Prevalence of hepatitis C virus antibodies in a clinic-based group of Italians from one geographic area (original) (raw)
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Hepatology, 1997
In 1996 the prevalence, risk factors, and genotype distribu-subject (0.7%), type 2c in 66 subjects (44.6%), type 3a in 4 subjects (2.7%), and type 4 in two subjects (1.3%). These tion of hepatitis C virus (HCV) infection were assessed in the general population of a town in southern Italy. The sample figures differ from those of Italian patients with chronic liver disease in whom genotype 2 is more rare. None of the individ-was selected from the census by a systematic 1:4 sampling procedure. The participation rate was 96.6%. Among the uals was infected with more than one genotype. The distribution of the two most common HCV viral types (1b and 2c) 1,352 subjects enrolled, 195 (14.4%) tested reactive to antibody to HCV (anti-HCV) with enzyme immunoassay (EIA was not statistically different in terms of mean age, sex, or risk factors and suggests that they may have had a parallel 3). When further tested with recombinant immunoblot assay (RIBA 3), 170 subjects (87.2%) tested positive, 23 subjects spread in this community. These findings provide one of the highest overall anti-HCV prevalence rates in a general popula-(11.8%) had indeterminate results, and 2 subjects (1%) tested negative. Thus, the overall anti-HCV EIA-positive RIBA-con-tion with a likely cohort effect, i.e., decreased risk of infection along generations. These observations may indicate an epi-firmed prevalence was 12.6% (170 of 1,352 subjects) and increased from 1.3% in subjects younger than 30 years to demic or focus of hepatitis C that occurred several years earlier. The majority of anti-HCV-positive subjects in the 33.1% in those ¢60 years of age. This latter age group accounted for 72.3% of all anti-HCV-positive subjects. Females oldest age group and with no clinical evidence suggests that HCV infection is a very prolonged and indolent disease. tested positive more frequently than males (14.1% vs. 10.5%; P õ .05). Alanine transaminase (ALT) concentrations were (HEPATOLOGY 1997;26:1006-1011.) abnormal in only 4.1% (7/170) of anti-HCV EIA-positive RIBA-confirmed subjects. This suggests that ALT screening Hepatitis C virus (HCV) infection represents a major is not useful in the detection of anti-HCV-positive subjects health problem in Italy. It has been found to be highly prevain a general population. The results of multiple logistic regreslent in subjects with chronic liver disease 1-2 and strongly sion analysis showed that an age of less than 45 years, the associated with hepatocellular carcinoma. 3-4 use of glass syringes, and dental therapy were all independent General population surveys in different countries that depredictors of anti-HCV positivity. HCV RNA was detected by termined the prevalence of hepatitis C virus antibodies (antipolymerase chain reaction in 75.9% of the 195 anti-HCV EIA-HCV) have mainly consisted of voluntary or paid blood positive subjects: in 84.7% (144/170) of the RIBA-confirmed donors. Because these populations usually have special charsubjects; in 17.4% (4/23) tested as RIBA indeterminate; and acteristics regarding age, sex, socioeconomic level and selecin neither of the two subjects who tested RIBA negative. HCV tive procedures, they are not representative of the general type 1b was detected in 75 subjects (50.7%), type 2b in 1 population. Few studies using valid sampling procedures have provided reliable figures for anti-HCV prevalence in given areas. 5-12 Abbreviations: HCV, hepatitis C virus; anti-HCV, hepatitis C virus antibodies; HBV, On the basis of the phylogenetic analysis of the viral gehepatitis B virus; ALT, alanine transaminase; RIBA, immunoblot assay; anti-HBc, hepatinome, Okamoto et al. 13 classified HCV into four genotypes. tis B core antigen antibodies; RT-PCR, reverse-transcription polymerase chain reaction; Similarly, Simmonds et al. 14 classified the virus into six major OR, odds ratio; CI, confidence interval. types and a series of subtypes. The characteristics of HCV
Journal of Viral Hepatitis, 2006
Knowledge of the current epidemiology of chronic liver disease in Italy is mostly obsolete and fragmentary for the lack of up-to-date consistent data. In 2001, a 6-month prevalence study was undertaken in 79 hospitals to assess the characteristics of chronic liver disease in Italy. Both prevalent and incident cases were enrolled. A total of 9,997 patients were recruited, of whom 939 (9.4%) had normal liver biochemistry, 6,210 (62.1%) had chronic hepatitis, 1,940 (19.4%) had liver cirrhosis, and 341 (3.4%) had hepatocellular carcinoma (HCC). In 567 patients (5.7%) the diagnosis was not established. Hepatitis C virus (HCV) was found in 69.9% of the patients and was the only etiological factor in 56.3% of all the patients. Hepatitis B surface antigen (HBsAg) was present in the serum of 13.4% of the cases (in 10% it was the only etiological factor). A history of alcohol abuse was found in 23% of the cases (9.4% without viral infection). The prevalence of HCV-related cases was significantly lower in incident than in prevalent cases (44.9% vs. 59.9%, P < 0.0001), while the proportion of patients with alcohol abuse was much higher in incident than in prevalent cases (18.1% vs. 6.6%, P < 0.0001). These findings indicate that nearly one quarter of patients with chronic liver diseases in Italy have a severe disease such as liver cirrhosis and HCC represents a not negligible burden for the national health system. Hepatitis B fell in importance as an etiological factor. Hepatitis C is the important pathogenic factor for chronic liver disease in Italy. However, a comparison between the prevalent and incident cases suggests that in future HCV infection will also play a progressively decreasing role, in part as a consequence of treatment.
European journal of gastroenterology & hepatology, 2000
Hepatitis C is now recognized as the most common infection causing chronic liver disease in the European population. Our aim was to assess the prevalence of the antibody to hepatitis C virus (HCV), and the incidence of HCV seroconversion in the general population and the main risk groups, namely intravenous drug users, haemodialysis and transfused patients, in seven countries of the European Union, by carrying out a critical analysis of the literature. Data sources used were the Medline database and a manual search using the key words: hepatitis C, prevalence, incidence, transmission, risk factors and epidemiology. Articles published between January 1990 and March 1997 were reviewed. Articles were reviewed according to a critical analysis method regarding title, type of article, study design, period and population, tests, results and their consistency with data. The tests performed were mainly second- or third-generation serological tests. The average prevalence rate in blood donors...
Journal of Medical Virology, 2016
Background According to small studies carried out in preselected populations, the estimated prevalence of anti-hepatitis C virus (HCV) antibodies in Poland ranges from 0.6 to 2.1%. Aims The aim of this study was to evaluate the prevalence of anti-HCV and HCV RNA among patients and healthcare workers. Methods Anti-HCV antibodies were measured (Elecsys, Roche) in serum samples from 26 057 adults, consecutive patients or healthcare workers, from hospitals and out patient clinics not involved in the management of liver diseases. The majority of them (18 233) consented to fill out an anonymous questionnaire related to possible risk factors for HCV infection. Anti-HCV-positive samples were assessed for HCV RNA (Cobas Amplicor, Roche). A multivariate logistic regression model and the v 2 test or the Fisher's exact test were applied. Results Anti-HCV antibodies were detected in 1.9% of individuals, and 31% of them demonstrated HCV RNA, which varied from 26% in hospitals to 66% in specialistic outpatient clinics. Prevalence of anti-HCV was significantly lower in healthcare workers (1.42%) than in patients (1.92%). Significant independent risk factors for anti-HCV positivity were as follows: male sex, more than three hospitalizations in a lifetime, blood transfusions before 1992, and intravenous drug use. The only significant risk factor for HCV RNA was intravenous drug use. An analysis carried out for multispecialistic hospitals demonstrated significantly lower prevalence of HCV RNA positivity in healthcare workers. Conclusion Prevalence of anti-HCV in the Polish population studied was up to 1.9%, but active infection could be diagnosed in only 31% of them. Intravenous drug use, blood transfusions before 1992, multiple hospitalizations, and male sex increase the risk of HCV infection.
Infection, 1991
and transfused with 1,898 units of blood were followed after transfusion in order to evaluate both the incidence of anti-hepatitis Cvirus (HCV) seroconversion in non-A, non-B post-transfusion hepatitis (PTH-NANB) cases and the usefulness of the screening for anti-HCV in comparison with that for serum glutamic pyruvic transaminase (SGPT) values in preventing PTH-NANB transmission. Fifteen recipients developed PTH-NANB (group A); ten of them (66.6%) showed anti-HCV seroconversion within 3-12 months. Eight of the ten anti-HCV positive patients developed chronic hepatitis, but none of the five PTH-NANB anti-HCV negative did. None of the 15 controls (group B) randomly chosen among the patient population showed anti-HCV seroconversion. A close correlation with the transmission of PTH was showed by anti-HCV positivity but not by SGPT elevation in blood donors. Eleven of 172 blood products transfused to group A but none of 139 products transfused to group B were anti-HCV positive. The incidence of elevated SGPT values was similar between the two groups of the transfused blood products. Nevertheless, the correlation observed between anti-HCV positivity and SGPT levels in the blood products involved in PTH confirms the need to exclude blood donors with abnormal SGPTvalues. On the whole, anti-HCV screening of donors showed a predictive value higher than that of SGPT (100% vs. 53.3%), allowing a minor blood donation exclusion. The percentage of anti-HCV seroconversion observed in PTH-NANB is probably underestimated because of the limits of the ELISA method we used for the detection of anti-HCV. Zusammenfassung: Inzidenz von anti-Hepatitis C Virus-AntikOrpern bei Non-A, Non-B-Transfusionshepatitis in einer Region in Norditalien. 210 konsekutive Patienten, die in der Universitfitsklinik Parma einen herzchirurgischen Eingriff durchmachten und bei denen insgesamt 1.898 Blutkonserven transfundiert wurden, wurden im Hinblick auf eine Serokonversion f/Jr anti-HCV (im Fall yon Non-A, Non-B-Transfusionshepatitis) und den Nutzen eines Screening auf anti-HCV im Vergleich zu SGPT-Werten fOr die Pr/ivention der 'Ubertragung der Non-A, Non-B-Transfusionshepatitis nachuntersucht. 15 Patienten hatten eine NANB-Transfusionshepatitis entwickelt (Gruppe A): davon zeigten zehn in den folgenden 3-12 Monaten eine anti-HCV Serokonversion. Acht dieser dem weniger Blutspender ausgeschlossen werden. Wahrscheinlich ist der Anteil der bei Transfusionshepatitis NANB erfal3ten anti-HCV-Serokonversionen zu gering; dies k6nnte auf die bei der ELISA-Methode festgelegten Grenzwerte ffir den Nachweis von Anti-HCV zur/ickzufohren sein.
Gut, 2002
Background: Hepatitis C virus (HCV) infection is common worldwide but there are different prevalence rates in different countries. Data on the incidence of HCV in the general population are scarce. Spontaneous viral clearance occurs in 10-25% of infected individuals after acute infection yet controversy exists regarding the frequency of spontaneous clearance during the natural course of HCV infection in the general population. Aims: Anti-HCV prevalence, HCV infection rate, and the kinetics of anti-HCV were studied in a cross section of the general population of central Italy. Study population and methods: Anti-HCV prevalence (EIA-3 Ortho, RIBA-3 Ortho Chiron) was estimated in 3884 randomly selected individuals. Infection rate and antibody kinetics were estimated in 2032 participants for whom a second blood sample was taken after a median follow up of seven years. HCV-RNA determination by polymerase chain reaction was performed on follow up sera. Results: The overall confirmed anti-HCV prevalence was 2.4%. Two participants seroconverted for anti-HCV, giving an overall infection rate of 1.4 cases per 10 000 person years (95% confidence interval 0.2-5.2 per 10 000 person years). Of the 36 individuals confirmed as anti-HCV positive at enrolment, seven (19.4%) showed complete seroreversion. Seven (87%) of the eight individuals with indeterminate results at enrolment were serologically non-reactive at the end of follow up. Of the 25 participants confirmed to be anti-HCV positive at both enrolment and follow up, 23 (92.0%) with stable serological profiles tested positive for HCV-RNA at the end of follow up. Conclusions: There is still a permanent risk, although low, of HCV spread in the general population in an area of low level endemicity. In this setting, a wide spectrum of modifications of viral and antibody patterns can be observed in HCV infected patients.
Prevalence of Hepatitis C Virus Infection in Different Population Groups in Southern Italy
Infection, 2005
A cross-sectional investigation was carried out between 2000 and 2002 to assess the prevalence of hepatitis C virus infection (HCV) in Naples, southern Italy. Patients and Methods: Five groups of individuals were investigated, two at low risk and three at high risk for HCV infection. Blood sample sera were collected among 5,391 individuals (4,059 men and 1,332 women): 1,972 general practitioner (GP) patients and 781 employees of the National Cancer Institute (NCI) of Naples (low-risk groups); 524 male prisoners, 1,436 intravenous drug users (IDUs) and 678 hemodialysis patients (high-risk groups). Results: Overall HCV seropositivity rates ranged from 6.4% among employees of the NCI to 37.4% among male prisoners. HCV infection tended to generally increase with age, but in IDUs and in male prisoners the upward trend leveled off at 50 years of age. As compared to GP patients, IDUs (both sexes) and male prisoners had a nearly 6-fold increased risk of HCV infection, while HCV was nearly 3-fold more common among hemodialysis patients. Employees of NCI were at reduced risk of HCV infection, particularly women (odds ratio = 0.3).
Saudi Medical Journal, 2002
To determine the prevalence of hepatitis C virus (HCV) antibodies among 5 different population groups including; healthy individuals, blood donors, hospital health care workers, renal dialysis patients and multiple blood transfusion group. To compare the ratios, relative and attributable risk among these groups. To outline a specific policy to reduce the potential risk of HCV among the different groups studied. A prospective study was carried out in the Department of Microbiology, Faculty of Medicine, Tripoli, Libya, over a 2 year period for 1999 to 2001, to determine the prevalence of HCV-antibodies in sera collected from 5 distinct groups using enzyme-linked immunosorbent assay test. The groups included 800 healthy adults, 1200 individuals of blood donors, 459 hospital health care workers, 200 patients on renal dialysis and multiple blood transfusion group which included 250 patients. The prevalence of HCV was correlated with relative and attributable risk that contributed to the ...
Epidemiology of hepatitis C virus infection
PubMed, 2005
Although a lot of novel information and data on the epidemiology of hepatitis C virus (HCV) infection are available worldwide, the majority of these information are often fragmentary and sometimes contradictory. This review tries to highlight all the data available on the prevalence (i.e. the number of cases present in a known population), the risk factors, the natural history and the incidence (i.e. the number of new cases that occur every year) of HCV infection in the world, and particularly in Italy.