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. 2017 Nov 14;12(11):e0187893.
doi: 10.1371/journal.pone.0187893. eCollection 2017.

Evolution of acute hepatitis C virus infection in a large European city: Trends and new patterns

César Garriga  1   2 , Sandra Manzanares-Laya  1   3 , Patricia García de Olalla  1   3 , Pilar Gorrindo  1 , Sabela Lens  4   5 , Ricard Solà  6 , María Martínez-Rebollar  7 , Montserrat Laguno  7 , Jordi Navarro  8 , Xavier Torras  9   5 , Mercè Gurguí  10 , María-Jesús Barberá  11 , Josep Quer  12 , Eva Masdeu  1 , Pere Simón  1 , Miriam Ros  1 , Anna de Andrés  1 , Joan A Caylà  1   3
Affiliations

Evolution of acute hepatitis C virus infection in a large European city: Trends and new patterns

César Garriga et al. PLoS One. .

Abstract

The aims of this study were to describe the evolution of acute hepatitis C virus (HCV) infections since 2004 and to determine its associated factors. Acute HCV infections diagnosed in Barcelona from 2004 to 2015 were included. Incidence ratios (IR) were then estimated for sex and age groups. Cases were grouped between 2004-2005, 2006-2011 and 2012-2015, and their incidence rate ratios (IRR) were calculated. In addition, risk factors for acute HCV infection were identified using multinomial logistic regression for complete, available and multiple imputed data. 204 new HCV cases were identified. Two peaks of higher IR of acute HCV infection in 2005 and 2013 were observed. Men and those aged 35-54 had higher IR. IRR for men was 2.9 times greater than in women (95% confidence intervals (CI): 1.8 ‒ 4.7). Factors related to the period 2012-2015 (versus 2006-2011) were: a) sexual risk factor for transmission versus nosocomial (relative-risk ratio (RRR): 13.0; 95% CI: 2.3 ‒ 72.1), b) higher educated versus lower (RRR: 5.4; 95% CI: 1.6 ‒ 18.7), and c) HIV co-infected versus not HIV-infected (RRR: 53.1; 95% CI: 5.7 ‒ 492.6). This is one of the few studies showing IR and RRRs of acute HCV infections and the first focused on a large city in Spain. Sexual risk for transmission between men, higher educational level and HIV co-infection are important factors for understanding current HCV epidemic. There has been a partial shift in the pattern of the risk factor for transmission from nosocomial to sexual.

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Conflict of interest statement

Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: Dr. Lens reports personal fees from Gilead, Janssen, and Abbvie, outside the submitted work. Dr. Solà reports receiving consulting fees from Bristol Myers Squibb, Abbvie and Jansen, and lecture fees from Abbvie, outside the submitted work. Dr. Navarro reports personal fees from Gilead, JanssenCilag, MSD, and Abbvie, outside the submitted work. Dr. Torras reports personal fees from Gilead, Abbvie, and MSD, outside the submitted work. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Cases of acute hepatitis C by symptom onset date grouped by quarter and risk factor.
Barcelona city, 2004─ 2015. (A) Men. (B) Women. Diagnosis date was used instead of missing symptom onset dates in 52 cases, notification date was used instead of missing symptom onset and diagnosis dates in 52 cases. Mean months elapsed among symptom onset date and diagnosis date was 1.5 (standard deviation (sd) = 8.0; n = 77); mean months elapsed among diagnosis date and notification date was 2.5 (sd = 5.3; n = 129). Hepatitis C virus, HCV; incidence ratio, IR; years old, y.
Fig 2
Fig 2. Trend in number of acute hepatitis C cases per 100,000 inhabitants and incidence rate ratio of hepatitis C by sex and age, Barcelona city residents, 2004–2015.
(A) IR for total cases. (B) IR for men and women. (C) IR layered by age group, data label is omitted in this panel to facilitate its comprehension. (D) Incidence rate ratio, reference period is 2006–2011. See explanation of dates used in the footnote of the Fig 1.
See this image and copyright information in PMC

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