Millbourn Charlotta, Psaros Einberg Afrodite, Lindh Gudrun, Hökeberg Ingegerd, Fischler Björn, Lindahl Karin
a Department of Medicine Huddinge , Karolinska Institutet , Stockholm , Sweden.
b Department of Infectious Diseases , Karolinska University Hospital , Stockholm , Sweden.
Scand J Gastroenterol. 2018 Jun-Jul;53(7):870-875. doi: 10.1080/00365521.2018.1476911. Epub 2018 Jun 18.
The prevalence of hepatitis C virus (HCV) infection in Sweden is estimated to 0.5%. Before 1992, blood transfusion posed a risk of HCV transmission. The primary aim of this study was to estimate anti-HCV prevalence in Stockholm County among individuals receiving blood transfusions 1965-1991. The secondary aim was to study the effect of age at transfusion on the development of liver disease and treatment outcome.
This is a retrospective analysis of individuals found to be anti-HCV tested positive in Stockholm County during a national screening campaign in Sweden 2008-2010. All anti-HCV-positive individuals were also HCV RNA tested. Data on age at transfusion, age at diagnosis, HCV genotype, viral load, fibrosis score, liver histology and antiviral treatment were recorded.
Out of 7473, 134 (1.8%) tested individuals were anti-HCV positive and 102 were HCV RNA positive resulting in a prevalence of chronic hepatitis C (CHC) of 1.4%. The rate of advanced liver damage was 18% (10/56). Patients younger than 19 years of age at transfusion were significantly more often started on antiviral treatment compared to adult patients, 65% vs 29% p < .001. No significant correlation was found between treatment outcome and gender or age at transfusion.
In this study, we found an anti-HCV prevalence of 1.8% which is considerably higher than the estimated prevalence in the Swedish general population (0.5%), and patients infected during childhood were more likely to receive antiviral treatment. Additional data on the HCV epidemic in Sweden are needed regarding prevalence and age distribution.
据估计，瑞典丙型肝炎病毒（HCV）感染率为0.5%。1992年前，输血存在HCV传播风险。本研究的主要目的是估计1965年至1991年期间在斯德哥尔摩县接受输血的个体中抗-HCV的流行率。次要目的是研究输血时的年龄对肝病发展和治疗结果的影响。
这是一项对2008 - 2010年瑞典全国筛查活动期间在斯德哥尔摩县抗-HCV检测呈阳性的个体进行的回顾性分析。所有抗-HCV阳性个体也进行了HCV RNA检测。记录了输血时的年龄、诊断时的年龄、HCV基因型、病毒载量、纤维化评分、肝脏组织学和抗病毒治疗情况。
在7473名检测个体中，134名（1.8%）抗-HCV呈阳性，102名HCV RNA呈阳性，慢性丙型肝炎（CHC）患病率为1.4%。晚期肝损伤发生率为18%（10/56）。与成年患者相比，输血时年龄小于19岁的患者开始抗病毒治疗的频率明显更高，分别为65%和29%，p <.001。未发现治疗结果与性别或输血时年龄之间存在显著相关性。
在本研究中，我们发现抗-HCV流行率为1.8%，显著高于瑞典普通人群的估计流行率（0.5%），儿童期感染的患者更有可能接受抗病毒治疗。关于瑞典HCV流行情况的患病率和年龄分布还需要更多数据。
