title: Acute hepatitis C in Brazil: results of a national survey.
abstract: The incidence of acute hepatitis C has decreased in the world. However, new cases are still reported. The objective of this study was to obtain data of acute hepatitis C in Brazil and to identify risk factors of transmission, diagnostic criteria, clinical presentation, evolution, and treatment. A questionnaire was sent to all members of the Brazilian Society of Hepatology. Sixteen centers participated with a total of 170 cases between 2000 and 2008. Among them, 37 had chronic renal failure on hemodialysis and were evaluated separately. The main diagnostic criterion in non-uremic patients was ALT (alanine aminotransferase) elevation associated with risk factors. In patients with chronic renal failure, anti-hepatitis C virus (HCV) seroconversion was the most frequent criterion. Among the 133 non-uremic patients the main risk factors were hospital procedures, whereas in hemodialysis patients, dialysis was the single risk factor in 95% of the cases. Jaundice was more frequent in non-uremic patients (82% vs. 13%; P < 0.001) and ALT levels were higher in these individuals (P < 0.001). Spontaneous clearance was more frequent in non-uremic patients (51% vs. 3%; P < 0.001). Sixty-five patients were treated: 39 non-uremic patients and 26 on dialysis. Sustained virological response rates were 60% for non-uremic and 58% for uremic patients (P = 0.98). There was no association of these rates with the study variables. These findings show that cases of acute hepatitis C are still occurring and have been related predominantly to hospital procedures. Measures to prevent nosocomial transmission should be adopted rigorously and followed to minimize this important source of infection observed in this survey.
authors.affiliation: Federal University of Maranhão, São Luis, MA, Brazil. adalgisaf@terra.com.br
authors.forename: Adalgisa de Souza Paiva
authors.initials: Ade S
authors.lastname: Ferreira
authors.forename: Renata de Mello
authors.initials: Rde M
authors.lastname: Perez
authors.forename: Maria Lucia Gomes
authors.initials: ML
authors.lastname: Ferraz
authors.forename: Lia Laura
authors.initials: LL
authors.lastname: Lewis-Ximenez
authors.forename: João Luis
authors.initials: JL
authors.lastname: Pereira
authors.forename: Paulo Roberto Lerias
authors.initials: PR
authors.lastname: de Almeida
authors.forename: Angelo Alves
authors.initials: AA
authors.lastname: de Mattos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007565:Jaundice / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors; D015229:Sexually Transmitted Diseases, Viral; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase