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In order to study the hepatitis C virus (HCV) epidemiology in Flanders, Belgium, the HCV genotype of 2,301 patients diagnosed with HCV between 2001 and 2009 was determined. HCV genotyping was conducted using the Versant LiPA 1.0 or Versant LiPA 2.0 assay. To explore the transmission history of a remarkable cluster of the rarely found HCV genotype 5a, face-to-face interviews based on detailed questionnaires and maximum likelihood phylogenetic analysis were performed. HCV genotype 1 was the most prevalent genotype in all provinces, followed by HCV genotype 3 in East Flanders, Antwerp, Flemish Brabant and Limburg. In Brussels, HCV genotype 4 was the second most prevalent genotype. This observation is due to the immigration of patients from the Middle East and Africa. Remarkably, a cluster of HCV genotype 5a was found in West Flanders, where it represents the second most prevalent genotype, accounting for 26.2% of HCV infections. We could not identify one major transmission source explaining the whole HCV genotype 5a epidemic. Instead, several smaller possible transmission chains were identified and confirmed phylogenetically. Overall, the HCV genotype 5a epidemic in West Flanders seems to be mainly associated with blood transfusion and unsafe medical practices. [ABSTRACT FROM AUTHOR]

Objectives: To assess to what extent hepatitis B vaccination of sex workers in Ghent, Belgium, is successful within the context of the existing health services and to compare this with alternative approaches such as outreach programmes; to compare two hepatitis B vaccination schemes in the outreach programme for sex workers.Methods: Testing all first contacts (n = 1096) in the outreach programme for hepatitis B virus (HBV) markers assessed success of hepatitis B vaccination in routine services. The performance of the outreach service was measured by counting the number of sex workers who started hepatitis B vaccination in the programme. The hepatitis B vaccination schemes were assessed by analysing the number of people completing the vaccination.Results: Naturally acquired HBV was found in 11.9% of 1096 sex workers (0.6% HBsAg), and 7% were vaccinated in existing services. In contrast, hepatitis B vaccination using outreach methodology was able to achieve higher vaccination rates: among non-immune sex workers 82.8% received the first dose of vaccine, and 71.5% the second. If given 1 month later, 67.9% received the third dose, in contrast with 47.9%, when given 6 months later.Conclusions: Existing services are not successful in vaccinating sex workers for HBV, in contrast with specifically targeted outreach services. Shorter intervals between vaccine doses gave better compliance. [ABSTRACT FROM AUTHOR]