Chiaramonte M, Stroffolini T, Lorenzoni U, Minniti F, Conti S, Floreani A, Ntakirutimana E, Vian A, Ngatchu T, Naccarato R
Department of Gastroenterology, Institute of Internal Medicine, University of Padova, Rome, Italy.
J Hepatol. 1996 Feb;24(2):129-34. doi: 10.1016/s0168-8278(96)80020-1.
AIMS/METHODS: A case-control study was carried out in Italy to assess the risk factors associated with chronic hepatitis C virus infection. Five hundred consecutive chronic anti-hepatitis C virus positive cases and 500 sex and exactly age-matched anti-hepatitis C virus negative/HBsAg negative controls entered the study. Information was collected through an interviewer-administered questionnaire. The adjusted Odds Ratios linking hepatitis C virus infection and risk factors were estimated by conditional multiple logistic regression. Demographic and socio-economic characteristics were similar in cases and controls. Seventy-five percent of patients were aged over 40: males were prominent in the group < or = 40, while the number of females increased with age.
As expected, drug addiction and blood transfusion emerged as independent risk factors: blood transfusion in all ages and in both sexes, drug addiction only in subjects under 41 years and mostly in males. Other risk factors independently associated with hepatitis C virus infection were: previous use of non-disposable needles, previous tuberculosis, and prolonged hospitalization before 1970. A history of sexually-transmitted diseases was not associated.
This study shows that the great spread of hepatitis C virus in Italy may have occurred several years ago through parenteral routes which are not now operating. Modern hygienic and sanitation measures have significantly controlled exposure to the infection, which in the younger generations is confined to high-risk groups such as drug addicts.
目的/方法：在意大利开展了一项病例对照研究，以评估与慢性丙型肝炎病毒感染相关的危险因素。连续纳入500例慢性抗丙型肝炎病毒阳性病例以及500例性别和年龄精确匹配的抗丙型肝炎病毒阴性/乙肝表面抗原阴性对照者进入研究。通过访员管理的问卷收集信息。通过条件多因素逻辑回归估计与丙型肝炎病毒感染和危险因素相关的校正比值比。病例组和对照组的人口统计学和社会经济特征相似。75%的患者年龄超过40岁：40岁及以下组男性居多，而女性数量随年龄增加。
正如预期的那样，药物成瘾和输血成为独立的危险因素：各年龄段和两性中输血均为危险因素，药物成瘾仅在41岁以下人群中存在，且大多为男性。与丙型肝炎病毒感染独立相关的其他危险因素有：既往使用非一次性针头、既往患结核病以及1970年前长期住院。性传播疾病史与之无关。
本研究表明，丙型肝炎病毒在意大利的广泛传播可能在数年前就已通过现已不再存在的非肠道途径发生。现代卫生和环境卫生措施已显著控制了感染暴露，在年轻一代中，感染仅限于吸毒者等高风险人群。
