Hepatitis and Liver Diseases

Biography

Biography: Arnolfo Petruzziello

Abstract

Hepatitis C virus (HCV) is one of the major globally prevalent pathogen and one of the main leading causes of death and morbidity. The last estimates of disease burden showed an increase in seroprevalence over the last 15 years to 2.8%, equating to >185 million infections worldwide. Persistent HCV infection is associated with the development of liver cirrhosis, hepatocellular cancer, liver failure and death and is basically the most common cause of death in HIV-positive patients on highly active antiretroviral therapy. Previous and more recent studies have reported regional level prevalence estimates, but always considering a limited number of countries. This study represent one of the most comprehensive effort to quantify global HCV epidemiology, using the best available published data between 2000 and 2015 from 138 countries (about 90% of the global population), grouped in 20 geographical areas (with the exclusion of Oceania), as defined by the Global Burden of Diseases project (GBD). Total global HCV prevalence is estimated at 2.5% (177.5 millions of HCV infected adults), ranging from 2.9% in Africa and 1.3% in Americas with a global viremic rate of 67% (118.9 millions of HCV RNA positive cases), varying from 64.4% in Asia to 74.8% in Australasia. HCV genotype 1 is the most prevalent worldwide (49.1%), followed by genotype 3 (17.9%), 4 (16.8%) and 2 (11.0%). Genotypes 5 and 6 are responsible for the remaining <5%. While genotypes 1 and 3 are common worldwide, the largest proportion of genotypes 4 and 5 is in lower-income countries. A more precise knowledge of HCV genotype distribution will be helpful to best inform national healthcare models to improve access to new treatments.