Epidemiology of HCV infection in the general population: a survey in a southern Italian town

OBJECTIVES

The objective of this study was to estimate the seroprevalence of hepatitis C virus (HCV) in the general population older than 18 years of age in a southern Italian town.

METHODS

The survey was conducted from July 2005 through January 2007 in Putignano, Bari, Apulia. A random 1:5 sampling from the list of records maintained by general practitioners was used. Serology for HCV, hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and genotyping for HCV were performed.

RESULTS

Of a total of 2,195 serum samples tested, 58 (2.6%) were positive for anti-HCV antibodies. The prevalence increased from 1% in subjects aged <30 years to 7.7% in those aged 70 years and was similar in both males and females (3.1 vs. 2.4%, P=0.4). Approximately one-third of 58 positive subjects also showed alanine transaminase levels and 53.5% tested positive for HCV RNA by TaqMan PCR. Genotypes 2a and 1b were represented in 21 and 10 subjects, respectively. In a multivariate logistic regression analysis, age (adjusted odds ratio (OR) 1.05; 95% confidence interval (CI): 1.03-1.07), blood transfusion (adjusted OR 3.3; 95% CI: 1.7-6.3), and household contact with HCV-infected individuals (adjusted OR 4.8; 95% CI: 1.8-13.1) were the independent variables predictive of HCV infection. The overall HBsAg and anti-HBc prevalence rates were 0.5 and 12%, respectively.

CONCLUSIONS

This survey confirms that HCV infection is clearly also declining in southern Italy, especially among the elderly. HCV genotype 2a predominates, reflecting the current epidemiology of HCV in Italy. Age, blood transfusion, and household contact with HCV-infected individuals may have had a role in the spread of HCV infection.

Electroencephalographic and electrocardiographic features of vasovagal syncope induced by head-up tilt

Two hundred and seventy-nine consecutive patients referred for transient loss of consciousness, compatible with syncope, underwent head-up tilt to 70 degrees during polygraphic (EEG, ECG, pneumographic) and blood pressure monitorings. Vasovagal syncopes occurred in 28 patients with the following EEG changes: progressive slowing until the appearance of middle or high amplitude delta waves generalized and synchronous in 9 patients; delta waves suddenly followed by transient flattening of EEG activity in 16 patients. In 2 patients EEG could not be interpreted because of muscle and/or movement artifacts. Fifteen out of 28 patients exhibited a marked cardioinhibition, expressed by long-lasting cardiac pauses; a relationship between duration of EEG flat and duration of asystole was not found.

[Transluminal angioplasty of the subclavian artery. Apropos of a case]

The authors described a case of left subclavian artery stenosis, treated by percutaneous transluminal angioplasty (PTA), in a patient with subclavian steal and arm claudication. The excellent technical and immediate clinical success justify this case report in consideration to the severe subocclusive lesion. The Authors present the clinical and technical aspects of subclavian artery PTA.