RESUMO
INTRODUCTION AND AIM: Observations of hepatitis C virus (HCV) infection in adults with hemochromatosis are limited. MATERIALS AND METHODS: We determined associations of serum ferritin (SF) with anti-HCV in non-Hispanic white North American adults in a post-screening examination. Cases included p.C282Y homozygotes (regardless of screening transferrin saturation (TS) and SF) and participants (regardless of HFE genotype) with high screening TS/SF. Controls included participants without p.C282Y or p.H63D who had normal screening TS/SF. Participants with elevated alanine aminotransferase underwent anti-HCV testing. We determined prevalence of chronic HCV infection in consecutive Alabama and Ontario referred adults with HFE p.C282Y homozygosity. RESULTS: In post-screening participants, anti-HCV prevalence was 0.3% [95% CI: 0.02, 2.2] in 294 p.C282Y homozygotes, 9.5% [7.2, 12.3] in 560 Cases without p.C282Y homozygosity, and 0.7% [0.2, 2.3] in 403 Controls. Anti-HCV was detected in 7.2% of 745 participants with and 0.8% of 512 participants without elevated SF (odds ratio 9.9 [3.6, 27.6]; p<0.0001). Chronic HCV infection prevalence in 961 referred patients was 1.0% (10/961) [95% confidence interval (CI): 0.5, 2.0]. Ten patients with chronic HCV infection had median age 45y (range 29-67) and median SF 1163µg/L (range 303-2001). Five of eight (62.5%) patients had biopsy-proven cirrhosis. CONCLUSIONS: Odds ratio of anti-HCV was increased in post-screening participants with elevated SF. Prevalence of anti-HCV in post-screening participants with HFE p.C282Y homozygosity and chronic HCV infection in referred adults with HFE p.C282Y homozygosity in North America is similar to that of Control participants with HFE wt/wt and normal screening TS/SF.
Assuntos
Proteína da Hemocromatose/genética , Hemocromatose/genética , Anticorpos Anti-Hepatite C/sangue , Hepatite C Crônica/epidemiologia , Mutação , Adulto , Idoso , Alabama/epidemiologia , Alanina Transaminase/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Ferritinas/sangue , Predisposição Genética para Doença , Hemocromatose/sangue , Hemocromatose/diagnóstico , Hemocromatose/epidemiologia , Hepatite C Crônica/sangue , Hepatite C Crônica/diagnóstico , Homozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Fenótipo , Prevalência , Medição de Risco , Fatores de RiscoRESUMO
Os objetivos deste estudo foram estimar a soroprevalência da infecção pelo vírus da hepatite C em um centro de diálise da grande Recife; e associar a soropositividade para o vírus da hepatite C em relação a alguns fatores de risco. Foram analisados 250 pacientes com idade variando de 17 a 92 anos e de ambos os sexos. Dados epidemiológicos desses pacientes foram obtidos para a determinação dos fatores de riscos para esta infecção. A pesquisa de anticorpos anti-HCV foi realizada pelo ELISA de 4ª geração. Foi observado que em relação aos fatores de riscos, como o tempo de hemodiálise, número e período das transfusões de hemocomponentes, foi encontrada uma associação estatisticamente significante (p< 0,05). A prevalência encontrada foi baixa (8,4 por cento) em relação a outros estudos do Brasil. Entretanto, seriam necessários mais estudos em outros centros a fim de estimar a real prevalência para infecção pelo vírus da hepatite C em pacientes submetidos a hemodiálise em Pernambuco.
The objectives of this study were to estimate the serum prevalence of hepatitis C virus (HCV) infection in a dialysis center in the greater Recife region, and to correlate HCV serum positivity with some risk factors. Analyses were performed on 250 patients of both sexes, with ages ranging from 17 to 92 years old. Epidemiological data on these patients were obtained in order to determine the risk factors for this infection. Anti-HCV antibodies were investigated using fourth-generation ELISA. Statistically significant associations (p < 0.05) were observed in relation to the risk factors of hemodialysis duration, number of blood component transfusions and time taken for transfusions. The prevalence was low (8.4 percent) in relation to other Brazilian studies. However, more studies in other centers are needed in order to estimate the real prevalence of HCV infection among patients undergoing hemodialysis in the State of Pernambuco.