{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T03:32:51Z","timestamp":1774409571165,"version":"3.50.1"},"reference-count":58,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"WHO Regional Office for Europe"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Hepatitis C virus (HCV) infection is among the leading causes of cirrhosis and hepatocellular carcinoma. Knowledge of its prevalence and risk factors can help to effectively fight the virus. This study was the first to investigate the seroprevalence of HCV, its genotypes, and factors associated with it among the general adult population of Armenia selected countrywide via cluster sampling. Anti-HCV antibodies were detected using third-generation immunoassay. Polymerase chain reaction and genotyping was performed among anti-HCV-positive individuals. Shortly after testing, the participants underwent a telephone survey. Logistic regression models were fitted to identify factors associated with anti-HCV antibody positivity and chronic HCV infection. The prevalence of anti-HCV antibodies among 3831 tested individuals was 2% (99% CI 1.4, 2.5), and chronic HCV infection was 0.7% (99% CI 0.4, 1.0), with genotypes 3 and 2 being the most common. The risk factors for chronic HCV infection included self-reported chronic liver disease (95% CI 1.47, 15.28), having tattoos (95% CI 1.34, 10.94), ever smoking (95% CI 1.16, 9.18), and testing positive for hepatitis B virus core antibody (95% CI 1.02, 7.17). These risk factors demonstrate that there could be room for strengthening infection control measures to prevent the transmission of HCV in Armenia.<\/jats:p>","DOI":"10.3390\/v16091446","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T02:34:49Z","timestamp":1726022089000},"page":"1446","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Seroprevalence of Hepatitis C Virus and Factors Associated with It in Armenia, 2021"],"prefix":"10.3390","volume":"16","author":[{"given":"Anahit","family":"Demirchyan","sequence":"first","affiliation":[{"name":"Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan 0019, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antons","family":"Mozalevskis","sequence":"additional","affiliation":[{"name":"Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, 1211 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7743-290X","authenticated-orcid":false,"given":"Serine","family":"Sahakyan","sequence":"additional","affiliation":[{"name":"Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan 0019, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9127-2700","authenticated-orcid":false,"given":"Lusine","family":"Musheghyan","sequence":"additional","affiliation":[{"name":"Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan 0019, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lusine","family":"Aslanyan","sequence":"additional","affiliation":[{"name":"Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan 0019, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Muradyan","sequence":"additional","affiliation":[{"name":"Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan 0019, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narina","family":"Sargsyants","sequence":"additional","affiliation":[{"name":"National Institute of Health, Ministry of Health, Republic of Armenia, Yerevan 0051, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gayane","family":"Ghukasyan","sequence":"additional","affiliation":[{"name":"World Health Organization Country Office in Armenia, Yerevan 0015, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6677-6408","authenticated-orcid":false,"given":"Varduhi","family":"Petrosyan","sequence":"additional","affiliation":[{"name":"Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan 0019, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"ref_1","first-page":"637","article-title":"Worldwide prevalence, genotype distribution and management of hepatitis C","volume":"84","author":"Guntipalli","year":"2021","journal-title":"Acta Gastroenterol. Belg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1016\/S0140-6736(19)32320-7","article-title":"Hepatitis C","volume":"394","author":"Spearman","year":"2019","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.ijid.2018.07.013","article-title":"Hepatitis C virus infection spontaneous clearance: Has it been underestimated?","volume":"75","author":"Ayoub","year":"2018","journal-title":"Int. J. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.cgh.2019.04.035","article-title":"Prevalence of Spontaneous Clearance of Hepatitis C Virus Infection Doubled from 1998 to 2017","volume":"18","author":"Seo","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101596","DOI":"10.1016\/j.clinre.2020.101596","article-title":"Epidemiology of hepatitis C virus infection","volume":"45","year":"2021","journal-title":"Clin. Res. Hepatol. Gastroenterol."},{"key":"ref_6","first-page":"3","article-title":"Extrahepatic manifestations of chronic hepatitis C virus infection","volume":"3","author":"Cacoub","year":"2016","journal-title":"Ther. Adv. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.gtc.2015.07.003","article-title":"Natural History of Hepatitis C","volume":"44","author":"Lingala","year":"2015","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_8","unstructured":"World Health Organization (WHO) (2021). Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2021, WHO."},{"key":"ref_9","unstructured":"World Health Organization (2017). Global Hepatitis Report, World Health Organization. Licence: CC BY-NC-SA 3.0 IGO."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/S2468-1253(21)00472-6","article-title":"Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: A modelling study","volume":"7","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_11","unstructured":"Polaris Observatory Collaborators (2017). Global prevalence and genotype distribution of hepatitis C virus infection in 2015: A modelling study. Lancet Gastroenterol. Hepatol., 2, 161\u2013176."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"7824","DOI":"10.3748\/wjg.v22.i34.7824","article-title":"Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes","volume":"22","author":"Petruzziello","year":"2016","journal-title":"World J. Gastroenterol."},{"key":"ref_13","unstructured":"World Health Organization (2018). Consolidated Strategic Information Guidelines for Viral Hepatitis: Planning and Tracking Progress towards Elimination, WHO. Licence: CC BY-NC-SA 3.0 IGO. i."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1111\/apt.17106","article-title":"Meta-analysis: Risk of hepatitis C virus infection associated with hospital-based invasive procedures","volume":"56","author":"Henriot","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s41124-017-0026-z","article-title":"Hepatitis C in Eastern Europe and Central Asia: A survey of epidemiology, treatment access and civil society activity in eleven countries","volume":"2","author":"Maistat","year":"2017","journal-title":"Hepatol. Med. Policy"},{"key":"ref_16","first-page":"20","article-title":"Epidemiological characteristic of viral hepatitis in Armenia","volume":"4","author":"Markosyan","year":"2013","journal-title":"World Viral Hepat."},{"key":"ref_17","unstructured":"Center for Disease Analysis Foundation in collaboration with WHO-EURO, The WHO Country Office in Armenia, and The Ministry of Health of Armenia (2018). Public Health Impact of a Population Based Approach to HBV and HCV Prevention and Treatment in Armenia, CDA Foundation."},{"key":"ref_18","unstructured":"Robert Koch Institute (2023). Report: Technical Assessment of Viral Hepatitis Response in Armenia, Robert Koch Institute."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S58","DOI":"10.1016\/j.jhep.2014.07.012","article-title":"Natural history of hepatitis C","volume":"61","author":"Westbrook","year":"2014","journal-title":"J. Hepatol."},{"key":"ref_20","unstructured":"GBD 2019 Hepatitis B Collaborators (2022). Hepatitis B Collaborators. Global, regional, and national burden of hepatitis B, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol. Hepatol., 7, 796\u2013829."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/S0140-6736(18)32277-3","article-title":"Scaling up prevention and treatment towards the elimination of hepatitis C: A global mathematical model","volume":"393","author":"Heffernan","year":"2019","journal-title":"Lancet"},{"key":"ref_22","unstructured":"World Health Organization (WHO) (2019). Web Annex 2. Template protocol for surveys to estimate the prevalence of biomarkers of infection with the hepatitis viruses. Consolidated Strategic Information Guidelines for Viral Hepatitis Planning and Tracking Progress towards Elimination, World Health Organization (WHO\/CDS\/HIV\/19.2). Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/280099\/WHO-CDS-HIV-19.3-eng.pdf?ua=1."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4103\/0973-6247.126683","article-title":"Hepatitis C virus: Screening, diagnosis, and interpretation of laboratory assays","volume":"8","author":"Gupta","year":"2014","journal-title":"Asian J. Transfus. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Hosmer, D.W., and Lemeshow, S. (2000). Applied Logistic Regression, A Wiley-Interscience Publication. [2nd ed.].","DOI":"10.1002\/0471722146"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.2105\/AJPH.81.12.1630","article-title":"The importance of assessing the fit of logistic regression models: A case study","volume":"81","author":"Hosmer","year":"1991","journal-title":"Am. J. Public Health"},{"key":"ref_26","unstructured":"Sargsyants, N.C. (2019, January 21\u201324). HCC development in HCV-infected patients and diagnosis challenges in resource-limited settings. Proceedings of the 17th International Workshop on Co-Infection of HIV and Hepatitis, Roma, Italy."},{"key":"ref_27","unstructured":"European Centre for Disease Prevention and Control (2020). Technical Protocol for Hepatitis C Prevalence Surveys in the General Population, ECDC."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1111\/j.1478-3231.2011.02494.x","article-title":"Hepatitis C virus infection in USA: An estimate of true prevalence","volume":"31","author":"Chak","year":"2011","journal-title":"Liver Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cld.2012.09.011","article-title":"The epidemiology of chronic hepatitis C and one-time hepatitis C virus testing of persons born during 1945 to 1965 in the United States","volume":"17","author":"Ward","year":"2013","journal-title":"Clin. Liver Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.4254\/wjh.v7.i10.1377","article-title":"Hepatitis C virus: Virology, diagnosis and treatment","volume":"7","author":"Li","year":"2015","journal-title":"World J. Hepatol."},{"key":"ref_31","unstructured":"Sargsyants, N.C., Melkonyan, A.K., and Kazanchyan, Y.G. (2015, January 9\u201313). Comparison of HCV genotype distribution in Armenia during ten years. Proceedings of 22nd International Symposium on Hepatitis C Virus and Related Viruses, Strasbourg, France."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1093\/epirev\/mxy002","article-title":"Prevalence of Drug Injection, Sexual Activity, Tattooing, and Piercing Among Prison Inmates","volume":"40","author":"Moazen","year":"2018","journal-title":"Epidemiol. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Mohd Suan, M.A., Said, S.M., Lim, P.Y., Azman, A.Z.F., and Abu Hassan, M.R. (2019). Risk factors for hepatitis C infection among adult patients in Kedah state, Malaysia: A case-control study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0224459"},{"key":"ref_34","unstructured":"Demirchyan, A., Mirzoyan, L., and Thompson, M.E. (2000). Synthesis of the Existing Data on Hepatitis B in Armenia, American University of Armenia, Center for Health Services Research."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1037\/0033-2909.125.3.367","article-title":"Gender Differences in Risk Taking: A Meta-Analysis","volume":"125","author":"Byrnes","year":"1999","journal-title":"Psychol. Bull."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Pereira, L.M., Martelli, C.M., Moreira, R.C., Merchan-Hamman, E., Stein, A.T., Cardoso, M.R., Figueiredo, G.M., Montarroyos, U.R., Braga, C., and Turchi, M.D. (2013). Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: A cross-sectional study. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-60"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Yee, L.J., Weiss, H.L., Langner, R.G., Herrera, J., Kaslow, R.A., and van Leeuwen, D.J. (2001). Risk factors for acquisition of hepatitis C virus infection: A case series and potential implications for disease surveillance. BMC Infect. Dis., 1.","DOI":"10.1186\/1471-2334-1-8"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Plessz, M., Ezdi, S., Airagnes, G., Parizot, I., Ribet, C., Goldberg, M., Zins, M., and Meneton, P. (2020). Association between unemployment and the co-occurrence and clustering of common risky health behaviors: Findings from the Constances cohort. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0232262"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1177\/140349489702500409","article-title":"Unemployment and sexual risk-taking among adolescents","volume":"25","author":"Janlert","year":"1997","journal-title":"Scand. J. Soc. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1093\/infdis\/jiad064","article-title":"Nationwide Hepatitis C Serosurvey and Progress Towards Hepatitis C Virus Elimination in the Country of Georgia, 2021","volume":"228","author":"Gamkrelidze","year":"2023","journal-title":"J. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/S1054-139X(00)00202-0","article-title":"High-risk behaviors associated with early smoking: Results from a 5-year follow-up","volume":"28","author":"Ellickson","year":"2001","journal-title":"J. Adolesc. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1111\/risa.13297","article-title":"Cigarette Smoking and Multiple Health Risk Behaviors: A Latent Class Regression Model to Identify a Profile of Young Adolescents","volume":"39","author":"Charrier","year":"2019","journal-title":"Risk Anal."},{"key":"ref_43","first-page":"530","article-title":"Hepatitis B and C virus infection among adult women in Jilin Province, China: An urban-rural comparison in prevalence of infection markers","volume":"31","author":"Zhang","year":"2000","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_44","first-page":"243","article-title":"Urban-rural comparison of HBV and HCV infection prevalence in eastern China","volume":"13","author":"Qu","year":"2000","journal-title":"Biomed. Environ. Sci. BES"},{"key":"ref_45","first-page":"221","article-title":"The spectrum of HBV\/HCV coinfection: Epidemiology, clinical characteristics, viralinteractions and management","volume":"28","author":"Konstantinou","year":"2015","journal-title":"Ann. Gastroenterol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"296","DOI":"10.14218\/JCTH.2018.00016","article-title":"HBV-HCV Coinfection: Viral Interactions, Management, and Viral Reactivation","volume":"6","author":"Mavilia","year":"2018","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.jhep.2006.05.013","article-title":"The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide","volume":"45","author":"Perz","year":"2006","journal-title":"J. Hepatol."},{"key":"ref_48","first-page":"31","article-title":"Natural history of hepatitis C virus infection: From chronic hepatitis to cirrhosis, to hepatocellular carcinoma","volume":"51","author":"Leone","year":"2005","journal-title":"Minerva Gastroenterol. E Dietol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1053\/j.gastro.2016.02.039","article-title":"Extrahepatic Manifestations of Hepatitis C: A Meta-analysis of Prevalence, Quality of Life, and Economic Burden","volume":"150","author":"Younossi","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.1016\/j.jhep.2016.07.005","article-title":"Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences","volume":"65","author":"Younossi","year":"2016","journal-title":"J. Hepatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/1479-5876-10-158","article-title":"Hepatitis C virus infection in the immunocompromised host: A complex scenario with variable clinical impact","volume":"10","author":"Zignego","year":"2012","journal-title":"J. Transl. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3443","DOI":"10.3748\/wjg.v20.i13.3443","article-title":"Immunologic, metabolic and genetic factors in hepatitis C virus infection","volume":"20","author":"Fierro","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1016\/j.jhep.2016.07.042","article-title":"Global genotype distribution of hepatitis C viral infection among people who inject drugs","volume":"65","author":"Robaeys","year":"2016","journal-title":"J. Hepatol."},{"key":"ref_54","first-page":"669","article-title":"Identification of People Infected With Hepatitis C Virus Who Have Never Been Diagnosed","volume":"15","author":"Kowdley","year":"2019","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/emmm.201303131","article-title":"Emerging therapies for the treatment of hepatitis C","volume":"6","author":"Lange","year":"2014","journal-title":"EMBO Mol. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1159\/000375359","article-title":"Antiviral Therapy in Patients with Hepatitis C Virus-Induced Cirrhosis","volume":"33","author":"Bailly","year":"2015","journal-title":"Dig. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1093\/cid\/ciz696","article-title":"Efficacy of Direct-acting Antivirals for Chronic Hepatitis C Virus Infection in People Who Inject Drugs or Receive Opioid Substitution Therapy: A Systematic Review and Meta-analysis","volume":"70","author":"Graf","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Zhang, J.Y., Li, Z.B., Zhang, L., Wang, J., Huang, L.P., Zhan, G.L., Li, Z., Du, J., and Zhao, M. (2019). DOES IT WORK?\u2014A randomized controlled trial to test the efficacy of HCV and HIV-related education on drug users in MMT, China. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-4421-5"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/9\/1446\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:53:28Z","timestamp":1760111608000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/9\/1446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,11]]},"references-count":58,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["v16091446"],"URL":"https:\/\/doi.org\/10.3390\/v16091446","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,11]]}}}