意大利南部地方性流行区丙型肝炎病毒感染 14 年后：感染正在消失的证据。

Hepatitis C virus infection in an endemic area of Southern Italy 14 years later: evidence for a vanishing infection.

机构信息

Chair of Infectious Diseases, School of Medicine and Surgery, University of Catanzaro, Italy.

出版信息

Dig Liver Dis. 2013 May;45(5):403-7. doi: 10.1016/j.dld.2012.10.014. Epub 2012 Nov 28.

DOI:10.1016/j.dld.2012.10.014

PMID:23199596

Abstract

BACKGROUND

In a 1996 survey, prevalence of hepatitis C virus antibodies (anti-HCV) in a southern Italian town was 12.6%.

AIMS

To identify changes in the epidemiology of hepatitis C virus (HCV) infection.

METHODS

Anti-HCV, HCV-RNA (PCR, detection limit 15 IU/mL), HCV genotype (Innolipa). Were performed in a random 1:4 systematic sample of the general population. Multiple logistic regression analysis was used to estimate factors independently associated with the likelihood of anti-HCV positivity.

RESULTS

Of 1012 subjects, 58 (5.7%) were anti-HCV-positive, compared to 12.6% 14 years earlier. Prevalence was 0.4% in individuals <30 years old and 31.8% in those ≥ 70 years old. Among 139 HCV-negative in 1996 re-sampled in 2010, only one had seroconverted (incidence: 0.05 × 100 persons/year). Alanine transaminase levels were elevated in 8 (13.8%). HCV-RNA was detected by PCR in 46.5% anti-HCV-positive subjects. In 2010 59% were genotype 2-infected, in 1996 50.7% genotype 1-infected. Previous use of non-disposable glass syringes was a strong independent predictor (OR 3.2; CI 95%=1.4-7.3).

CONCLUSION

Epidemiology of HCV infection in an endemic area of south Italy has changed over 14 years, now largely confined to the oldest age group; this seems to be due to the disappearance of its past main mode of transmission, namely the use of glass syringes.

摘要

背景

在 1996 年的一项调查中，意大利南部一个城镇的丙型肝炎病毒抗体（抗-HCV）流行率为 12.6%。

目的

确定丙型肝炎病毒（HCV）感染的流行病学变化。

方法

对普通人群进行了 1:4 的随机系统抽样，检测抗-HCV、HCV-RNA（PCR，检测限 15IU/mL）和 HCV 基因型（Innolipa）。采用多元逻辑回归分析来估计与抗-HCV 阳性可能性相关的独立因素。

结果

在 1012 名受试者中，有 58 名（5.7%）抗-HCV 阳性，而 14 年前为 12.6%。在年龄<30 岁的个体中，患病率为 0.4%，而在年龄≥70 岁的个体中，患病率为 31.8%。在 1996 年随机抽取的 139 名 HCV 阴性者中，2010 年仅有 1 名发生血清转换（发病率：0.05×100 人/年）。丙氨酸转氨酶水平升高者 8 例（13.8%）。PCR 检测到 HCV-RNA 的 46.5%抗-HCV 阳性者。2010 年，59%的患者感染基因型 2，而 1996 年为 50.7%感染基因型 1。既往使用非一次性玻璃注射器是一个强有力的独立预测因素（OR 3.2；95%CI=1.4-7.3）。