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Seroprevalence of viral hepatitis in an older nursing home population
N T Chien1, G Dundoo, M H Horani
1Division of Geriatric Medicine, Saint Louis University School of Medicine, Missouri 63104, USA.
Objectives:
To assess the prevalence of current or previous infection with viral hepatitis agents in an older nursing home population.
Design:
A prospective cohort study.
Setting:
Three nursing homes in the greater St. Louis area affiliated with Saint Louis University.
Subjects:
Older residents admitted to these facilities.
Measurements:
Residents were interviewed and examined for evidence of hepatitis or liver disease. Serum samples were tested for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core and surface antigens (anti-HBc and anti-HBs), antibody to hepatitis A virus (anti-HAV), antibody to hepatitis C virus (anti-HCV), and hepatitis G virus RNA (HGV RNA).
Results:
Of 329 residents queried, 199 gave consent and were able to participate. The seroprevalence of hepatitis was: HBsAg 0%, anti-HBc 24.1%, anti-HBs 19.5%, anti-HAV 79.9%, anti-HCV 4.5%, and HGV-RNA 10.6%. Frequency of HAV infection increased significantly with age whereas HBV infection correlated with ethnic status and former occupation as a manual worker. A history of blood transfusion was associated with a higher rate of anti-HCV. End stage renal disease, present in 17 patients, was associated with anti-HBc, anti-HCV, and HGV RNA positivity but not with anti-HBs or anti-HAV positivity
Conclusions:
The seroprevalence of anti-HCV was surprisingly high in this population residing in skilled nursing facilities, and we recommend that all new patients admitted to this type of institution be screened for anti-HCV. The prevalence of HGV RNA was higher than in the general US blood donor population, but the significance of this finding remains uncertain.