Clinical course and risk factors of hepatitis C virus related liver disease in the general population: report from the Dionysos study

BACKGROUNDThe severity, clinical course, and risk of hepatitis C virus (HCV) related chronic liver disease are still rather poorly defined.AIMSTo investigate the prevalence, risk factors, and severity of HCV related liver disease in the general population, and investigate whether infection with a specific genotype is associated with an increased risk of cirrhosis or hepatocellular carcinoma.METHODSHCV RNA determination by polymerase chain reaction (PCR) and HCV genotyping were performed in all anti-HCV positive subjects belonging to the Dionysos study (6917 subjects). Diagnosis of cirrhosis and hepatocellular carcinoma was established by liver biopsy in all cases. All the data were analysed by univariate and multivariate statistics in all the cohort. To investigate the natural history of HCV infection, anti-HCV positive subjects were followed up every six months for three years with liver function tests and ultrasonograms.RESULTSThe overall prevalence of HCV RNA positivity was 2.3%. Positivity increased progressively with age, and was higher in women (ratio of men to women = 0.7). Genotypes 1b and 2a were the most frequent (42 and 24% of HCV RNA positive patients), with a prevalence of 1 and 0.6% respectively. Intravenous drug use, blood transfusions received before 1990, history of previous hepatitis among the cohabiting, and history of animal (mainly dogs) bites were significantly (p<0.05) associated with HCV infection, independently of age and sex. Multivariate analysis showed that, independently of age, sex, and alcohol intake, genotype 1b infection, with or without coinfection with other genotypes, is the major risk factor associated with the presence of cirrhosis and/or hepatocellular carcinoma. During the three years of follow up, 57 (35%) of the HCV RNA positive subjects had consistently normal alanine aminotransferase and γ-glutamyltransferase values. Two of the 22 HCV RNA positive cirrhotic patients, all drinking more than 90 g of alcohol a day, developed hepatocellular carcinoma (incidence rate = 3.0% per year).CONCLUSIONSIn the general population of Northern Italy, HCV infection is widespread, but only less than 50% of the anti-HCV positive subjects, particularly those infected with genotype 1b, are associated with a more severe liver disease. Alcohol consumption greater that 30 g a day significantly aggravates the natural course of the disease.

Download Full-text

Prevalence and Risk Factors of Hepatitis C Virus (HCV) in Tehsil Batkhela District Malakand, KPK, Pakistan

International Journal of Contemporary Research and Review ◽

10.15520/ijcrr/2018/9/06/525 ◽

2018 ◽

Vol 9 (06) ◽

pp. 20251-20256

Author(s):

Mudassir Khan ◽

Shahrukh Khan ◽

Shohra Haider ◽

Fazal Jalil ◽

Muhsin Jamal ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Skin Color ◽

Significant Risk ◽

Rapid Test ◽

Prevalence Ratio ◽

Hcv Infection ◽

Hcv Rna ◽

Common Symptom

Background: Prevalence of Hepatitis C viral infection and its major risk factors has been found out in population of Batkhela, Khyber Pakhtunkhwa, Pakistan by taking number of volunteers from the interested area. HCV prevalence has not been researched in recent time here in this area, so that’s why we contributed. Materials and Methods: Ab rapid test cassette serum/plasma (USA) kit has been used for the mentioned purpose following by ELISA and finally PCR to find out active infection of virus. ICT positive individuals were reconfirmed by ELISA and then ELISA positive samples were carefully investigated by RT-PCR for Hepatitis C Virus. Results: The study population was of 770 volunteers belonging to the mentioned area of research, 453 males and 317 females. The overall prevalence was found to be 5.32% of HCV in Batkhela. This prevalence ratio was 3.12% in males and 2.20 % in females. 3rd generation ELISA was used to refine ICT positive samples which showed that 37 of the ICT positive samples had antibodies detected by ELISA. To find out active HCV infection, ELISA positive samples were refined by real time PCR which showed 2.98% of prevalence of active HCV infection in Batkhela based on HCV RNA in their blood. Principle Conclusion: Overall prevalence was found 5.32%, contaminated reused syringes and blades at Barbour’s shop, blood transfusion, surgical operations and unhygienic food in stalls etc were found significant risk factors for acquiring HCV infection. Body weakness and pale yellow skin color was common symptom in HCV positive volunteers. Safe sexual activities, blood screening before donation and sterilizing surgical equipment’s can protect us from Hepatitis C Virus.

Download Full-text

Hepatitis C Virus Prevalence and Risk Factors in a Village in Northeastern Romania—A Population-Based Screening—The First Step to Viral Micro-Elimination

Healthcare ◽

10.3390/healthcare9060651 ◽

2021 ◽

Vol 9 (6) ◽

pp. 651

Author(s):

Laura Huiban ◽

Carol Stanciu ◽

Cristina Maria Muzica ◽

Tudor Cuciureanu ◽

Stefan Chiriac ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Antiviral Treatment ◽

Population Based ◽

Hcv Infection ◽

World Health ◽

Hcv Rna ◽

Virus Eradication ◽

Tertiary Center

(1) Background: The World Health Organization adopted a strategy for the Global Health Sector on Viral Hepatitis in 2016, with the main objective of eliminating hepatitis C virus (HCV) by 2030. In this work, we aimed to evaluate the prevalence of HCV infection and risk factors in a Romanian village using population-based screening as part of the global C virus eradication program. (2) Methods: We conducted a prospective study from March 2019 to February 2020, based on a strategy as part of a project designed to educate, screen, treat and eliminate HCV infection in all adults in a village located in Northeastern Romania. (3) Results: In total, 3507 subjects were invited to be screened by rapid diagnostic orientation tests (RDOT). Overall, 2945 (84%) subjects were tested, out of whom 78 (2.64%) were found to have positive HCV antibodies and were scheduled for further evaluation in a tertiary center of gastroenterology/hepatology in order to be linked to care. In total, 66 (85%) subjects presented for evaluation and 55 (83%) had detectable HCV RNA. Of these, 54 (98%) completed antiviral treatment and 53 (99%) obtained a sustained virological response. (4) Conclusions: The elimination of hepatitis C worldwide has a higher chance of success if micro-elimination strategies based on mass screening are adopted.

Download Full-text

Testing for Hepatitis C Virus Infection Among Adults Aged ≥18 in the United States, 2013-2017

Public Health Reports ◽

10.1177/00333549211047236 ◽

2021 ◽

pp. 003335492110472

Author(s):

Hope King ◽

J. E. Soh ◽

William W. Thompson ◽

Jessica Rogers Brown ◽

Karina Rapposelli ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Hepatitis C Virus ◽

Liver Disease ◽

Hepatitis C ◽

The United States ◽

Hcv Infection ◽

High School Education ◽

Related Risk ◽

Hcv Testing

Objective Approximately 2.4 million people in the United States are living with hepatitis C virus (HCV) infection. The objective of our study was to describe demographic and socioeconomic characteristics, liver disease–related risk factors, and modifiable health behaviors associated with self-reported testing for HCV infection among adults. Methods Using data on adult respondents aged ≥18 from the 2013-2017 National Health Interview Survey, we summarized descriptive data on sociodemographic characteristics and liver disease–related risk factors and stratified data by educational attainment. We used weighted logistic regression to examine predictors of HCV testing. Results During the study period, 11.7% (95% CI, 11.5%-12.0%) of adults reported ever being tested for HCV infection. Testing was higher in 2017 than in 2013 (adjusted odds ratio [aOR] = 1.27; 95% CI, 1.18-1.36). Adults with ≥some college were significantly more likely to report being tested (aOR = 1.60; 95% CI, 1.52-1.69) than adults with ≤high school education. Among adults with ≤high school education (but not adults with ≥some college), those who did not have health insurance were less likely than those with private health insurance (aOR = 0.78; 95% CI, 0.68-0.89) to get tested, and non–US-born adults were less likely than US-born adults to get tested (aOR = 0.77; 95% CI, 0.68-0.87). Conclusions Rates of self-reported HCV testing increased from 2013 to 2017, but testing rates remained low. Demographic characteristics, health behaviors, and liver disease–related risk factors may affect HCV testing rates among adults. HCV testing must increase to achieve hepatitis C elimination targets.

Download Full-text

Chronic hepatitis C in Austria, 1992–2006: genotype distribution and demographic factors

Eurosurveillance ◽

10.2807/ese.15.08.19492-en ◽

2010 ◽

Vol 15 (8) ◽

Cited By ~ 8

Author(s):

A Maieron ◽

S Metz-Gercek ◽

F Hackl ◽

C Luger ◽

A Ziachehabi ◽

...

Keyword(s):

Risk Factors ◽

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Risk Groups ◽

Hcv Rna ◽

Age Difference ◽

Genotype Distribution ◽

Upper Austria

Chronic hepatitis C is a leading cause of end-stage liver disease and, with a worldwide prevalence of up to 3%, is a pandemic infectious disease. Austria, like most western European countries can be considered as a low prevalence country. This analysis aimed to assess the distribution of hepatitis C virus (HCV) genotypes in patients with chronic HCV infection in Upper Austria. Between September 1992 and December 2006, we identified 1,318 consecutive patients who tested positive for HCV RNA. Genotyping was routinely performed in 1,239 of the 1,318 patients, and in a subgroup of 617 patients data on the source of transmission were collected. Additionally we obtained data on liver histology and body mass index in a subsample of 273 of the 617 patients. Hepatitis C genotypes 1, 2, 3, 4, 6 and co-infections were found in 80.4%, 4.5%, 12.3%, 2.7%, 0.1% and 0.2% of the patients, respectively. There was a highly significant age difference in relation to gender at the time of diagnosis of chronic hepatitis C, with women being older than men (men: 45.0 years; women: 49.3 years; p<0.0001). The number of new cases of chronic hepatitis C decreased substantially over the last decade, but although risk factors for obtaining HCV are well established, we did not find a decrease in the age of first diagnosis. Besides consistent screening in defined risk groups it is important to raise awareness for risk factors for HCV acquisition and liver disease progression.

Download Full-text

Prevalence of hepatitis C virus infection and risk factor analysis in Changsha, central China, about population undergoing routine check-up, 2013–2015

10.21203/rs.2.9450/v1 ◽

2019 ◽

Author(s):

Shaohui Liu ◽

Chang Zeng ◽

Xintong Kang ◽

Ying Tan ◽

Wei Zhou ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Hepatitis C Virus ◽

Hepatitis C ◽

General Population ◽

Rural Areas ◽

Adult Population ◽

Hcv Infection ◽

Central China ◽

Major Public Health Problem

Abstract Background Currently, Hepatitis C virus (HCV) infection remains a major public health problem. The aim of current study wanted to determine the prevalence of HCV virus infections, and to explore the risk factors for HCV infection in the general adult population undergoing routine check-ups in Changsha City. Methods We collected 59688 blood samples from the adult population undergoing routine check-ups in 2013–2015 and obtained relevant information using a standardized questionnaire. We then conducted association and logistic regression analyses. We used the enzyme immunoassay method to test for anti-HCV antibodies in the serum samples. Results The positivity rate of anti-HCV was about 0.57% (340/59688) in the general population. Participants from rural areas showed significantly higher HCV seroprevalence rates than did those from the urban area (0.83% vs 0.19%, p < 0.001). HCV seropositivity increased progressively with age, peaking at 55–64 years (1.23%), and decreasing in participants aged 65 and older. The positivity rate of anti-HCV for males was slightly higher than that of females (0.67% vs 0.48%, p = 0.002). The results of multiple logistic regression showed that history of blood transfusion, surgery, living in rural areas, and transmission in families were the main risk factors for HCV infection. Conclusions: The prevalence of HCV infection is low in the general population in Changsha. This information vital for healthcare settings and health education entities in public, especially in rural areas.

Download Full-text

Risk Factors Contributing to the Occurrence and Recurrence of Hepatocellular Carcinoma in Hepatitis C Virus Patients Treated with Direct-Acting Antivirals

Biomedicines ◽

10.3390/biomedicines8060175 ◽

2020 ◽

Vol 8 (6) ◽

pp. 175

Author(s):

Sara Kishta ◽

Ashraf Tabll ◽

Tea Omanovic Kolaric ◽

Robert Smolic ◽

Martina Smolic

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Hepatitis C ◽

Dna Ploidy ◽

Hcv Rna ◽

Direct Acting Antivirals ◽

Hepatic Cells ◽

Chronic Hcv ◽

Direct Acting

Although hepatitis C virus (HCV) RNA may be eliminated from blood circulation by direct-acting antivirals (DAA) therapy as assessed by real-time polymerase chain reaction (PCR), HCV RNA can still be present in liver tissue, and this is known as occult HCV. There has been a lot of controversy surrounding the recurrence of hepatocellular carcinoma (HCC) after DAA treatment of hepatic cells infected with chronic HCV. One of the main risk factors that leads to de novo HCC is the chronicity of HCV in hepatic cells. There are many studies regarding the progression of HCV-infected hepatic cells to HCC. However, there is a lack of research on the different molecular mechanisms that lead to the progression of chronic HCV infection to HCC, as well as on the effect of HCV on the alteration of DNA ploidy, which eventually leads to a recurrence of HCC after DAA treatment. In this review article, we will address some risk factors that could lead to the development/recurrence of HCC after treatment of HCV with DAA therapy, such as the role of liver cirrhosis, the alteration of DNA ploidy, the reactivation of hepatitis B virus (HBV), the role of cytokines and the alteration of the immune system, concomitant non- alcoholic fatty liver disease (NAFLD), obesity, alcohol consumption and also occult HCV infection/co-infection. Clinicians should be cautious considering that full eradication of hepatocarcinogenesis cannot be successfully accomplished by anti-HCV treatment alone.

Download Full-text

Risk factors for hepatitis C virus infection. A case-control study of blood donors in the Trent Region (UK)

Epidemiology and Infection ◽

10.1017/s0950268800051293 ◽

1994 ◽

Vol 112 (3) ◽

pp. 595-601 ◽

Cited By ~ 41

Author(s):

K. R. Neal ◽

D. A. Jones ◽

D. Killey ◽

V. James

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Blood Transfusion ◽

Blood Donors ◽

Case Control Study ◽

Case Control ◽

Hcv Infection ◽

History Of ◽

Control Study

SUMMARYThe introduction of screening for hepatitis C virus (HCV) by the National Blood Transfusion Service identified donors who had acquired HCV infection. We undertook a case-control study amongst blood donors in the Trent Region to determine risks for HCV infection. A total of 74 blood donors confirmed positive for hepatitis C infection and 150 age, sex and donor venue matched controls were included in the study. Fifty-three percent of hepatitis C infected blood donors reported previous use of injected drugs compared to no controls; relative risk (RR) not estimatable (lower limit 95% CI = 20). Other risk factors were a history of: receipt of a blood transfusion or blood products RR = 3·6 (95% CI 1·5–8·3), having been a ‘health care worker’ RR = 2·8 (95% CI 1·1–7·6), tattooing RR = 3·3 (95% CI 1·2–8·7), and an association with having been born abroad RR = 3·2 (95% CI 1·1–9·5). No risk was shown for a history of multiple sexual partners, ear piercing or acupuncture. Injecting drug use explains more than 50% of hepatitis C infections in blood donors, a group who are less likely to have injected drugs than the general population.

Download Full-text

Hepatitis C infection among survivors of childhood cancer

Blood ◽

10.1182/blood.v95.10.3065 ◽

2000 ◽

Vol 95 (10) ◽

pp. 3065-3070 ◽

Cited By ~ 69

Author(s):

Donald K. Strickland ◽

Caroline A. Riely ◽

Christian C. Patrick ◽

Dana Jones-Wallace ◽

James M. Boyett ◽

...

Keyword(s):

Liver Disease ◽

Hepatitis C ◽

Liver Function ◽

Childhood Cancer ◽

Normal Liver ◽

Hcv Infection ◽

Hcv Rna ◽

Hepatitis C Infection ◽

Primary Malignancy ◽

Survivors Of Childhood Cancer

Abstract Preliminary reports have suggested that survivors of childhood cancer and aplastic anemia who are infected with the hepatitis C virus (HCV) have a low risk for progression to significant liver disease. Among our surviving patients who were transfused between 1961 and March 1992, 77 (6.6% of surviving patients tested thus far) have evidence of HCV infection, whereas 4 surviving patients who were transfused after March 1992 are HCV-infected. One patient chronically infected with HCV died of liver failure, and 2 patients died of hepatocellular carcinoma. To characterize the risk for these and other complications, 65 patients are enrolled in a longitudinal study of HCV infection, of whom 58 (89.2%) had circulating HCV RNA at the time of protocol enrollment, with genotypes 1A and 1B most commonly isolated. Most enrolled patients have few or no symptoms, carry out normal activities, and have normal liver function. To date, 35 patients have undergone liver biopsy for abnormal liver function since the diagnosis of primary malignancy; central pathology review shows 28 (80%) have chronic active hepatitis, 25 (71%) have fibrosis, and 3 (9%) have cirrhosis. These preliminary data suggest that though most survivors of childhood cancer who are infected with HCV are clinically well, some are at risk for clinically significant liver disease. Identification of other HCV-infected patients and prospective monitoring of this cohort are ongoing to determine the risk for, and to identify factors associated with the progression of, liver disease.

Download Full-text