Ten year incidence of HCV infection in northern Italy and frequency of spontaneous viral clearance

Abstract

Background: Little is known of the incidence of hepatitis C virus (HCV) infection, and the frequency of spontaneous viral clearance in the general population is unknown. We conducted an epidemiological study in two Apennine towns in northern Italy. Methods: Anti-HCV (ELISA and RIBA third generation) and HCV-RNA by polymerase chain reaction were tested in thawed sera from an adult general population of Loiano-Monghidoro in 1986 and 1996, obtained in the context of the MICOL (Multicenter Italian Study on Cholelithiasis). In 1999, anti-HCV positive subjects and sex and age matched controls were recalled in order to identify risk factors for acquiring HCV infection and to assess the family composition of anti-HCV + subjects. Results: For 1646 subjects, sera were available from both 1986 and 1996 (mean age in 1986 43 (0.39) years). In 1986, 57 (3.46%) subjects were HCV antibody positive (HCV-Ab + ). Eight new cases were recorded in 1996: adult incidence was 50.3 cases/100 000 inhabitants/year. Fifty three of 63 (84.1%) HCV-Ab + sera were also HCV-RNA + . Genotype 2a/2c accounted for 44% and 1b for 47.0% of cases. HCV-Ab + subjects had higher serum levels of alanine aminotransferase with respect to controls (p<0.005), as did subjects infected with genotype 1 with respect to those with genotype 2 (p<0.05). Eleven of 65 (16.9%) HCV-Ab + subjects spontaneously cleared HCV-Ab; 7/11 also lost HCV-RNA − in both serum and leucocytes. Sixteen anti-HCV + subjects belonged to families containing more than one infected member. Married couples accounted for 10 of these 16 subjects. In four of these five married couples, HCV genotype was identical in the two spouses. Conclusions: In rural northern Italy, the adult incidence of HCV is approximately 50 cases/100 000 inhabitants/year. Our findings suggest that as many as 17% of infected subjects may spontaneously clear HCV-Ab. Interfamilial transmission seems to have a role in the spread of infection.

Visceral leishmaniasis presented with Evans syndrome: A case report

“…The median age was 55.7 years (range 23-78 years). Three hundred and sixty-one patients In the present study, the overall prevalence of HCV infection found in lymphoproliferative disorders was not dissimilar from that observed in the general population from the same geographical area by Mazzeo et al (5.8% vs. 5.4%) [8]. However, among all types of lymphoproliferative disorders reported, MZL and DLBCL accounted for the vast majority of the cases (42/55, 76.4%).…”

Incidence and risk factors for community-acquired hepatitis C infection from birth to 5 years of age in rural Egyptian children

“…Rarely individuals have viraemia with intermittently undetectable levels of HCV antibodies. 23,24 Others reported 0.2–0.9% of anti-HCV-negative organ donors were HCV-RNA-positive in France and the USA, 25,26 and 7 of the 232 mothers in the parent cohort who were HCV-RNA-positive did not have detectable anti-HCV. 10 …”

Hepatitis C virus (HCV) genotypes in 373 Italian children with HCV infection: changing distribution and correlation with clinical features and outcome

“…[29][30][31][32][33] Genotype 1b is prevalent, particularly among transfused patients; genotype 2 is frequent in community acquired cases, especially in Southern Italy, while the proportion of genotypes 1a, 3, and 4 depends on the prevalence of drug abuse in a given area. These patterns and their fluctuations are the result of important socio-sanitary events recorded in the past decades, such as: the disappearance of post transfusion hepatitis C; improvement in sanitation policies which reduced the risk of community acquired hepatitis 32 ; spread of IVDA which caused an epidemic of viral hepatitis among young adults, especially in the Northern urban areas between the mid 1970s and the mid 1980s 34 ; and unsafe sexual behaviours and frequent travel to highly endemic areas of the far East, 35 which promoted the circulation of genotypes different from 1b and 2.…”