Viral hepatitis C – a challenge for the public health

Abstract

Abstract Background Viral hepatitis C (VH C) is a global health problem with overall prevalence in 3-5% of the human population. This study provides the relevance of viral genome characterization in clinical settings. Methods Retrospective study was conducted upon epidemiological, demographic, clinical, laboratory and viral characteristics in fifty cases of VH C confirmed with positive anti-HCV, evaluated by ELISA. Thirty eight of cases were hospitalized in different clinics of the University Hospital “Dr Georgi Stranski” - Pleven (2017-2018) and remainders were blood-donors registered in Regional Center of Transfusion Hematology - Pleven. The viral load and genotype of HCV had been investigated by Real-Time PCR in Laboratory of Virology at Military Medical Academy - Sofia. Results The prevalence of cases was equal and highest in age groups 30-39 years and 60-69 years (24%, respectively). Males were 69.81% (p < 0.05). Surgical interventions (26.32%), blood infusions (23.68%) and hemodialysis (15.79%) were at highest risk for VHC (p > 0.05). Thirty hospital patients were with chronic VH C (78.95%) (p < 0.05). Clinical symptoms suggestive viral hepatitis were adynamia (39.47%; OR 5.25), anorexia (28.95%; OR 2.16), heaviness in the abdomen (21.05%; OR 23.33), and 52.63% of patients were asymptomatic (p < 0.0005). Laboratory investigations revealed slightly or moderately elevated total bilirubin (mean 53.27±37.38 µmol/L; 95% CI 18.48-88.06) and transaminases - ASAT (mean 231.36±155.82 IU/L; 95% CI 79.91-382.80) and ALAT (mean 294.48±196.26 IU/L; 95% CI 96.37-492.59) (p > 0.05). Investigation of viral load of HCV revealed 22 samples with detectable viral load (range 683-673 720 copies/ml). All isolates of HCV had been proved to be genotype 1b. Conclusions VH C is mostly asymptomatic. Screening for anti-HCV in risk groups and genotyping of HCV will improve surveillance, reduce nosocomial HCV-infections, facilitate therapeutic management and prevent complications of infected individuals. Key messages • Screening for anti-HCV in risk groups and genotyping of HCV improves surveillance and reduces nosocomial HCV-infections. • Screening for anti-HCV facilitates therapeutic management and prevents complications of infected individuals.