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Risk factors and outcome among a large patient cohort with community-acquired acute hepatitis C in Italy

Santantonio, Teresa and Medda, Emanuela and Ferrari, Carlo and Fabris, Paolo and Cariti, Giuseppe and Massari, Marco and Babudieri, Sergio and Toti, Mario and Francavilla, Ruggero and Ancarani, Fausto and Antonucci, Giorgio and Scotto, Gaetano and Di Marco, Vito and Pastore, Giuseppe and Stroffolini, Tommaso (2006) Risk factors and outcome among a large patient cohort with community-acquired acute hepatitis C in Italy. Clinical Infectious Diseases, Vol. 43 (9), p. 1154-1159. eISSN 1537-6591. Article.

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DOI: 10.1086/507640

Abstract

BACKGROUND: The epidemiology of acute hepatitis C has changed during the past decade in Western countries. Acute HCV infection has a high rate of chronicity, but it is unclear when patients with acute infection should be treated. METHODS: To evaluate current sources of hepatitis C virus (HCV) transmission in Italy and to assess the rate of and factors associated with chronic infection, we enrolled 214 consecutive patients with newly acquired hepatitis C during 1999-2004. The patients were from 12 health care centers throughout the country, and they were followed up for a mean (+/- SD) period of 14+/-15.8 months. Biochemical liver tests were performed, and HCV RNA levels were monitored. RESULTS: A total of 146 patients (68%) had symptomatic disease. The most common risk factors for acquiring hepatitis C that were reported were intravenous drug use and medical procedures. The proportion of subjects with spontaneous resolution of infection was 36%. The average timespan from disease onset to HCV RNA clearance was 71 days (range, 27-173 days). In fact, 58 (80%) of 73 patients with self-limiting hepatitis experienced HCV RNA clearance within 3 months of disease onset. Multiple logistic regression analyses showed that none of the variables considered (including asymptomatic disease) were associated with increased risk of developing chronic hepatitis C. CONCLUSIONS: These findings underscore the importance of medical procedures as risk factors in the current spread of HCV infection in Italy. Because nearly all patients with acute, self-limiting hepatitis C - both symptomatic and asymptomatic - have spontaneous viral clearance within 3 months of disease onset, it seems reasonable to start treatment after this time period ends to avoid costly and useless treatment.

Item Type:Article
ID Code:492
Status:Published
Refereed:Yes
Uncontrolled Keywords:Hepatitis C virus (HCV), epidemiology, intravenous drug use, Italy
Subjects:Area 06 - Scienze mediche > MED/17 Malattie infettive
Divisions:001 Università di Sassari > 03 Istituti > Malattie infettive e parassitarie
Publisher:University of Chicago Press
eISSN:1537-6591
Copyright Holders:© 2006 by the Infectious Diseases Society of America
Publisher Policy:Depositato in conformità con la politica di copyright dell'Editore
Deposited On:18 Aug 2009 10:02

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