Screening program in healthy individuals reveals a high prevalence of chronic hepatitis c in the general population of Austria

Background and Aims Hepatitis C virus (HCV) infection is a common cause of chronic liver disease. However, data on the prevalence is scarce. The cost-effectiveness of a population-based HCV screening to achieve WHO goals for eradication is under debate. Here, we provide data of a population-based HCV screening program in Austria.

Method As part of programs for colorectal carcinoma (CRC) screening (SAKKOPI) and health screening (Paracelsus 10.000) in and around the cities of Oberndorf and Salzburg, we investigated 1896 asymptomatic subjects for HCV infection. If HCV antibodies were detectable, chronic HCV infection was confirmed by PCR. Individuals were screened for liver disease by means of medical history, liver enzymes and abdominal ultrasound. Transient elastography was performed in a subset of participants.

Results In total, 14 (0.74%) individuals had detectable HCV antibodies. No patients had cleared the virus spontaneously. Five (0.26%) patients had been previously diagnosed and already successfully treated. Three (0.16%) patients with detectable HCV antibodies were lost to follow up. Six (0.32%) patients were newly diagnosed with chronic HCV infection. Of these, four were infected with HCV-genotype 1a (66.7%) and two with 1b (33.3%). Among them, the median age was 59.9 years (49.2-64.1), two were male (33.3%), median BMI was 24.91 (20.7-42.9), two (33.3%) had steatosis on ultrasound and/or elevated GGT/ALT values, mean Fib4 score was 1.23 (0.6-7.8). One (16.7%) presented with liver cirrhosis, three patients had no evidence of chronic liver disease (50%). On elastography, a median stiffness of 4.7 kPa (3.7-27.7) and CAP values of 270.5 dB/m (217-351) were described.

Conclusion We show a high prevalence of chronic HCV infection in this asymptomatic screening cohort. A majority of newly diagnosed individuals had no obvious signs of chronic liver disease. This emphasizes the need of a screening in a population-based manner, for instance as part of CRC screening.

Publication History

Article published online:
26 August 2022