Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy.
Department of Infectious and Tropical Diseases, Policlinico Umberto I, Rome, Italy.
Eur J Intern Med. 2018 Jul;53:79-84. doi: 10.1016/j.ejim.2018.02.015. Epub 2018 Feb 21.
Data on the prevalence of hepatitis C virus (HCV) infection in Italy are outdated and usually derived from studying residents in small towns.
To assess prevalence of and risk factors for HCV infection among Italian residents in 5 metropolitan areas, subjects ≥20 years of age were randomly selected from the list of the general practitioners' registers in 2015. Anti-HCV was tested by a salivary test; HCV-RNA, HCV genotypes, and ALT were determined in positive individuals. Logistic regression analysis evaluated independent risk factors for HCV.
Of the 4907 enrolled subjects, 112 (2.3%) tested anti-HCV positive. The prevalence of HCV increased with age, from 0.2% in subjects born after the year 1984, to 4.2% in those born before the year 1935 (P < 0.01). The birth-cohort prevalence peaked (7.0%) in elderly. Serum HCV-RNA was detected in 1.7% of the whole population. Nearly 80% of anti-HCV subjects were aware of their status. Age > 70 years, low education level, past use of glass syringes, blood transfusion, intravenous drug use, and cohabitation with an anti-HCV positive subject predicted the HCV positivity.
In metropolitan areas in Italy, HCV is prevalent in elderly, reflecting a cohort effect determined by modalities of viral transmission no longer operative. The impact of the infection will further diminish in the years to come due to the natural depletion of the reservoir of the virus. This age pattern and the high proportion of subjects aware of their status do not warrant a policy of screening.
意大利丙型肝炎病毒 (HCV) 感染的流行数据已经过时，并且通常来自对小城镇居民的研究。
为了评估意大利 5 个大都市区居民 HCV 感染的流行率和危险因素，2015 年从全科医生登记册中随机选择年龄≥20 岁的受试者。通过唾液检测抗 HCV；对阳性个体进行 HCV-RNA、HCV 基因型和 ALT 检测。Logistic 回归分析评估 HCV 的独立危险因素。
在纳入的 4907 名受试者中，有 112 名（2.3%）抗 HCV 检测呈阳性。HCV 的患病率随年龄增长而增加，从 1984 年后出生的受试者的 0.2%增加到 1935 年前出生的受试者的 4.2%（P<0.01）。在老年人中，出生队列的患病率达到峰值（7.0%）。在整个人群中检测到血清 HCV-RNA 的占 1.7%。近 80%的抗 HCV 受试者知晓自己的 HCV 状态。年龄>70 岁、低教育程度、过去使用玻璃注射器、输血、静脉吸毒和与抗 HCV 阳性者同居是 HCV 阳性的预测因素。
在意大利的大都市区，HCV 在老年人中流行，反映了由不再起作用的病毒传播方式决定的队列效应。由于病毒储存库的自然枯竭，感染的影响将在未来几年进一步减少。这种年龄模式和高比例的受试者知晓其状况并不需要进行筛查。
