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.

Epidemiological and Clinical Characteristics of Hepatitis C Viral Infections in Tertiary Centres in Sulaimani City / Kurdistan Region of Iraq

“…In contrast a study was conduct in north Italy reported 67.62% of the patients had normal ALT [27]. Our result may be due to the patients had no commitment with the prescriptive antiviral drugs.…”

Hepatitis C virus core antigen: Analytical performances, correlation with viremia and potential applications of a quantitative, automated immunoassay

“…The spontaneous clearance of HCV in 17% of untreated subjects found positive for anti-HCV and HCV RNA in an open population study has ben reported 18 and cross-sectional surveys on HCV infection indicate that only a proportion of anti-HCV positive subjects show signs of viral replication. [18][19][20] This is relevant also in high-risk populations, since it has been shown that a previous humoral response towards HCV, albeit not protective against reinfections, may lead to a shorter course of active infection with clearance of RNA within 150 days in the majority of reinfected subjects. 21 Determining the presence of an active HCV infection is clinically relevant, and in this respect the automated assay for HCV Ag evaluated in this study is more suitable than HCV-RNA methods, that are more expensive and require a dedicated sample and skilled personnel.…”

Prospective study in 142 cases of hepatitis C virus infection

“…New cases have been decreased through the detection of blood donors since 1990 s, but part of patients would progress to chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Although there are many reports on this aspect in Western countries [9][10][11][12][13] , few similar researches have been carried out in China. So it is very necessary to summarize the natural outcome of HCV in China.…”