Summary
During a survey of acute symptomatic viral hepatitis conducted in Padua over the last 16 years, 404 (20%) cases of non-A, non-B hepatitis were observed, including 55% with overt parenteral exposure (35% drug abusers) and 45% with unknown exposure. Between 1978 and 1982 the attack rate of the disease increased significantly (p < 0.01) in males, (from 3.8 to 17.3/105 inhabitants), in adolescents and in youths. The prevalence of drug abusers rose up to 58% in 1982 suggesting the occurrence of an outbreak in this risk group. In subsequent years the attack rate returned to initial levels in males, although drug abuse still remains the single most important route of infection, and declined in females, especially after the disappearance of post-transfusion hepatitis since 1991. Retrospective anti-HCV testing of patients seen up to 1990 and prospective investigation of patients hospitalized later have shown an antibody prevalence of 88% among parenterally transmitted cases, and of 29% in the other patients, without significant differences between the prospective and the retrospective study. These findings suggest that an outbreak of hepatitis C occurred in our area in the early eighties and that drug abuse is still the most important mode of transmission of acute hepatitis C.
Zusammenfassung
In Padua wurde während der vergangenen 16 Jahre eine Überwachungsstudie zur akuten, symptomatischen Virushepatitis durchgeführt. Dabei fanden sich 404 (20%) Fälle von Non-A-, Non-B-Hepatitis, einschließlich 55% mit offensichtlicher parenteraler Exposition (35% Drogenabhängige) und 45% mit unbekannter Exposition. Von 1978 bis 1982 war eine signifikante Zunahme der Fälle (p < 0,01) bei männlichen Adoleszenten und Jugendlichen (von 3,8 auf 17,3/105 Einwohner) zu beobachten. 1982 stieg der Anteil der Drogenabhängigen auf bis zu 58% an. Dies läßt auf einen Ausbruch in dieser Risikogruppe schließen. In den folgenden Jahren kehrte die Infektionsrate bei Männern auf die ursprüngliche Höhe zurück. Drogenabusus ist jedoch nach wie vor die wichtigste Infektionsdeterminante. Die Infektionsrate hat bei Frauen, vor allem nach Verschwinden der Posttransfusionshepatitis, seit 1991 abgenommen. Eine nachträgliche Testung der bis 1990 beobachteten Fälle auf anti-HCV und die prospektive Untersuchung der danach stationär aufgenommenen Patienten ließ bei parenteral infizierten Fällen eine Antikörperprävalenz von 88% erkennen. Von den anderen Patienten waren 29% anti-HCV positiv. Zwischen den retrospektiv und prospektiv untersuchten Fallgruppen ergaben sich keine signifikanten Unterschiede. Die Befunde lassen auf eine Hepatitis C-Epidemie in den frühen 80er Jahren in unserer Gegend schließen. Es ist anzunehmen, daß Drogenmißbrauch noch immer der wichtigste Übertragungsmodus für die akute Hepatitis C ist.
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Bortolotti, F., Bertolini, A., Barbierato, E. et al. Acute non-A, non-B hepatitis in Italy: A 16-year prospective epidemiological study. The possible role of hepatitis C virus. Infection 22, 321–325 (1994). https://doi.org/10.1007/BF01715537
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DOI: https://doi.org/10.1007/BF01715537