Short summary

DANVIR is a national database containing test results for Hepatitis B, C and D, from all laboratories performing these tests. It was initiated in 2004 and covers tests from the nineties up to 2022. The database is is dynamic and updated on a yearly basis. A unique feature is that it also contains negative test results, and thus can determine who has been tested for viral hepatitis.

Rationale

In Denmark, examinations for viral hepatitis are conducted across numerous laboratories distributed among various specialties. In Region South, for instance, there are four facilities: the Department of Clinical Immunology in Odense and Sønderborg, the Department of Clinical Microbiology in Vejle, and the Department of Clinical Biochemistry in Esbjerg. Currently, there is no public national registry for these results. This implies that the mandated national registration for viral hepatitis relies on clinical reporting, and several studies have estimated that fewer than half of diagnosed cases are reported to the Statens Serum Institut. From 2004 to 2018, the DANVIR research group collected laboratory results for viral hepatitis for the purpose of scientific studies, including estimates of the number of patients with viral hepatitis B and C in Denmark. In 2019 a mayor revision was performed and new national registers (Laboreatoriedatabasen and MIBA) was integrated. The database is now under the responsibility of Region Syddanmark and data are stored in OPEN at Odense University Hospital/University of Southern Denmark, Odense. As of September 2023, the database contained laboratory results for 6,285,744 unique hepatitis tests conducted on 1,294,930 individuals. This initiative coincides with a breakthrough in the treatment of hepatitis C, allowing all patients to be cured through a short and side-effect-free treatment regimen. In this context, the WHO launched a goal in 2016 to achieve control over viral hepatitis by diagnosing 90% and treating 80% of cases by 2030. The CfritSyd campaign aims to meet WHO targets by 2025, in which the DANVIR database plays a crucial role: both in documenting the number of individuals tested and those infected, and in ensuring that all diagnosed patients are referred for treatment.

Description of the cohort

DANVIR is a national database containing test results for Hepatitis B, C, D, from 1976 to the beginning of 2023. Initially, the DANVIR database comprised of 14 of 17 laboratories and included approximately 2 million tests. Most laboratories only included tests from the start of electronic records (mid-90thies) but some included old manual records as well. From 2018 it was expanded to include all Danish laboratories with the national laboratory register (Laborartorie registret") as the principal source. However the few microbiological laboratories who did not report to laboratorieregistret supplied data separately.

Data and biological material

Laboratory results for viral hepatitis, performed on blood: HBsAg, antiHBs, antiHBc, HBeAg, antiHBe, HBVDNA, HBV genotype AntiHCV, HCVRNA, HCVgenotype Both positive and negative test results are collected at an individual level, identified by the national person identification number ("CPR number"). It is a dynamic database, and we estimated it will contain 1,5 mill persons with approximately 8 mill unique tests.

Collaborating researchers and departments

The Danvir database is managed by a steering committee representing the following scientific societies: Danish Society of Infectious Diseases, Danish Society of Gastroenterology and Hepatology, Danish Society of Clinical Immunology, Danish Society of Clinical Microbiology and Danish Society of Clinical Biochemistry. Chairman Peer Brehm Christensen, Department of Infectious Diseases, Odense University Hospital

Publications associated with the project

Hepatitis C prevalence in Denmark in 2016-An updated estimate using multiple national registers. Nielsen S, Hansen JF, Hay G, Cowan S, Jepsen P, Omland LH, Krarup HB, Søholm J, Lazarus JV, Weis N, Øvrehus A, Christensen PB.

Hepatitis C prevalence in Denmark -an estimate based on multiple national registers. Christensen PB, Hay G, Jepsen P, Omland LH, Just SA, Krarup HB, Weis N, Obel N, Cowan S. BMC Infect Dis. 2012 Aug 6;12:178. doi: 10.1186/1471-2334-12-178. PMID: 22866925

Hepatitis B prevalence in Denmark - an estimate based on nationwide registers and a national screening programme, as on 31 December 2007. Hansen N, et al. Euro Surveill. 2013. PMID: 24300884

Increasing prevalence of chronic hepatitis B virus infection and low linkage to care in Denmark on 31 December 2016 - an update based on nationwide registers. Bollerup S, Wessman M, Hansen JF, Nielsen S, Hay G, Cowan S, Krarup H, Omland L, Jepsen P, Weis N, Christensen PB.

Combining cross-sectional survey and register data improved the estimate of hepatitis C prevalence among patients attending a psychiatric emergency department in Denmark. Rose TV, Christensen PB, Hjorth P, Madsen LW, Hansen JF, Dröse S, Harvald GB, Røge BT, Øvrehus ALH. Infect Dis (Lond). 2024 Apr;56(4):277-284. doi: 10.1080/23744235.2023.2298460. Epub 2023 Dec 27. PMID: 38150183

Risk of all-type cancer, hepatocellular carcinoma, non-Hodgkin lymphoma and pancreatic cancer in patients infected with hepatitis B virus. Andersen ES, Omland LH, Jepsen P, Krarup H, Christensen PB, Obel N, Weis N; DANVIR Cohort Study. J Viral Hepat. 2015 Oct;22(10):828-34. doi: 10.1111/jvh.12391. Epub 2015 Feb 4. PMID: 25650146

Fracture risk in hepatitis C virus infected persons: results from the DANVIR cohort study. Hansen AB, Omland LH, Krarup H, Obel N; DANVIR cohort study. J Hepatol. 2014 Jul;61(1):15-21. doi: 10.1016/j.jhep.2014.03.007. Epub 2014 Mar 17. PMID: 24650694

Liver cancer and non-Hodgkin lymphoma in hepatitis C virus-infected patients: results from the DANVIR cohort study. Omland LH, Jepsen P, Krarup H, Christensen PB, Weis N, Nielsen L, Obel N, Sørensen HT, Stuver SO; DANVIR cohort study. Int J Cancer. 2012 May 15;130(10):2310-7. doi: 10.1002/ijc.26283. Epub 2011 Aug 24. PMID: 21780099

Mortality among patients with cleared hepatitis C virus infection compared to the general population: a Danish nationwide cohort study. Omland LH, Christensen PB, Krarup H, Jepsen P, Weis N, Sørensen HT, Obel N; DANVIR Cohort Study. PLoS One. 2011;6(7):e22476. doi: 10.1371/journal.pone.0022476. Epub 2011 Jul 18. PMID: 21789259

Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study. Omland LH, Krarup H, Jepsen P, Georgsen J, Harritshøj LH, Riisom K, Jacobsen SE, Schouenborg P, Christensen PB, Sørensen HT, Obel N; DANVIR Cohort Study. J Hepatol. 2010 Jul;53(1):36-42. doi: 10.1016/j.jhep.2010.01.033. Epub 2010 Mar 29. PMID: 20400197