Prevalence and characteristics of hepatitis C virus infection detected by extended screening of working-age adults in Madrid (Spain).

Abstract

Hepatitis C virus (HCV) infection is a leading cause of liver-related morbidities and mortality. Antiviral treatment is highly successful but only a fraction of infected subjects are aware of their HCV status; therefore, prevalence studies are essential to identify HCV-infected individuals. Our aim was to analyze the prevalence and characteristics of HCV infection among working-age adults in Madrid (Spain). Extended screening for HCV infection was performed by measuring HCV antibodies in blood collected preoperatively from individuals requiring surgical treatment of work-related injuries or at baseline from subjects suffering occupational exposures to biological fluids. HCV RNA was measured in HCV antibody-positive subjects unaware of their HCV status. Serum aminotransferases were measured in all participants. During a six-year period (2013-2018), 16,734 consecutive patients were studied. Two hundred and twenty-eight (1.4%) were HCV antibody-positive [191 (83.8%) males; 37 (16.2%) females; median (SD) age: 49.2 (7.5) years], 94 (41.2%) were unaware of their HCV status, and 41 (17.9%) had detectable HCV RNA [mean (SD) log10 UI/mL: 5.6 (1.1)]. Most HCV antibody-positive subjects were born during the 1945-1965 period (birth cohort group), and the prevalence of active HCV infection was higher in this group (56.1% vs 43.9%; p = 0.194). Overall, 62 (27.8%) participants had elevated serum aminotransferases, including 22 (57.9%) with active HCV infection (p < 0.001). Screening for HCV infection in working-age adults detected a significant proportion of HCV-infected individuals with viremia and normal transaminase levels, who were unaware of their infection status. Extended screening for HCV infection is warranted.