Epidemiology and prevention of hepatitis type C in Italy.

Viral hepatitis type C is of public health importance in all parts of the world. In Italy, hepatitis C accounts for approximately 18% of the annually reported cases of acute viral hepatitis. The national rate of acute non-A, non-B hepatitis (the majority of which are hepatitis C) has significantly decreased during the last decades. At present, the onset of the disease occurs more frequently in individuals 15-24 years old, in men more frequently than in women and in persons living in the south of the country. During the last 5 years the rate of transfusion-associated hepatitis C has dropped (4.8 cases per 1,000,000 in 1989 versus 0.4 per 1,000,000 in 1993), while the percentage of patients who are intravenous drug abusers (IVDA) has increased from 18% to 33%. The high prevalence of anti-HCV (hepatitis C virus) antibody in blood and blood products recipients, IVDA and health-care workers with occupational exposure to blood indicates that HCV is efficiently transmitted parenterally. Data concerning transmission of HCV from mother to infant or by person-to-person contact, either by sexual or by nonsexual household contact, are controversial. However, there is almost universal agreement that the presence of concurrent infection with HCV and human immunodeficiency virus enhances the rate of vertical/perinatal HCV transmission as well as transmission through sexual and other types of person-to-person contact. The implementation of screening of anti-HCV donors and the adoption of other preventive measures, such as virucidal treatment of blood derivatives, appropriate disinfection, sterilization, disposal of waste and education and periodic training of health workers at occupational risk, have contributed to reducing the spread of HCV infection. The development of a safe and effective vaccine would further contribute to the elimination of hepatitis C.