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- •In Italy the seroprevalence for anti-HCV among the general population is outdated.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Data on the prevalence of hepatitis C virus (HCV) infection in Italy are outdated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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Article info
Publication history
Published online: February 20, 2018
Accepted:
February 14,
2018
Received in revised form:
January 6,
2018
Received:
November 13,
2017
Identification
Copyright
© 2018 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
