The Epidemiological and Clinical Aspects of Hepatitis C in Italy

Overt parenteral transmission of HCV infection justifies only a portion of new cases. After the introduction of anti-HCV screening performed on blood donors the incidence of post-transfusional C hepatitis in Italy has decreased. Indeed, it is probable that other routes of diffusion (intrafamilial spreading) are relevant. In our experience the anti-HCV+ prevalence (determined on 1670 family members of 578 anti-HCV+ subjects) is 15.6% in spouses and 2.1% in offspring (p < 0.01). It is even higher in subjects older than 50 years compared to younger ones. These results indicate a prevalent horizontal trasmission which happened in the past when poor sanitary conditions facilitated the intrafamilial diffusion. This determined a cohort effect interrupted by the enhanced knowledge of transmission mechanisms of HCV infection.