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High seroprevalence of HCV in the Abruzzo Region, Italy: results on a large sample from opt-out pre-surgical screening

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Abstract

Purpose

Available estimates of the prevalence of chronic HCV infection in Italy are quite conflicting, varying from 1.5 to 22.5 %, with an apparent north to south gradient. As Direct Acting Antivirals are expensive, both National and local governmental Agencies are in urgent need of detailed and reliable estimates of HCV patients to be treated, nationwide and in each district. We investigated the prevalence of anti-HCV antibodies in a large unselected sample of surgical patients providing consent to in-hospital opt-out pre-surgical HCV screening, at two hospitals from the Abruzzo Region, Italy.

Methods

Data were retrieved for 55,533 screened patients (4.1 % of the total population in the Abruzzo Region), admitted in the Orthopedic and General Surgery wards of Pescara and Teramo Hospitals from 1999 to 2014.

Results

The prevalence of anti-HCV antibodies was 4.4 % in the total sample. HCV-positive patients had a mean age of 63.8 ± 19.9 years; 49.2 % were males. From 1999 to 2014, the prevalence of HCV antibodies decreased from 5.4 % to 4.1 %; at both sites, however, two age-related-peaks were evidenced, the first among patients aged 30–49 years, the second among those older than 70 years. Statistical analyses confirmed a significant trend to decrease over time and a higher prevalence in Pescara and among males (all p < 0.01).

Conclusions

Data retrieved from opt-out pre-surgical screening programs may allow inexpensive and easy-to-perform estimates of HCV seroprevalence from large samples of unselected patients with a well-defined provenience, which may turn useful for future treatment resource allocation.

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References

  1. Muhlberger N, Schwarzer R, Lettmeier B, Sroczynski G, Zeuzem S, Siebert U. HCV-related burden of disease in Europe: a systematic assessment of incidence, prevalence, morbidity, and mortality. BMC Public Health. 2009;9:34.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61:S45–57.

    Article  PubMed  Google Scholar 

  3. Deuffic-Burban S, Deltenre P, Buti M, Stroffolini T, Parkes J, Muhlberger N, et al. Predicted effects of treatment for HCV infection vary among European countries. Gastroenterology. 2012;143:974–8514.

    Article  PubMed  Google Scholar 

  4. Altekruse SF, McGlynn KA, Reichman ME. Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005. J Clin Oncol. 2009;27:1485–91.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Negro F. Epidemiology of hepatitis C in Europe. Dig Liver Dis. 2014;46S5:S158–64.

    Article  Google Scholar 

  6. Sacks-Davis R. C VANG, Bergeri I, Stoove M, Hellard M. Identifying newly acquired cases of hepatitis C using surveillance: a literature review. Epidemiol Infect. 2012;140:1925–34.

    Article  CAS  PubMed  Google Scholar 

  7. Cornberg M, Razavi HA, Alberti A, Bernasconi E, Buti M, Cooper C, et al. A systematic review of hepatitis C virus epidemiology in Europe. Canada and Israel. Liver Int. 2011;31:30–60.

    Article  PubMed  Google Scholar 

  8. Bruggmann P, Berg T, Ovrehus AL, Moreno C, Brandao Mello CE, Roudot-Thoraval F, et al. Historical epidemiology of hepatitis C virus (HCV) in selected countries. J Viral Hepat. 2014;21:5–33.

    Article  PubMed  Google Scholar 

  9. Puoti M, Girardi E. Chronic hepatitis C in Italy: the vanishing of the first and most consistent epidemic wave. Dig Liver Dis. 2013;45:369–70.

    Article  PubMed  Google Scholar 

  10. Alberti A, Chemello L, Benvegnu L. Natural history of hepatitis C. J Hepatol. 1999;31:17–24.

    Article  PubMed  Google Scholar 

  11. Grebely J, Matthews GV, Dore GJ. Treatment of acute HCV infection. Nat Rev Gastroenterol Hepatol. 2011;8:265–74.

    Article  CAS  PubMed  Google Scholar 

  12. Zaltron S, Spinetti A, Biasi L, Baiguera C, Castelli F. Chronic HCV infection: epidemiological and clinical relevance. BMC Infect Dis. 2012;12:S2.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Vermehren J, Schlosser B, Domke D, Elanjimattom S, Muller C, Hintereder G, et al. High prevalence of anti-HCV antibodies in two metropolitan emergency departments in Germany: a prospective screening analysis of 28,809 patients. PLoS ONE. 2012;7:e41206.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Puoti C, Guarisco R, Spilabotti L, Bellis L, Mitidieri Costanza O, Dell’ Unto O, et al. Should we treat HCV carriers with normal ALT levels? The ‘5Ws’ dilemma. J Viral Hepat. 2012;19:229–35.

    Article  CAS  PubMed  Google Scholar 

  15. Deacon RM, Wand H, Stelzer-Braid S, Treloar C, Maher L. Improving surveillance for acute hepatitis C. Commun Dis Intell Q Rep. 2011;35:16–20.

    PubMed  Google Scholar 

  16. Guy R, Devadason D, Lim M, Higgins N, Pedrana A, Gibson K, et al. Enhanced case detection for newly acquired hepatitis C infection: epidemiological findings and health service implications. Commun Dis Intell Q Rep. 2008;32:250–6.

    PubMed  Google Scholar 

  17. Guadagnino V, Stroffolini T, Caroleo B, Menniti Ippolito F, Rapicetta M, Ciccaglione AR, et al. Hepatitis C virus infection in an endemic area of Southern Italy 14 years later: evidence for a vanishing infection. Dig Liver Dis. 2013;45:403–7.

    Article  PubMed  Google Scholar 

  18. Maio G, d’Argenio P, Stroffolini T, Bozza A, Sacco L, Tosti ME, et al. Hepatitis C virus infection and alanine transaminase levels in the general population: a survey in a southern Italian town. J Hepatol. 2000;33:116–20.

    Article  CAS  PubMed  Google Scholar 

  19. Guadagnino V, Stroffolini T, Rapicetta M, Gulletta E. Alanine aminotransferase assay to detect anti-HCV positive subjects in non-selected populations. J Clin Pathol. 1997;50:709.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Di Stefano R, Stroffolini T, Ferraro D, Usticano A, Valenza LM, Montalbano L, et al. Endemic hepatitis C virus infection in a Sicilian town: further evidence for iatrogenic transmission. J Med Virol. 2002;67:339–44.

    Article  PubMed  Google Scholar 

  21. Pendino GM, Mariano A, Surace P, Caserta CA, Fiorillo MT, Amante A, et al. Prevalence and etiology of altered liver tests: a population-based survey in a Mediterranean town. Hepatology. 2005;41:1151–9.

    Article  PubMed  Google Scholar 

  22. Fabris P, Baldo V, Baldovin T, Bellotto E, Rassu M, Trivello R, et al. Changing epidemiology of HCV and HBV infections in Northern Italy: a survey in the general population. J Clin Gastroenterol. 2008;42:527–32.

    Article  PubMed  Google Scholar 

  23. Cozzolongo R, Osella AR, Elba S, Petruzzi J, Buongiorno G, Giannuzzi V, et al. Epidemiology of HCV infection in the general population: a survey in a southern Italian town. Am J Gastroenterol. 2009;104:2740–6.

    Article  PubMed  Google Scholar 

  24. Raffaele A, Valenti M, Iovenitti M, Matani A, Bruno ML, Altobelli E, et al. High prevalence of HCV infection among the general population in a rural area of central Italy. Eur J Epidemiol. 2001;17:41–6.

    Article  CAS  PubMed  Google Scholar 

  25. Mazzeo C, Azzaroli F, Giovanelli S, Dormi A, Festi D, Colecchia A, et al. Ten year incidence of HCV infection in northern Italy and frequency of spontaneous viral clearance. Gut. 2003;52:1030–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Campello C, Poli A, Dal MG, Besozzi-Valentini F. Seroprevalence, viremia and genotype distribution of hepatitis C virus: a community-based population study in northern Italy. Infection. 2002;30:7–12.

    Article  CAS  PubMed  Google Scholar 

  27. Ansaldi F, Bruzzone B, Salmaso S, Rota MC, Durando P, Gasparini R, et al. Different seroprevalence and molecular epidemiology patterns of hepatitis C virus infection in Italy. J Med Virol. 2005;76:327–32.

    Article  CAS  PubMed  Google Scholar 

  28. Bellentani S, Tiribelli C. The spectrum of liver disease in the general population: lesson from the Dionysos study. J Hepatol. 2001;35:531–7.

    Article  CAS  PubMed  Google Scholar 

  29. Brant LJ, Hurrelle M, Balogun MA, Klapper P, Ramsay ME. Where are people being tested for anti-HCV in England? Results from sentinel laboratory surveillance. J Viral Hepat. 2008;15:729–39.

    Article  CAS  PubMed  Google Scholar 

  30. Simonian PT, Gilbert M, Trumble TE. Incidence of hepatitis C in patients requiring orthopaedic surgery. J Bone Joint Surg Br. 1995;77:971–4.

    CAS  PubMed  Google Scholar 

  31. Thorburn D, Roy K, Cameron SO, Johnston J, Hutchinson S, McCruden EA, et al. Risk of hepatitis C virus transmission from patients to surgeons: model based on an unlinked anonymous study of hepatitis C virus prevalence in hospital patients in Glasgow. Gut. 2003;52:1333–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Montecalvo MA, Lee MS, DePalma H, Wynn PS, Lowenfels AB, Jorde U, et al. Seroprevalence of human immunodeficiency virus-1, hepatitis B virus, and hepatitis C virus in patients having major surgery. Infect Control Hosp Epidemiol. 1995;16:627–32.

    Article  CAS  PubMed  Google Scholar 

  33. Weber P, Eberle J, Bogner JR, Schrimpf F, Jansson V, Huber-Wagner S. Is there a benefit to a routine preoperative screening of infectivity for HIV, hepatitis B and C virus before elective orthopaedic operations? Infection. 2013;41:479–83.

    Article  CAS  PubMed  Google Scholar 

  34. SEIEVA. (Sistema epidemiologico integrato dell’epatite virale acuta). Istituto Superiore di Sanità. SEIEVA website: http://www.iss.it/seieva/docu/cont Accessed: October 2012.

  35. Centro Operativo AIDS (COA). Aggiornamento delle nuove diagnosi di infezione da HIV e dei casi di AIDS in Italia al 31 dicembre 2013. Notiziario Istituto Superiore di Sanità. 2014;27:1–48.

    Google Scholar 

  36. Prestmo A, Hagen G, Sletvold O, Helbostad JL, Thingstad P, Taraldsen K, et al. Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet. 2015;385:1623–33.

    Article  PubMed  Google Scholar 

  37. Torre GL, Gualano MR, Semyonov L, Nicolotti N, Ricciardi W, Boccia A. Hepatitis C Virus infections trends in Italy, 1996–2006. Hepat Mon. 2011;11:895–900.

    PubMed Central  PubMed  Google Scholar 

  38. Ciccozzi M. Lo Presti A, Ciccaglione AR, Zehender G, Ciotti M. Phylogeny and phylodinamic of Hepatitis C in Italy. BMC Infect Dis. 2012;12:S5.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Esteban JI, Sauleda S, Quer J. The changing epidemiology of hepatitis C virus infection in Europe. J Hepatol. 2008;48:148–62.

    Article  PubMed  Google Scholar 

Download references

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Author notes

    Authors and Affiliations

    1. Head, Infectious Disease Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy

      Ennio Polilli, Monica Tontodonati, Tamara Ursini & Giustino Parruti

    2. Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy

      Maria Elena Flacco, Giorgia Fragassi & Lamberto Manzoli

    3. Regional Healthcare Agency of Abruzzo, Pescara, Italy

      Maria Elena Flacco & Lamberto Manzoli

    4. Immunohematology and Transfusion, Apheresis Unit, Pescara General Hospital, Pescara, Italy

      Palmira Striani & Patrizia Accorsi

    5. Infectious Disease Unit, Teramo General Hospital, Teramo, Italy

      Dante Di Giammartino

    6. Infectious Disease Unit, Avezzano General Hospital, Avezzano, Italy

      Maurizio Paoloni

    7. Immunohematology and Transfusion Unit, Teramo General Hospital, Teramo, Italy

      Luigi Vallarola & Gabriella Lucidi Pressanti

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    1. Ennio Polilli
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    Correspondence to Giustino Parruti.

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    On behalf of all authors, the corresponding author states that there is no conflict of interest.

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    E. Polilli and M. Tontodonati equally contributed to this work.

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    Polilli, E., Tontodonati, M., Flacco, M.E. et al. High seroprevalence of HCV in the Abruzzo Region, Italy: results on a large sample from opt-out pre-surgical screening. Infection 44, 85–91 (2016). https://doi.org/10.1007/s15010-015-0841-3

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    • DOI: https://doi.org/10.1007/s15010-015-0841-3

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