications pour des recommandations de dépistage élargi

Abstract : Background – Recent HCV therapeutic advances make effective screening crucial for potential hepatitis C virus (HCV) eradication. To identify the potential target population for a possible population-based screening strategy to complement current risk-based testing in France, we aimed to estimate the number of adults with undiagnosed chronic HCV infection, as well as their age and gender distribution at two time points: 2004 and 2014. Methods – A model taking into account mortality, HCV incidence and diagnosis rates was applied to the 2004 French national seroprevalence survey on hepatitis B and C. Results – In 2014, an estimated 74,102 individuals aged 18 to 80 were undiagnosed for chronic HCV infection (plausible interval: 64.920-83,283) compared with 100,868 [95%CI:58,534-143,202] in 2004. Men aged 18-59 represented approximately half of the undiagnosed population in 2014. The proportion of undiagnosed individuals for chronic hepatitis C in 2004 (43%) varied from 21.9% to 74.1% in the 1945-1965 and 1924-1944 birth cohorts. Consequently, age and gender distributions between the chronically-infected (diagnosed and undiagnosed) and undiagnosed HCV populations were different, the 1945-1965 birth cohort representing 48.9% and 24.7%, respectively. Conclusions – Many individuals were still undiagnosed in 2014 despite a marked reduction with respect to 2004. The present work contributed to the development of a new screening recommendation in 2014 aiming at complementing the screening strategy, consisting in one-time simultaneous HCV, HBV and HIV testing in men aged 18-60, regardless of risk exposures. Further studies are needed to assess the cost-effectiveness and feasibility of such a strategy. We also demonstrated that data on the undiagnosed HCV population are crucial to help adapt testing strategies, as the features of the chronically-infected HCV population are very distinct.
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https://hal-cnrs.archives-ouvertes.fr/hal-03479165
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Submitted on : Tuesday, December 14, 2021 - 11:14:42 AM
Last modification on : Thursday, December 23, 2021 - 3:01:36 AM

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  • HAL Id : hal-03479165, version 1

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C Brouard, Y Le Strat, C Larsen, Marie Jauffret-Roustide, F Lot, et al.. Estimation du nombre de personnes non diagnostiquées pour une hépatite C chronique en France en 2014. Implications pour des recommandations de dépistage élargi. Bulletin Epidémiologique Hebdomadaire - BEH, Saint-Maurice (Val de Marne) : Institut de veille sanitaire, 2015, pp.329-339. ⟨hal-03479165⟩

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