Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
Department of Tropical and Infectious Diseases, University of Rome, Rome, Italy.
J Med Virol. 2017 Feb;89(2):291-297. doi: 10.1002/jmv.24635. Epub 2016 Jul 27.
Data on the prevalence of HCV infection in Italy are often outdated and from non-urban populations. This study assessed the prevalence and risk factors for HCV infection in a large metropolitan area in southern Italy. A random 1:3 systematic sample of the adult general population of Naples was selected from three general practitioner patient registers in three different city districts. Socioeconomic indicators and risk factors for HCV infection were collected. Anti-HCV and HCV-RNA assays were performed. Logistic regression analysis was used to identify independent predictors of HCV infection. Of 1,500 randomly selected subjects, 1,315 (87.7%) participated in the study. Forty subjects (3.0%; 95%CI: 2.1-4.0) were anti-HCV-positive, with HCV-RNA detected by PCR in 31 (77.5%) of these. Anti-HCV prevalence increased with age, peaking (8.2%) in people born during the years 1945-1955. It was 1.7% in people residing in the better socioeconomic districts; but 5.7% in those residing in the district with lower socioeconomic status (P < 0.01). In multivariate analysis, age ≥60 years (OR 2.8, 95%CI: 1.3-6.1) and lower educational level (OR 3.6; 95%CI: 1.4-9.3), which is a proxy of low socioeconomic status, were the only independent predictors of the likelihood of anti-HCV positivity. Overall, 22.5% of anti-HCV positive subjects were previously unaware of their status. In the large city of Naples, infection with HCV is most common in people aged older than 60 years. Differences in socioeconomic conditions have played an important role in the spread of this infection. HCV positive subjects born during the years 1945-1955 are those who may benefit, to a greater extent, to be identified in order to receive the new effective therapy. J. Med. Virol. 89:291-297, 2017. © 2016 Wiley Periodicals, Inc.
意大利有关 HCV 感染流行的数据往往已经过时，且来源于非城市人群。本研究评估了意大利南部一个大都市区的 HCV 感染流行率和危险因素。从那不勒斯三个不同城区的三个全科医生患者登记处，采用 1:3 随机系统抽样方法抽取成年一般人群。收集社会经济指标和 HCV 感染危险因素。进行抗 HCV 和 HCV-RNA 检测。采用 logistic 回归分析鉴定 HCV 感染的独立预测因子。在随机选择的 1500 名受试者中，有 1315 名（87.7%）参加了研究。40 名（3.0%；95%CI：2.1-4.0）受试者抗 HCV 阳性，其中 31 名（77.5%）通过 PCR 检测到 HCV-RNA。抗 HCV 流行率随年龄增长而增加，在 1945-1955 年出生的人群中达到峰值（8.2%）。在社会经济状况较好的地区，抗 HCV 流行率为 1.7%；而在社会经济地位较低的地区，流行率为 5.7%（P<0.01）。多变量分析显示，年龄≥60 岁（OR 2.8，95%CI：1.3-6.1）和较低的教育水平（OR 3.6；95%CI：1.4-9.3），这是社会经济地位较低的一个替代指标，是抗 HCV 阳性的唯一独立预测因子。总的来说，22.5%的抗 HCV 阳性患者之前并不知道自己的病情。在那不勒斯这个大城市，年龄超过 60 岁的人最容易感染 HCV。社会经济条件的差异在这种感染的传播中发挥了重要作用。1945-1955 年出生的 HCV 阳性患者可能会受益更多，更有可能被发现，以便接受新的有效治疗。J. Med. Virol. 89:291-297, 2017. © 2016 Wiley Periodicals, Inc.
