Hepatic and extra-hepatic sequelae, and prevalence of viral hepatitis C infection estimated from routine data in at-risk groups

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http://www.biomedcentral.com/1471-2334/10/97

Research article

Hepatic and extra-hepatic sequelae, and prevalence of viral hepatitis C

infection estimated from routine data in at-risk groups

Annunziata Faustini , Paola Colais , Emanuele Fabrizi , Bargagli ,

Marina Davoli , Domenico Di Lallo , Anteo Di Napoli , Patrizio Pezzotti , Chiara

Sorge , Rita Grillo , Carla Maresca , Olga Recchia , Carlo A Perucci and HCV

laboratory surveillance Lazio-Region Group HCVLabSurv

BMC Infectious Diseases 2010, 10:97doi:10.1186/1471-2334-10-97

Published: 19 April 2010

Abstract (provisional)

Background

Concerns about the hepatitis C virus (HCV) are due to the high risk of chronic

liver disease and poor treatment efficacy. Synthesizing evidence from multiple

data sources is becoming widely used to estimate HCV-infection prevalence. This

paper aims to estimate the prevalence of HCV infection, and the hepatic and

extrahepatic sequelae in at-risk groups, using routinely collected data in the

Lazio region, Italy.

Methods

HCV laboratory surveillance and dialysis, hospital discharge, and drug-user

registers were used as information sources to identify at-risk groups and to

estimate HCV prevalence and sequelae. Full name and birth date were used as

linkage keys for the various health registries. Prevalence was estimated as the

percentage of cases within the general population and the at-risk groups, with

95% confidence intervals (95% CI) from 1997 to 2001. The risk of sequelae was

estimated through a follow-up of hospital discharges up to December 31, 2004 and

calculated as the prevalence ratio in HCV-positive and HCV-negative people,

within each at-risk group, with 95% CI.

Results

There were 65,127 HCV-infected people in the study period; the prevalence was

1.24% (95%CI = 1.23%-1.25%) in the whole population, higher in males and older

adults. Drug users (35.1%; 95%CI = 34.6-35.7) and dialysis patients (21.1%;

95%CI = 20.2%-22.0%) showed the highest values. Medical procedures with little

exposure to blood resulted in higher estimates, ranging between 1.3% and 3.4%,

which was not conclusively attributable to the surgical procedures. Cirrhosis,

hepatocellular carcinoma and encephalopathy were the most frequent hepatic

sequelae; cryoglobulinaemia and non-Hodgkin's lymphoma were the most frequent

extrahepatic sequelae.

Conclusions

Synthesising data from multiple routine sources improved estimates of HCV

prevalence and sequelae in dialysis patients and drug users, although prevalence

validity should be assessed in survey and sequelae need a well-defined

longitudinal approach.

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