Abstract
Few Latin American studies have assessed the prevalence of hepatitis C virus (HCV) infection in elderly individuals, in whom the highest rates are expected. We aimed to investigate the prevalence of and factors associated with HCV infection in elderly residents in the municipality of Tubarão, Santa Catarina. This cross-sectional study included 820 individuals (aged ≥ 60 years) who were selected by simple random sampling. The presence of anti-HCV antibodies was tested by chemiluminescence, and HCV RNA detection was performed for the anti-HCV-reactive subjects. Those individuals who were anti-HCV reactive but had undetectable HCV RNA levels were tested using a third-generation recombinant immunoblot assay. The variables were compared using the chi-squared test or Fisher's exact test, and those variables with p < 0.05 were included in the logistic regression model. The mean patient age was 68.6 years (SD 7.0 years); 39% were men, and 92% were Caucasian. Eighteen subjects were anti-HCV positive. Among these individuals, 4 were characterized as false-positives, leaving 14 (1.7%) individuals with confirmed infections for analysis. HCV infection was associated with an age older than 65 years, households with 3 or more residents and the previous transfusion of blood products. In the logistic regression analysis, the following variables were independently associated with HCV infection: households with 3 or more residents (OR 7.9, 95% CI 1.7-35.9, p = 0.008) and previous blood transfusion (OR 6.2, 95% CI 2.1-18.6, p = 0.001). The HCV prevalence in the elderly population in the municipality of Tubarão was higher than that found in previous studies of blood donors in the same region. Although exposure to contaminated blood products remained important, other transmission routes, such as household transmission, could play a role in HCV infection.
Highlights
Few Latin American studies have assessed the prevalence of hepatitis C virus (HCV) infection in elderly individuals, in whom the highest rates are expected
This epidemiological profile is most likely related to increased exposure to specific risk factors, such as the transfusion of blood products before HCV screening was introduced in blood banks and having undergone medical or therapeutic procedures performed under poor conditions and without the current standard precautionary measures
The seroprevalence of hepatitis C in this study was 2.2%, and the prevalence of confirmed current HCV infection was 1.7%
Summary
Few Latin American studies have assessed the prevalence of hepatitis C virus (HCV) infection in elderly individuals, in whom the highest rates are expected. Studies in various parts of the world have found a higher prevalence of hepatitis C in elderly populations[9,10,11,12,13] This epidemiological profile is most likely related to increased exposure to specific risk factors, such as the transfusion of blood products before HCV screening was introduced in blood banks and having undergone medical or therapeutic procedures performed under poor conditions and without the current standard precautionary measures. Older age is associated with disease progression and is related to more advanced stages of fibrosis, higher rates of fibrosis progression and an increased incidence of hepatocellular carcinoma[14] Because of these relationships, it is likely that the prevalence of and factors associated with HCV infection among elderly individuals will provide important tools for developing health policy strategies
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