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Declining prevalence and increasing awareness of HCV infection in Italy: A population-based survey in five metropolitan areas

Published:February 20, 2018DOI:https://doi.org/10.1016/j.ejim.2018.02.015

      Highlights

      • In Italy the seroprevalence for anti-HCV among the general population is outdated.
      • We evaluated 4907 subjects in 5 metropolitan areas.
      • The birth-cohort prevalence peaked in elderly.
      • Nearly 80% of the anti-HCV subjects were aware of their status.
      • This epidemiological pattern does not warrant a policy of screening in 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      Data on the prevalence of hepatitis C virus (HCV) infection in Italy are outdated and usually derived from studying residents in small towns.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.

      Keywords

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