Baldo V, Floreani A, Menegon T, Angiolelli G, Trivello R
Institute of Hygiene, University of Padua, Italy.
Gerontology. 2000 Jul-Aug;46(4):194-8. doi: 10.1159/000022159.
The prevalence of antibodies against hepatitis C virus (anti-HCV) increases in the general population with advancing age. Several discrepancies exist in the epidemiology of HCV, however, when selected elderly population groups are tested.
To evaluate the HCV prevalence in two groups of elderly people living in the same geopgraphical area of northeast Italy, i.e., one including residents of a nursing home, the other including subjects living at home.
The overall sample included 496 subjects (mean age 79.31 +/- 8.9 years); 288 were in a nursing home, and 208 were living at home. Enrollment in the latter group was based on all subjects over 65 years old listed under the public health service in the same district. The overall rate of adhesion to the study was 90%. Each subject was administered an anonymous questionnaire testing sociodemographic data and risk factors for HCV infection. Serological tests included: anti-HCV and hepatitis B virus serum markers. Multiple logistic regression analysis was performed to evaluate risk factors for anti-HCV positivity.
Anti-HCV positivity was found in 34 of 288 (11.8%) elderly in the nursing home and in 23 of 208 (11.1%) in the open population. When the total population was considered, females exhibited a significantly a higher prevalence of anti-HCV than males (13.4 vs. 7.5%, p < 0.05). In both males and females, the highers rate of anti-HCV prevalence was found among the 75- to 79-year-old subjects. A decline in anti-HCV prevalence was observed in the very old subjects (over 80 years of age). None of the anti-HCV-positive subjects was found to be coinfected with hepatitis B surface antigen. However, multiple logistic regression analysis identified the age group between 70 and 79 years, female gender, and positivity for antihepatitis B surface antigen and/or antihepatitis B core antigen as independent variables significantly associated with HCV prevalence.
The prevalence of anti-HCV proved identical among elderly people living in the nursing home or at home, suggesting that nursing homes do not represent a risk factor for HCV infections; the significant association between HCV prevalence and antihepatitis B surface antigen and/or antihepatitis B core antigen positivity supports a common route of transmission of the two viruses; these findings would suggest that there was an epidemic of HCV infection during the Second World War and in the years immediately afterwards.
丙型肝炎病毒抗体（抗-HCV）在普通人群中的流行率随年龄增长而升高。然而，在对特定老年人群进行检测时，丙型肝炎病毒的流行病学存在一些差异。
评估居住在意大利东北部同一地理区域的两组老年人中的丙型肝炎病毒流行情况，即一组为养老院居民，另一组为居家生活的老年人。
总样本包括496名受试者（平均年龄79.31±8.9岁）；288人在养老院，208人居家生活。后一组的纳入基于同一地区公共卫生服务列出的所有65岁以上受试者。研究的总体依从率为90%。对每位受试者进行一份匿名问卷调查，以检测社会人口统计学数据和丙型肝炎病毒感染的危险因素。血清学检测包括：抗-HCV和乙型肝炎病毒血清标志物。进行多因素logistic回归分析以评估抗-HCV阳性的危险因素。
在养老院的288名老年人中，34人（11.8%）抗-HCV呈阳性，在非养老院人群的208人中，23人（11.1%）呈阳性。在考虑总人口时，女性抗-HCV的流行率显著高于男性（13.4%对7.5%，p<0.05）。在男性和女性中，75至79岁的受试者抗-HCV流行率最高。在非常年老的受试者（80岁以上）中观察到抗-HCV流行率下降。未发现抗-HCV阳性受试者同时感染乙型肝炎表面抗原。然而，多因素logistic回归分析确定70至79岁年龄组、女性性别以及抗乙型肝炎表面抗原和/或抗乙型肝炎核心抗原阳性为与丙型肝炎病毒流行率显著相关的独立变量。
事实证明，养老院或居家生活的老年人中抗-HCV的流行率相同，这表明养老院并非丙型肝炎病毒感染的危险因素；丙型肝炎病毒流行率与抗乙型肝炎表面抗原和/或抗乙型肝炎核心抗原阳性之间的显著关联支持了这两种病毒有共同的传播途径；这些发现表明在第二次世界大战期间及之后的几年里曾有丙型肝炎病毒感染的流行。
