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A Journal on Internal Medicine

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Frequency: Quarterly

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 2003 December;45(4):253-9


High prevalence of hepatitis C virus infection in a Southern Italian rural region. Clinical aspects and evidence of inapparent parenteral exposure

Cecere A. 1, Marotta F. 1, Lucariello A. 2, Tancredi L. 1, Vangieri B. 1, Gattoni A. 1

1 “F. Magrassi” Department of Clinical and Experimental Medicine II University of Naples School of Medicine, Naples, Italy
2 Institute of Internal Medicine “Federico II” University School of Medicine, Naples, Italy

Aim. Infection by hep­a­titis C ­virus (HCV) gen­er­al­ly deter­mines an asymp­to­mat­ic ­acute hep­a­titis ­which ­becomes chron­ic in ­about 90% of cas­es. In ­order to con­trib­ute ­data on the prev­a­lence and the trans­mis­sion of HCV infec­tion and its asso­ciat­ed con­di­tions, ­anti-HCV ser­o­pos­i­tiv­ity ­records in a ­large sam­ple of a pop­u­la­tion liv­ing in a ­rural ­area in Southern Italy ­were col­lect­ed and exam­ined.
Methods. Data ­were ­obtained ­from the reg­is­ters of ­local gen­er­al prac­ti­tion­ers oper­at­ing in 4 neigh­bour­ing coun­tries ­which ­make up the ­region ana­lysed. Information on estab­lished or poten­tial ­risk fac­tors for HCV trans­mis­sion was ­obtained by ­means of a ques­tion­naire.
Results. More ­than ­half of the ­entire pop­u­la­tion of the exam­ined ­region (19800 sub­jects, 60%) had a ­record for an ­anti-HCV ­blood test­ing. Out of ­these 19800 sub­jects, 2213 ­were ­found to be ser­o­pos­i­tive, ­with a result­ing over­all ­anti-HCV prev­a­lence high­er ­than ­that report­ed for the ­whole coun­try (11.1% vs 3%). Genotype 1b was the ­most com­mon­ly detect­ed (86%). Anti-HCV prev­a­lence was sig­nif­i­cant­ly high­er in the 50-59 and 60-69 year age ­groups ­than in oth­er age ­groups. The ­results of mul­ti­ple regres­sion anal­y­sis ­showed ­that ­blood trans­fu­sion, use of ­glass syring­es, sur­gi­cal inter­ven­tions, pro­mis­cu­ous use of ­tooth-­brush, pro­mis­cu­ous use of ­sharp-­edged instru­ments and low­est num­ber of ­years of school­ing ­were all inde­pen­dent pre­dic­tors of ­anti-HCV pos­i­tive. No asso­ci­a­tion was ­found ­with fam­i­ly his­to­ry of liv­er dis­ease and alco­hol con­sump­tion. A total 46.6% of the sub­jects had chron­ic hep­a­titis, 24.4% had cir­rho­sis, 1.8% had hepat­o­cel­lu­lar car­ci­no­ma and cir­rho­sis and 27.2% ­were “asymp­to­mat­ic” (­with nor­mal ser­um ALT lev­els and no his­to­log­i­cal fea­tures of chron­ic hep­a­titis ­despite HCV vire­mia).
Conclusion. The ­most strik­ing ­result of the ­study was ­that the ­high lev­els of HCV ende­mic­ity was not fre­quent­ly asso­ciat­ed ­with appar­ent evi­dence of paren­ter­al expo­sure, sug­gest­ing ­that HCV ­spread in the com­mu­nity can ­even ­occur most­ly ­through inap­par­ent paren­ter­al ­routes.

language: English


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