Hepatitis C Virus Infection Trends in Italy, 19962006 (original) (raw)
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Hepatitis C Virus infections trends in Italy, 1996-2006
Hepatitis Monthly, 2011
Behavioral changes are a leading factor in the decrease of HCV infections. Every effort should be made with the aim to maintain low levels of HCV infection. More attention, in particular, needs to be placed to improve socio-economic condition and to sanitation during medical procedures, even for those performed at home. c 2011, BRCGL, Published by Kowsar M.P.Co. All rights reserved.
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.
Current Pharmaceutical Design, 2008
It is estimated that approximately 130-170 million people worldwide are infected with hepatitis C virus (HCV). According to data from WHO community and blood donor surveys, the African and Eastern Mediterranean countries report the highest prevalence rates (>10%). The rates of infection in the general population and the incidence of newly-acquired cases indicate an appreciable change in the epidemiology of the infection in recent years. Prior to the widespread screening of blood donations, infected blood and blood products represented a common source of infection. On the other hand, the high peak in HCV antibodies among the elderly in Italian epidemiological studies on the population at large reflects a cohort effect due to an epidemic of HCV infection occurring after the Second World War. According to data reported by the CDC Surveillance System, the incidence of acute hepatitis C has declined since the late 1980s. In 2005, as in previous years, the majority of such cases in North America and Northern Europe occurred among young adults and injected drug use was the most common risk factor. Other, less commonly reported modes of HCV acquisition are occupational exposure to blood, high-risk sexual activity, tattooing, body piercing and other forms of skin penetration. Finally, the overall rate of mother-tochild transmission from HCV-infected, HIV-negative mothers has been estimated at around 5% (coinfection with HIV raises this figure to 19.4%). HCV prevention relies on identifying and counseling uninfected persons at risk of contracting hepatitis C.
Estimation of the number of HCV-positive patients in Italy
PLOS ONE, 2019
Background HCV is one of the main causes of cirrhosis, hepatocellular carcinoma (HCC) and liver transplantation. Aim The aim of this study was to estimate the number of living individuals diagnosed with hepatitis C in Italy. This study also aimed to stratify these subjects as diagnosed and cured, diagnosed awaiting a cure, and undiagnosed (individuals who were not diagnosed, living or lived with hepatitis C). Methods To quantify the number of ill patients in Italy, an inquiry was conducted based on questionnaires submitted to three nationally representative regions, namely, Campania, Lazio and Piemonte, as representatives of the three main areas of Italy (North, Centre and South regions). The data were collected through a questionnaire to acquire demographic and clinical information on patients in the participating hospitals. The questionnaires contained 6 questions on sex, age, region of residence, disease condition, type of exemption and category. The questionnaires were administered individually to consecutive patients through face-to-face interviews conducted by specialised personnel in each centre. Data were collected between September 2017 and January 2018.
Epidemiology of HCV Infection in the General Population: A Survey in a Southern Italian Town
The American Journal of Gastroenterology, 2009
The prevalence of HCV seropositivity observed in various populations raise the issue of the contamination routes and the corollary exclusion criteria of risk subjects from blood donation. There are various diagnostic methods for HCV infection. The biological diagnosis is reached at three levels: circulating antibody screening by second and third generation tests; screening validation by immunoblot, to distinguish between the various HCV specific antibodies and detection of viral nucleic acids by molecular biology. In blood donors in France, 0.5% were seropositive in 1990, 0.3% in 1992 and 0.1% (essentially new donors) in 1995. This decrease is the result of improved test specificity and sensitivity and donor selection. In Europe, prevalences range from 0.1-1.5% with a North-South gradient. In other countries: 0.3% in Canada, 0.6% in the USA, 1-2% in China, Thailand and Japan, from 0.2 to 20% in Africa. In risk populations contamination by blood is manifest: HCV seropositivity in 80% of drug abusers, 10-60% of dialysis patients before 1991, more than 80% of haemophiliacs treated before 1986, 10% of labile blood product recipients before 1988. The nosocomial transmission figures are even worse: 2-5% of hospitalized patients are thought to be contaminated. Perinatal and sexual contaminations are not excluded (3-30%) and they vary according to the degree of exposure and the viral type of post-transfusional HCV infection: prevention implies several types of action: information and education of populations about risk factors; medical interview before each blood donation; systematic serological testing; manufacturing measures for stable (SD processing) and labile (deleukocytation, plasma seroattenuation) blood products; prescription recommendations and follow-up measures: haemovigilance (clinical and biological follow-up of all recipients of human blood products).
Predicted Effects of Treatment for HCV Infection Vary Among European Countries
Gastroenterology, 2012
See Covering the Cover synopsis on page 876; see editorial on page 887. BACKGROUND & AIMS: The dynamics of hepatitis C virus (HCV) infection, as well as screening practices and access to therapy, vary among European countries. It is important to determine the magnitude of the effects of such differences on incidence and mortality of infection. We compared the dynamics of infection and screening and treatment practices among Belgium, France, Germany, Italy, Spain, and the United Kingdom. We also assessed the effects of treatment with pegylated interferon and additional effects of triple therapy with protease inhibitors. METHODS: We created a country-specific Markov model of HCV progression based on published epidemiologic data (on HCV prevalence, screening, genotype, alcohol consumption among patients, and treatments) and reports of competitive and hepatocellular carcinoma mortality for the 6 countries. The model was used to predict the incidence of HCV-related cirrhosis and its mortality until 2021 for each country. RESULTS: From 2002 to 2011, antiviral therapy reduced the cumulative incidence of cirrhosis by 7.1% and deaths by 3.4% overall. Reductions in incidence and mortality values ranged from 4.0% and 1.9%, respectively, in Italy to 16.3% and 9.0%, respectively, in France. From 2012 to 2021, antiviral treatment of patients with HCV genotype 1 infection that includes protease inhibitor-based triple therapy will reduce the cumulative incidence of cirrhosis by 17.7% and mortality by 9.7% overall. The smallest reduction is predicted for Italy (incidence reduced by 10.1% and mortality by 5.4%) and the highest is for France (reductions of 34.3% and 20.7%, respectively). CONCLUSIONS: Although HCV infection is treated with the same therapies in different countries, the effects of the therapies on morbidity and mortality vary significantly. In addition to common guidelines that are based on virologic response-guided therapy, there is a need for public health policies based on population-guided therapy.
A population-based study of the epidemiology of hepatitis C in a North American population
Journal of Hepatology, 2012
Background & Aims: Chronic hepatitis C virus (HCV) infection is a major public health problem with approximately 3% of the world's population thought to be chronically infected. However, population-based data regarding HCV incidence rates, prevalence, residence, age, and gender distributions within North America are limited. We aimed at providing a detailed descriptive epidemiology of HCV infection in a North American population with a focus on time trends in incidence rates and prevalence of newly diagnosed HCV infection since 1991, the time when laboratory testing for HCV infections became first available. Methods: A Research Database was developed linking records from multiple administrative sources. HCV positive residents of the Canadian province of Manitoba were identified during a twelve-year period (1991-2002). The cumulative and annual incidence rates and the prevalence of newly diagnosed HCV infection in Manitoba were examined and compared between different demographic groups and urban vs. rural residents. Results: A total of 5018 HCV positive cases were identified over a 12-year period. The annual number of newly diagnosed HCV infections peaked in 1998 (59.2/100,000). On the other hand, the known prevalence of HCV continued to increase (4.6-fold during the 12-year study period) among both men and women reflecting the chronic nature of the disease. Males were 1.7 times more often infected than females. HCV infections were more common in urban centers. Conclusions: Between 1995 and 2002, there was a fairly constant trend for newly diagnosed HCV infection, ranging from approximately 500 to 600 new cases annually. Hence, with a stable population size, and a low case fatality rate, the prevalence of HCV infected persons in our population has been steadily rising. There is no evidence to suggest that the incidence of HCV infection will raise, however, the burden of chronic HCV infection will continue to increase, particularly amongst older males and those residing in urban centers.
High prevalence of HCV infection among the general population in a rural area of central Italy
European Journal of Epidemiology, 2001
The hepatitis C virus infection (HCV) is the most frequent cause of hepatic infection in Europe. In Italy, anti-HCV positivity values are extremely variable, depending on the age and geographic location of the population being analysed. The aims of the study were: (1) evaluating positivity for anti-HCV antibodies in various age groups and determining the HBsAg in a mountainous and