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      Eleven-Year Distribution Pattern of Hepatitis C Virus in Southern Italy

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          Abstract

          Analysis of the Hepatitis C Virus (HCV) genotype spread in a particular area has a crucial impact on public health. In this study, we update information on the distribution of HCV genotypes, by evaluating a hospital-based cohort of 2,153 chronic hepatitis C patients, collected prospectively among subjects attending University Hospital of Catanzaro, within an area of Southern Italy. We assessed the rates (%) of HCV genotypes during two consecutive periods, from 2001 to 2005 and from 2006 to 2011, according to age and gender. Considering overall observation time, subtype 1b was predominant followed by subtypes 2a/2c, genotype 3 and 4. Statistical evaluation of the age of HCV patients stratified by genotypes, revealed a slight but significant increase in the median age of 1b, 2a/2c and 3 HCV genotype-infected subjects, during the 2006–2011 period, whilst genotype 4 patients exhibited a decrease in the median age during the same period studied. Moreover genotype 4 increased between 2002 and 2003 as well as between 2010 and 2011. Due to the peculiar diagnostic/clinical/therapeutic features of HCV-4, our findings warrant a deeper investigation to better control infections caused by such genotype.

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          The changing epidemiology of hepatitis C virus infection in Europe.

          The epidemic of hepatitis C virus (HCV) infection in Europe is continuously evolving and epidemiological parameters (prevalence, incidence, disease transmission patterns and genotype distribution) have changed substantially during the last 15 years. Four main factors contribute to such changes: increased blood transfusion safety, improvement of healthcare conditions, continuous expansion of intravenous drug use and immigration to Europe from endemic areas. As a result, intravenous drug use has become the main risk factor for HCV transmission, prevalent infections have increased and genotype distribution has changed and diversified. Hence, prevalence data from studies conducted a decade ago may not be useful to estimate the current and future burden of HCV infection and additional epidemiological studies should be conducted, as well as new preventive strategies implemented to control the silent epidemic. This review summarizes recently published data on the epidemiology of HCV infection in Europe focusing on the factors currently shaping the epidemic.
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            Transmission of hepatitis C virus by blood transfusions and other medical procedures: a global review.

            Hepatitis C virus (HCV) is a leading cause of chronic blood-borne infection and chronic liver disease. The global epidemic of HCV infection emerged in the second half of the 20th century, and several lines of evidence indicate that it was primarily triggered and fed iatrogenically by the increasing use of parenteral therapies and blood transfusion. In developed countries, the rapid improvement of healthcare conditions and the introduction of anti-HCV screening for blood donors have led to a sharp decrease in the incidence of iatrogenic hepatitis C, but the epidemic continues to spread in developing countries, where the virus is still transmitted through unscreened blood transfusions and non-sterile injections. This article reviews the published literature concerning HCV transmission through blood transfusions and other unsafe medical procedures. Given the substantial difference in current disease transmission patterns between the northern and southern hemispheres, the situation in developed and developing countries is separately analysed.
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              Different seroprevalence and molecular epidemiology patterns of hepatitis C virus infection in Italy.

              The epidemiological picture of hepatitis C virus (HCV) infection in the general population is largely unknown, even in developed countries. The aim of this study was to estimate the prevalence and genotype distribution of HCV amongst a large sample of the Italian general population. A total of 3,577 serum samples were collected and screened for anti-HCV antibodies. ELISA and RIBA tests were used to assess the presence of anti-HCV. NS5b region sequencing was performed for molecular characterization. Of 3,577 tested sera, 95 (2.7%) were anti-HCV positive and a genome was detected and sequenced in 50 sera. The age-adjusted prevalence was 4.4%. Seroprevalence increased with age, following a North-South gradient, and increased steeply between the 15 and 30 and 31-45 age groups. Subtype 1b showed the highest prevalence in all geographical areas and age groups, followed by subtypes 2c (detected mainly in the elderly population in Southern Italy), 4a/d, and 3a (detected exclusively in adults) and 1a. These findings confirm that Central and Southern Italy are hyperendemic areas. The high prevalence observed in adults over age 30 is mainly attributable to an increase in 1b-prevalence but also to subtypes 2c- and 3/4-infections. Age-specific prevalence data and molecular characterization of the virus suggest that two transmission patterns co-exist in Italy: one characterized by subtype 1b and 2c infections, mainly in adults older than 60 years, and the other by subtype 3 and 4 infections, mainly in the 31-60 year age group, and consistent with intravenous drug use and immigration. Copyright (c) 2005 Wiley-Liss, Inc.
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                Author and article information

                Journal
                J Pathog
                J Pathog
                JPATH
                Journal of Pathogens
                Hindawi Publishing Corporation
                2090-3057
                2090-3065
                2012
                9 August 2012
                : 2012
                : 631095
                Affiliations
                1Department of Health Sciences, Institute of Microbiology, University “Magna Graecia” of Catanzaro, Viale Salvatore Venuta, Germaneto, 88100 Catanzaro, Italy
                2Department of Experimental and Clinical Medicine, Institute of Infectious Diseases, University “Magna Graecia” of Catanzaro 88100, Catanzaro, Italy
                Author notes
                *Maria Carla Liberto: mliberto@ 123456unicz.it

                Academic Editor: Slobodan Paessler

                Article
                10.1155/2012/631095
                3425789
                22934187
                7dcc74dc-f89f-4618-8ced-e51b845cafba
                Copyright © 2012 Nadia Marascio et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 March 2012
                : 21 June 2012
                Categories
                Research Article

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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