Anca Streinu-Cercel1,2, Oana Săndulescu1,2, Alina Cristina Neguț1,2, Mioara Predescu2,

Alexandra Mărdărescu3, Mihai Săndulescu1, Adrian Streinu-Cercel1,

Sibiu mai 2016

• Despite the introduction of national immunization against HBV since 1996 through neonatal vaccination and catch-up regimens, hepatitis B remains prevalent and underdiagnosed in Romania in 2016

• Hepatitis C and HIV infection also remain important public health concerns and require the implementation of nationwide screening studies to ascertain real-life incidences and the extent to which they are underdiagnosed.

• We have implemented a study to screen for hepatitis B and C viruses (HBV, HCV) and HIV infection in the general population in Romania

• Patients were referred to the National Institute for Infectious Diseases “Prof. Dr. Matei Balș” from the general practitioner (GP)*

*The GPs were previously trained by infectious diseases

specialists and received support during the program

All subjects voluntary signed a study-specific informed consent form and filled out a questionnaire assessing risk

factors for transmission of HBV, HCV and HIV

We present the results of the first 9937 patients screened in this study from May to August 2015

Screened

9937 pts

Ethnicity Romanian Romani(gipsy)

9 751 pts 186 pts

M/F ratio 36% Male 64% female

Mean age 48 years old ± 29 years

0

100

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23

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Distributie dupa an nastere

Results • Out of the total number of 9937 persons

tested, 540 were found positive for HBsAg(5.4%), 267 for anti-HCV (2.7%), and 11 (0.1%) had positive ELISA tests for HIV infection.

• However, viral loads for HBV DNA, HCV RNA and HIV RNA were negative in 230 (42.6%), 104 (39.0%) and 2 (18.2%) cases, respectively.

11,75612,452 12,108

0

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AgHBs Anti HIV 1+2 Anti-HCV

Negativ

Pozitiv

Special populations

• The Romani population group had good addressability to general practitioners and to the screening study.

• Notably, the incidence of HBV, HCV and HIV infection was lower in the Romani group than in the rest of the patients: 2/186 (1.1%) HBV, 1/186 (0.5%) HCV, 0/186 (0%) HIV infection vs. 308/9751 (3.2%) HBV, 162/9751 (1.7%) HCV and 9/9751 (0.1%) HIV infection.

Ag HBs positive

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Rezultat HBV-DNA la pacienții cu AgHBs pozitiv

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Ab HCV positive

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Rezultat HCV-RNA la pacienții cu AcHCV pozitiv

Detectabil

Nedetectabil

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Ab HIV

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Arad Argeș Brașov București Constanța Covasna Olt Tulcea Total

Rezultat HIV-RNA la pacienții cu AcHIV pozitiv

Detectabil

Nedetectabil

• Among self-declared diabetic patients, the seroprevalence of HCV Ab was 6.2%, compared with 2.8% in the rest of the study population, p=0.008, χ(2)=9.745.

• This association was however not true for HIV infection (0% vs. 0.1%, p=0.820), or for HBV infection (6.2% vs. 5.7%, p=0.939)

• Patients reporting previous STDs had a higher prevalence of HBV infection (16.7% vs. 5.7%, p=0.020),

• but not HCV (0% vs. 2.9%, p=0.620) or HIV (0% vs. 0.1%, p=0.980)

• Patients reporting chronic kidney diseases had a higher prevalence of HCV infection (7.4% vs.2.9%, p<0.001), but not HBV (10.5% vs. 5.7%, p=0.128) or HIV (0% vs. 0.1%, p=0.031).

• Patients reporting hemodialysis had a higher prevalence of HCV infection (10.5% vs.2.9%, p=0.024), but not HBV (10.5% vs. 5.7%, p=0.277) or HIV (0% vs. 0.1%, p=0.952)

• Patients reporting needle sharing had a higher prevalence of HCV infection (20% vs.2.9%, p=0.032), but not HBV (0% vs. 5.7%, p=0.554) or HIV (0% vs. 0.1%, p=0.987)

• Interestingly, patients reporting intercourse with more than one partner in the past 6 months had consistently lower prevalences of HCV (1.3% vs.3 %, p=0.030), HBV (3.4% vs. 5.8%, p=0.016) or HIV infection (0.1% vs. 0.1%, p=0.493), suggesting a better adherence to barrier protection.

Conclusion

• The preliminary results of the study characterized the relative incidence of HBV, HCV and HIV infection in Romania.

• The study group was representative, and the age distribution was normal, suggesting that the data are valid for the general population in Romania, although specific high-risk groups still need to be defined.

• The relative incidences of HIV and hepatitis B and C in this study were fairly low, and the Romani population had lower incidences compared with the rest of the group, suggesting that these viral infections may still be underdiagnosed in the general population.

VHB 5,4%

VHC 2,7%

HIV 0,1%

• O15. Romanian nationwide screening for infection with HIV and hepatitis B and C viruses

•

• Anca Streinu-Cercel1,2, Oana Săndulescu1,2, Alina Cristina Neguț1,2, Mioara Predescu2, Alexandra Mărdărescu3, MihaiSăndulescu1, Adrian Streinu-Cercel1,2

•

• 1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

• 2National Institute for Infectious Diseases “Prof. Dr. MateiBalș”, Bucharest, Romania

• 3Romanian HIV Center, Bucharest, Romania