Prevalence and factors associated with HCV infection among elderly individuals in a southern Brazilian city

Abstract

Introduction: Few Latin American studies have assessed the prevalence of hepatitis C virus (HCV) infection in elderly individuals, in whom the highest rates are expected. We aimed to investigate the prevalence of and factors associated with HCV infection in elderly residents in the municipality of Tubarão, Santa Catarina. Methods: This cross-sectional study included 820 individuals (aged ≥ 60 years) who were selected by simple random sampling. The presence of anti-HCV antibodies was tested by chemiluminescence, and HCV RNA detection was performed for the anti-HCV-reactive subjects. Those individuals who were anti-HCV reactive but had undetectable HCV RNA levels were tested using a third-generation recombinant immunoblot assay. The variables were compared using the chi-squared test or Fisher's exact test, and those variables with p < 0.05 were included in the logistic regression model. Results: The mean patient age was 68.6 years (SD 7.0 years); 39% were men, and 92% were Caucasian. Eighteen subjects were anti-HCV positive. Among these individuals, 4 were characterized as false-positives, leaving 14 (1.7%) individuals with confi rmed infections for analysis. HCV infection was associated with an age older than 65 years, households with 3 or more residents and the previous transfusion of blood products. In the logistic regression analysis, the following variables were independently associated with HCV infection: households with 3 or more residents (OR 7.9, 95% CI 1.7-35.9, p = 0.008) and previous blood transfusion (OR 6.2, 95% CI 2.1-18.6, p = 0.001). Conclusions: The HCV prevalence in the elderly population in the municipality of Tubarão was higher than that found in previous studies of blood donors in the same region. Although exposure to contaminated blood products remained important, other transmission routes, such as household transmission, could play a role in HCV infection.

Prevalence of serological markers for hepatitis and potential associated factors in patients with diabetes mellitus

“…The prevalence of HCV infection was 3.3% higher than the national prevalence for the general population from 20 to 69 years old, which was 1.6% 24 , 27 , as well as national studies with specific populations such as the deaf, military males, and workers collecting household waste 31 - 33 . On the other hand, a study that investigated the prevalence of HCV infection in elderly patients in southern Brazil found a prevalence of 2.2% 34 .…”

Recommendations on hepatitis C screening for adults

“…The proportion of confirmed active infections among positive screening test results varies widely across studies and test types. The proportion of RNA-positive, active HCV infection cases ranged from 0% to 89.7% among positive antibody-based assays [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][45][46][47][48][51][52][53][54] and from 0% to 100% among antigen-based assays. 39,44,49,50 Only three studies conducted confirmatory polymerase chain reaction on samples that tested negative for HCV antibody or antigen.…”

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“…U ukupnom broju obolelih od hroničnog hepatitisa C zastupljeniji je muški pol, kako kod nas, tako i u radovima drugih autora [12−14]. Međutim, kod osoba starijeg životnog doba sa hroničnim hepatitisom C zastupljeniji je ženski pol, što se može objasniti nešto dužim prosečnim životnim vekom osoba ženskog pola; ovakav rezultat je dobijen u radu brazilskih autora koji su proučavali hepatitis C kod osoba starih 60 ili više godina gde je ženski pol bio zastupljen u 61,7% slučajeva [15].…”