Community and personal risk factors for hepatitis C virus infection: a survey of 23,820 residents in Taiwan in 1991-2.
OBJECTIVE
The aim of this study was to explore the community-level risk factors, such as high hepatitis C viruse (HCV)-RNA positive rate and limited medical resources in a township, for HCV infection, one major cause of liver cirrhosis and hepatocellular carcinoma.


METHODS
This study enrolled 23,820 residents living in 155 villages of seven townships in Taiwan in 1991-2 to explore both individual and community risk factors for HCV infection. Antibodies against HCV (anti-HCV), HCV-RNA and HCV genotype in serum samples were determined by enzyme immunoassay, PCR and melting curve analysis, respectively.


RESULTS
The overall anti-HCV seroprevalence was 5.5%, HCV-RNA was detectable in 68.1% of the seropositives of anti-HCV, and genotype 1 was the most prevalent genotype (54.6%). Personal risk factors for the seropositivity of anti-HCV included older age, female gender, low educational level and history of blood transfusion. Based on the multilevel analysis, persons living in villages with high HCV-RNA-positive rates and limited healthcare resources had an increased seroprevalence of anti-HCV after adjustment for individual risk factors. The multivariate-adjusted prevalence OR (95% CI) was 3.49 (1.80 to 6.76) and 8.48 (5.07 to 14.20) for villages with medium and high HCV-RNA positive rate, respectively. The multivariate-adjusted OR (95% CI) was was 1.75 (0.76 to 4.01) and 3.91 (2.25 to 6.80), respectively, for villages with medium and poor healthcare resources.


CONCLUSIONS
This study suggests that community risk factors contribute significantly to the variation in anti-HCV seroprevalence. It implies both the adequacy of healthcare resources and the treatment of patients positive for HCV-RNA may prevent individual residents from the acquisition of HCV infection from the community.
Genomics Research Center, Academia Sinica, Nankang, Taipei 11529, Taiwan.
Mei-Hsuan
MH
Lee
Hwai-I
HI
Yang
Chin-Lan
CL
Jen
Sheng-Nan
SN
Lu
Shiou-Hwei
SH
Yeh
Chun-Jen
CJ
Liu
San-Lin
SL
You
Chien-An
CA
Sun
Li-Yu
LY
Wang
Wei J
WJ
Chen
Chien-Jen
CJ
Chen
D000328:Adult; D017677:Age Distribution; D000368:Aged; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D014766:Viremia / Q000453:epidemiology / Q000209:etiology
D018937:Hepatitis C Antibodies; D012367:RNA, Viral