Hepatitis C virus infection in an endemic area of Southern Italy 14 years later: evidence for a vanishing infection

Dig Liver Dis. 2013 May;45(5):403-7. doi: 10.1016/j.dld.2012.10.014. Epub 2012 Nov 28.

Abstract

Background: In a 1996 survey, prevalence of hepatitis C virus antibodies (anti-HCV) in a southern Italian town was 12.6%.

Aims: To identify changes in the epidemiology of hepatitis C virus (HCV) infection.

Methods: Anti-HCV, HCV-RNA (PCR, detection limit 15 IU/mL), HCV genotype (Innolipa). Were performed in a random 1:4 systematic sample of the general population. Multiple logistic regression analysis was used to estimate factors independently associated with the likelihood of anti-HCV positivity.

Results: Of 1012 subjects, 58 (5.7%) were anti-HCV-positive, compared to 12.6% 14 years earlier. Prevalence was 0.4% in individuals <30 years old and 31.8% in those ≥ 70 years old. Among 139 HCV-negative in 1996 re-sampled in 2010, only one had seroconverted (incidence: 0.05 × 100 persons/year). Alanine transaminase levels were elevated in 8 (13.8%). HCV-RNA was detected by PCR in 46.5% anti-HCV-positive subjects. In 2010 59% were genotype 2-infected, in 1996 50.7% genotype 1-infected. Previous use of non-disposable glass syringes was a strong independent predictor (OR 3.2; CI 95%=1.4-7.3).

Conclusion: Epidemiology of HCV infection in an endemic area of south Italy has changed over 14 years, now largely confined to the oldest age group; this seems to be due to the disappearance of its past main mode of transmission, namely the use of glass syringes.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Female
  • Genotype
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification*
  • Hepatitis C Antibodies / blood*
  • Hepatitis C, Chronic / epidemiology*
  • Humans
  • Italy / epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • RNA, Viral / analysis*
  • Risk Factors
  • Young Adult

Substances

  • Hepatitis C Antibodies
  • RNA, Viral