Angelo Andriulli1, Tommaso Stroffolini2, Andrea Mariano3, Maria Rosa Valvano4, Ignazio Grattagliano5, Antonio Massimo Ippolito4, Adriano Grossi6, Giuseppina Brancaccio6, Christian Coco7, Maurizio Russello7, Antonina Smedile8, Elisa Petrini8, Silvia Martini8, Giovanni Battista Gaeta6, Mario Rizzetto8. 1. Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy. Electronic address: a.andriulli@operapadrepio.it. 2. Department of Infectious and Tropical Diseases, Policlinico Umberto I, Rome, Italy. 3. Division of Infectious and Tropical Diseases, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Rome, Italy. 4. Division of Gastroenterology, Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy. 5. Italian College of General Practitioners, Bari, Italy. 6. Clinics of Infectious Diseases, 2nd University of Naples, Naples, Italy. 7. Hepatology Unit, ARNAS "Garibaldi", Catania, Italy. 8. Department of Medical Sciences, University of Torino, Department of Gastroenterology and Hepatology, Azienda Ospedaliera Città della Salute e della Scienza, Torino, Italy.
Abstract
BACKGROUND: Data on the prevalence of hepatitis C virus (HCV) infection in Italy are outdated and usually derived from studying residents in small towns. METHODS: 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. RESULTS: 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. INTERPRETATION: 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.
BACKGROUND: Data on the prevalence of hepatitis C virus (HCV) infection in Italy are outdated and usually derived from studying residents in small towns. METHODS: 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. RESULTS: 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. INTERPRETATION: 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.
Authors: Loreta A Kondili; Ivane Gamkrelidze; Sarah Blach; Andrea Marcellusi; Massimo Galli; Salvatore Petta; Massimo Puoti; Stefano Vella; Homie Razavi; Antonio Craxi; Francesco S Mennini Journal: Liver Int Date: 2020-04-02 Impact factor: 5.828
Authors: Loreta A Kondili; Sarah Robbins; Sarah Blach; Ivane Gamkrelidze; Anna L Zignego; Maurizia R Brunetto; Giovanni Raimondo; Gloria Taliani; Andrea Iannone; Francesco P Russo; Teresa A Santantonio; Massimo Zuin; Luchino Chessa; Pierluigi Blanc; Massimo Puoti; Maria Vinci; Elke M Erne; Mario Strazzabosco; Marco Massari; Pietro Lampertico; Maria G Rumi; Alessandro Federico; Alessandra Orlandini; Alessia Ciancio; Guglielmo Borgia; Pietro Andreone; Nicola Caporaso; Marcello Persico; Donatella Ieluzzi; Salvatore Madonia; Andrea Gori; Antonio Gasbarrini; Carmine Coppola; Giuseppina Brancaccio; Angelo Andriulli; Maria G Quaranta; Simona Montilla; Homie Razavi; Mario Melazzini; Stefano Vella; Antonio Craxì Journal: Liver Int Date: 2018-08-10 Impact factor: 5.828