Kondili L A, Chionne P, Costantino A, Villano U, Lo Noce C, Pannozzo F, Mele A, Giampaoli S, Rapicetta M
Department of Virology, Istituto Superiore di Sanità, Rome, Italy.
Gut. 2002 May;50(5):693-6. doi: 10.1136/gut.50.5.693.
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.
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.
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.
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 enrollment, seven (19.4%) showed complete seroreversion. Seven (87%) of the eight individuals with indeterminate results at enrollment were serologically non-reactive at the end of follow up. Of the 25 participants confirmed to be anti-HCV positive at both enrollment and follow up, 23 (92.0%) with stable serological profiles tested positive for HCV-RNA at the end of follow up.
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.
丙型肝炎病毒（HCV）感染在全球普遍存在，但不同国家的患病率有所不同。一般人群中HCV发病率的数据较为匮乏。急性感染后，10%-25%的受感染个体可出现病毒自发清除，但关于一般人群中HCV感染自然病程中自发清除的频率仍存在争议。
在意大利中部一般人群的横断面研究中，对抗-HCV患病率、HCV感染率及抗-HCV动力学进行研究。
对3884名随机选取的个体进行抗-HCV患病率（酶免疫分析-3 Ortho、重组免疫印迹分析-3 Ortho Chiron）评估。对2032名参与者进行感染率及抗体动力学评估，这些参与者在中位随访7年后采集了第二份血样。采用聚合酶链反应对随访血清进行HCV-RNA检测。
总体确诊抗-HCV患病率为2.4%。两名参与者抗-HCV血清学转换，总体感染率为每10000人年1.4例（95%置信区间为每10000人年0.2-5.2例）。入组时确诊为抗-HCV阳性的36人中，7人（19.4%）出现完全血清学逆转。入组时结果不确定的8人中，7人（87%）在随访结束时血清学无反应。在入组和随访时均确诊为抗-HCV阳性的25名参与者中，23人（92.0%）血清学特征稳定，在随访结束时HCV-RNA检测呈阳性。
在低流行地区的一般人群中，HCV传播仍存在永久性风险，尽管风险较低。在此情况下，HCV感染患者可观察到病毒和抗体模式的广泛变化。
