More details on the inclusion/exclusion criteria are shown in Additional file 1

More details on the inclusion/exclusion criteria are shown in Additional file 1. The extraction form included year, country, characteristics of the analysed population, the sampling method, laboratory test used, participation rate, number of participants, and anti-HCV results. period from 2015 to 2018. All included studies were evaluated for risk of selection bias and summarised together in a narrative form. Results from previous Broussonetine A reviews and updated searches were compared per country among different populations, respectively. Results Among the 3871 studies identified, 46 studies were included: 20 studies were used for the estimate of the general population; 3 for men who have sex with men (MSM); 6 for prisoners; and 17 for people who inject drugs (PWID). Compared with the results reported Broussonetine A in previous systematic reviews, the updated estimates were lower than previously in most available countries. Anti-HCV general population prevalence estimates ranged from 0.54 to 1 1.50% by country. The highest prevalence of anti-HCV was found among PWID (range of 7.90C82.00%), followed by prisoners (7.00C41.00%), HIV-positive MSM (1.80C7.10%), HIV-negative MSM (0.20C1.80%), pregnant women (0.10C1.32%) and first-time blood donors (0.03C0.09%). Conclusions Our study highlights the heterogeneity in anti-HCV prevalence across different population groups in EU/EEA. The prevalence also varies widely between European countries. There are many countries that are not represented in our results, highlighting the need for the development of robust epidemiological studies. Electronic supplementary material The online version of this article (10.1186/s12879-019-4284-9) contains supplementary material, which is available to authorized users. strong class=”kwd-title” Keywords: Hepatitis C, Prevalence, Europe, People who inject drugs, Men who have sex with men, Prisoners, High-risk groups, Systematic review Background Infection with hepatitis C virus (HCV) leads to an asymptomatic acute stage. However, approximately 75% of acutely infected patients face a Broussonetine A substantial risk of developing chronic HCV infection [1]. During the 2 decades Broussonetine A after infection, 27% develop liver cirrhosis, and 25% develop hepatocellular carcinoma (HCC) [2, 3]. Worldwide, an estimated 71 million people were living with chronic HCV infection (1.0% of the global population) [4]. Whilst, in the European Union/European Economic Area (EU/EEA), it was estimated that more than 14 million people were living with chronic HCV infection, suggesting a relatively higher prevalence of 1 1.5% in this region [4]. Given to the slow rates of liver disease progression, many countries are yet to experience the full Broussonetine A burden of HCV-related disease [5]. However, decade-long delays between infection and the expression of chronic liver disease or liver cancer made it difficult to link these diseases to earlier HCV infections. Reliable and timely prevalence data is therefore important to describe the current burden of the disease. Most people infected with HCV remain unaware of their infection. The hidden burden estimated, based on limited data from the EU/EEA, shows that less than 15% of those chronically infected with HCV are aware of their diagnosis [6C8]. An anti-HCV antibodies serology test is recommended by the European Association for the Study of the Liver (EASL), as the first-line diagnostic test for HCV screening, which is evident of the past or current HCV infection [9]. If the result is positive, then the current infection should be confirmed by a sensitive RNA test. Anti-HCV antibodies are detectable by enzyme immunoassay (EIA) in the vast majority of patients with an HCV infection. In addition, rapid diagnostic tests (RDTs) are also recommended TLR9 in settings where there is limited access to laboratory infrastructure and testing or populations where access to RDTs would facilitate linkage to care [10]. The primary goal of diagnostic testing is to identify and link infected individuals to appropriate treatment. Several modelling studies suggest that scaling up an HCV treatment can lead to substantial reductions in anti-HCV prevalence and reduce transmission [11C14]. The introduction of direct-acting antivirals (DAAs) has been a major breakthrough in the treatment of hepatitis C. However, the high acquisition costs of sofosbuvir-based regiments limit the.