Estimating the hepatitis C burden in the EU/EEA

Robust estimates of the national burden of hepatitis C are necessary to enable countries to understand the epidemiological situation in order to develop services accordingly and monitor progress towards the elimination goals. Limited estimates of the hepatitis C virus (HCV) prevalence exist covering the general population or low risk populations, although there exist surveys on prevalence in high risk groups such as migrants, men who have sex with men, and prisoners. Most European Union (EU)/European Economic Area (EEA) countries do not have a clear picture of the total HCV burden in the general population and ECDC would like to support countries in calculating an estimate of the national hepatitis C burden by making efficient use of all available data sources using a well validated method.

In the absence of representative general population based surveys, estimates of the number of individuals with HCV can be obtained from combining different data sources using statistical methods. Methods such as the UNAIDS/WHO Workbook method and the Multiparameter Evidence Synthesis (MPES) method are currently being explored by ECDC. The MPES methodology has been piloted in England and Wales in estimating hepatitis C prevalence and facilitates the use of multiple data sources. The method also has been used in other countries to estimate national hepatitis C burden and validated for other diseases.

For most EU/EEA countries, available data sources are not mutually exclusive (as required by the Workbook method), but the MPES method is able to account for combinations of multiple sources interactions and prior and indirect information about the input parameters. The estimates in combination with the population sizes of each of the risk groups allow EU/EEA countries to produce a national prevalence estimate with uncertainty bounds derived from the underlying study and data characteristics.
ECDC has been asked by the Hepatitis B and C Network to offer support to Member States in calculating national Hepatitis C prevalence estimates using the MPES method in a standardized and harmonized manner. ECDC therefore requests technical support to develop for each of the EU/EEA Member States a national Hepatitis C burden estimate using the MPES method. A report with the obtained estimates and how the estimates were achieved with regard to data availability, method assumptions and expert opinion for each of the Member States should be provided.