Spada Enea, Marcantonio Cinzia, Vescio Maria F, Marascio Nadia, Villano Umbertina, Pisani Giulio, Tritarelli Elena, Bruni Roberto, Barreca Giorgio S, Torti Carlo, Matera Giovanni, Liberto Maria C, Focà Alfredo, Pezzotti Patrizio, Ciccaglione Anna Rita
Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy -
Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy.
Minerva Med. 2023 Apr;114(2):191-202. doi: 10.23736/S0026-4806.21.07280-3. Epub 2021 Apr 29.
General population data on hepatitis C virus (HCV) prevalence in Italy come mostly from studies conducted in small towns. The highest rates have consistently been found in southern regions, especially in Calabria. Herein, we aimed to determine HCV prevalence, awareness, and risk factors in the general population of Catanzaro, the capital city of Calabria, Italy.
A stratified probability-based random sample of adult population was drawn from the Census. Anti-HCV and HCV-RNA were assayed. Data on sociodemographycs, risk factors and awareness of infection status were also collected. Crude and age and sex directly standardized rates (DSR), using Catanzaro's general population as standard, were calculated. Log binomial regressions with sampling weights was used to identify independent predictors of infection.
The final study population consisted of 1003 people. Of them 27 (2.69%; 95% confidence interval, [CI] 1.78-3.89) (DSR: 2.34%; 95% CI: 1.37-3.30) and 9 (0.9%; 95% CI: 0.41-1.70) (DSR: 0.79%; 95% CI: 0.21-1.37) were anti-HCV and HCV RNA positive, respectively. Most HCV-positive participants were older people. Age ≥65 and past use of illicit drugs were both positive independent predictors of anti-HCV positivity, while female sex was an independent protective predictor of infection. Only 9 (33.3%) of anti-HCV positive participants had awareness of their status.
We detected a much lower anti-HCV prevalence than those previously found in Calabria, along with a substantial change in HCV transmission modes. Infected people were almost only elderly and mostly unaware of their infection. Improving diagnosis and linkage to care for these infected persons would be needed.
意大利丙型肝炎病毒（HCV）流行率的一般人群数据大多来自在小城镇开展的研究。一直以来，最高流行率出现在南部地区，尤其是卡拉布里亚。在此，我们旨在确定意大利卡拉布里亚首府卡坦扎罗一般人群中的HCV流行率、知晓率及危险因素。
从人口普查中抽取基于概率分层的成年人群随机样本。检测抗-HCV和HCV-RNA。还收集了社会人口统计学、危险因素及感染状况知晓率的数据。以卡坦扎罗的一般人群为标准，计算粗率以及年龄和性别直接标准化率（DSR）。采用带抽样权重的对数二项回归来确定感染的独立预测因素。
最终研究人群包括1003人。其中27人（2.69%；95%置信区间，[CI] 1.78 - 3.89）（DSR：2.34%；95% CI：1.37 - 3.30）抗-HCV阳性，9人（0.9%；95% CI：0.41 - 1.70）（DSR：0.79%；95% CI：0.21 - 1.37）HCV RNA阳性。大多数HCV阳性参与者为老年人。年龄≥65岁及既往使用非法药物均为抗-HCV阳性的独立阳性预测因素，而女性是感染的独立保护预测因素。抗-HCV阳性参与者中只有9人（33.3%）知晓自己的状况。
我们检测到抗-HCV流行率远低于此前在卡拉布里亚发现的水平，同时HCV传播模式也有显著变化。感染者几乎全是老年人，且大多不知晓自己已感染。需要改善对这些感染者的诊断及与治疗的衔接。
