State of epidemiological knowledge and national management of hepatitis C virus infection in the European Community, 1996

Background: Since the identification of the hepatitis C virus (HCV) in 1989 , hepatitis C infection has been recognized as an infection of public healt h importance. However, the magnitude of the problem is not well estimated a t the European level. In order to assess the burden of HCV infection and to analyse the prevention and management policies of this illness at the Euro pean level, we performed a survey of European Union (EU) member state healt h authorities. Methods: For this purpose, we collected all currently runnin g policies regarding the surveillance, prevention and medical care of HCV i nfection in EU states through a questionnaire sent to the public health aut horities of each member state. Results: Based on the data reported by the d ifferent member states, we estimated that 2.4-5.0 million subjects are HCV seropositive in the EU. If we assume, in accordance with the literature, th at approximately 70% of those seropositive for HCV have a viral multiplicat ion, 1.7-3.5 million subjects are potentially infectious and most of them m ay need to be treated. However, the level of assessment of HCV burden is ve ry variable from one state to another and needs to be improved. For HCV pre vention and management, the current national policies and practices are ver y heterogeneous. The surveillance systems for HCV developed in the EU count ries need to be improved and harmonized before the establishment of a Europ ean surveillance network. Conclusions: Based on these findings, there is ne ed to promote, coordinate, support and fund European collaborations for thi s major public health problem.