TY - JOUR
T1 - Risk factors for and incidence of acute hepatitis C after the achievement of blood supply safety in Italy
T2 - Results from the national surveillance system
AU - Spada, Enea
AU - Mele, Alfonso
AU - Mariano, Andrea
AU - Zuccaro, Ornella
AU - Tosti, Maria Elena
PY - 2013/3
Y1 - 2013/3
N2 - Surveillance systems for acute hepatitis C allow monitoring of disease incidence trends and transmission patterns. This study aimed to describe the epidemiological profile of reported cases of symptomatic acute hepatitis C in Italy after the achievement of blood supply safety. The incidence of symptomatic acute hepatitis C since 1991 was estimated. Risk factors for acute hepatitis C were analyzed for the period 2003-2010 through a case-control study within a population-based surveillance for acute viral hepatitis. From 1991 to 2010, the incidence decreased from 2 to 0.2 per 100,000, with a more evident decrease among persons aged 15-24 years. During 2003-2010, 1,053 cases were reported. Intravenous drug use (adjusted odds ratio [adjOR], 30.5; 95% confidence interval [CI], 18.9-49.1), cohabitation or sexual partnership with an hepatitis C virus (HCV) carrier (adjOR, 11.2; 95% CI, 6.6-19.2), nosocomial exposure (adjOR, 6.6; 95% CI, 4.6-9.4); unsafe sexual practices (adjOR, 3.1; 95% CI, 1.9-5.2), and cosmetic treatments with percutaneous exposure (adjOR, 1.7; 95% CI, 1.2-2.4) were independently associated with acute hepatitis C. Population attributable risk estimates indicated nosocomial exposure (39.6%) and intravenous drug use (30.5%) as responsible for most cases. In conclusion, the incidence of symptomatic acute hepatitis C is declining in Italy. Currently, the most important risk factors are: having an HCV-positive household or sexual partner, unsafe sexual practices, cosmetic percutaneous treatments, intravenous drug use, and nosocomial exposure; the latter two factors are responsible for most cases. Effective prevention programs for intravenous drug users and strict adherence to universal precautions in healthcare settings are needed.
AB - Surveillance systems for acute hepatitis C allow monitoring of disease incidence trends and transmission patterns. This study aimed to describe the epidemiological profile of reported cases of symptomatic acute hepatitis C in Italy after the achievement of blood supply safety. The incidence of symptomatic acute hepatitis C since 1991 was estimated. Risk factors for acute hepatitis C were analyzed for the period 2003-2010 through a case-control study within a population-based surveillance for acute viral hepatitis. From 1991 to 2010, the incidence decreased from 2 to 0.2 per 100,000, with a more evident decrease among persons aged 15-24 years. During 2003-2010, 1,053 cases were reported. Intravenous drug use (adjusted odds ratio [adjOR], 30.5; 95% confidence interval [CI], 18.9-49.1), cohabitation or sexual partnership with an hepatitis C virus (HCV) carrier (adjOR, 11.2; 95% CI, 6.6-19.2), nosocomial exposure (adjOR, 6.6; 95% CI, 4.6-9.4); unsafe sexual practices (adjOR, 3.1; 95% CI, 1.9-5.2), and cosmetic treatments with percutaneous exposure (adjOR, 1.7; 95% CI, 1.2-2.4) were independently associated with acute hepatitis C. Population attributable risk estimates indicated nosocomial exposure (39.6%) and intravenous drug use (30.5%) as responsible for most cases. In conclusion, the incidence of symptomatic acute hepatitis C is declining in Italy. Currently, the most important risk factors are: having an HCV-positive household or sexual partner, unsafe sexual practices, cosmetic percutaneous treatments, intravenous drug use, and nosocomial exposure; the latter two factors are responsible for most cases. Effective prevention programs for intravenous drug users and strict adherence to universal precautions in healthcare settings are needed.
KW - Acute hepatitis
KW - Epidemiology
KW - HCV
KW - Italy
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U2 - 10.1002/jmv.23485
DO - 10.1002/jmv.23485
M3 - Article
C2 - 23280786
AN - SCOPUS:84873140216
VL - 85
SP - 433
EP - 440
JO - Journal of Medical Virology
JF - Journal of Medical Virology
SN - 0146-6615
IS - 3
ER -