Hepatitis B and C Screening Practices among At Risk Population Groups in6 European Countries: A Survey of Experts in Hungary, Germany, Italy,Spain, The Netherlands, and The United Kingdom

Abstract

Background: The national low prevalence of hepatitis B and C reported in a number of European countries is not entirely accurate. Higher rates are found among individuals in the population identified as at-risk groups. Early discovery through screening in these groups is essential in alleviating the potential burden due to complications of chronic hepatitis B and C. Not much is known on current practices of hepatitis B and C screening in Europe, despite existing international or national policies and guidelines on viral hepatitis management in most countries. This study is designed to fulfill that information gap and provide an overview of such practices in Europe. Method: The countries included in the study were Germany, Hungary, Italy, Spain, the Netherlands, and the UK. Questionnaires on hepatitis B and C screening recommendations to specified at-risk groups were developed and translated into five other main languages. Questions were tailored to different fields of expertise as follows: general viral hepatitis care, general practitioners, sexual health services providers, antenatal care providers, and asylum seekers’ care providers. The questionnaires were made available on an online platform (LIME survey). Potential respondents were selected based on their involvement in viral hepatitis care. Direct personalized links were disseminated per email, and answers were descriptively analyzed with SPSS 19. Results: The survey yielded 286 completed questionnaires. The response rates from the surveyed six countries varied considerably (UK: 19.0%, Germany: 14.8%, Netherlands: 53.8%, Hungary: 27.7%, Italy: 35.7% and Spain: 32.5%). Total responses in each field of expertise also varied extensively, with the most coming from antenatal care providers (81 respondents) and the least from asylum seekers’ care providers (18 respondents) across the six countries. The results show varying practices in recommending hepatitis B and C screening to all at-risk groups, except in hepatitis B screening among pregnant women. This variety demonstrates a lack of consensus among experts in screening recommendation standards within their knowledge or services, albeit recommendations in available policies or guidelines. Regional differences in standard practices were also suggested in antenatal care for hepatitis C and in asylum seekers’ care in most study countries.