ABSTRACT Introduction: Hepatitis C virus (HCV) infection continues to be an important public health problem worldwide. Despite the availability of drugs that promote the cure of infection in more than 95% of cases, the identification of HCV carriers remains a major challenge. Objective: To evaluate a strategy for identifying HCV carriers based on combined criteria: screening in emergency units and specialty outpatient clinics of a tertiary hospital and among older adults (≥45 years), both suggested as efficient in epidemiological studies. Methods: A cross-sectional, analytical and descriptive study was conducted on individuals of both sexes, aged 45 years and older, attending the emergency department and specialty outpatient clinics of a University Hospital in São Paulo, Brazil, from January 2016 to June 2018. After giving formal consent, the patients were submitted to a standardized interview and rapid testing for the identification of HCV antibodies (SD BIOLINE® anti-HCV). Results: A total of 606 adult patients (62% women and 37% men) were evaluated. The mean age was 62 ± 10 years. Four positive tests were identified, with confirmation by conventional serology and HCV-RNA determination. Thus, the prevalence of HCV identified in the sample was 0.66%. All patients had a history of risk factors for infection. Conclusion: The strategies of birth-cohort testing and screening in emergency medical services for the identification of HCV carries, both suggested in the literature as efficient for the diagnosis of hepatitis C, resulted in a low rate of HCV infection. These findings highlight the magnitude of the challenge of identifying asymptomatic HCV carriers in Brazil.

Racional — A hemocromatose hereditária associada ao gene HFE é a doença hepática hereditária mais comum nas populações caucasianas e refere-se à associação de estoques aumentados de ferro com um dano tissular progressivo (como por exemplo, cirrose hepática, diabetes mellitus, cardiomiopatia), quando o diagnóstico e o tratamento são tardios. Objetivos - É apresentado o caso de uma paciente de 44 anos portadora de hemocromatose hereditária assintomática, cujo diagnóstico foi feito a partir da detecção casual de alterações na cinética do ferro. Apresenta-se, também, uma breve revisão da literatura sobre a doença. Conclusão - A existência de métodos diagnósticos capazes de identificar a doença antes que surjam suas complicações e a possibilidade de terapêutica efetiva que permita evitar as suas manifestações, tornam a hemocromatose hereditária entidade ideal para profilaxia primária, alterando completamente a sua história natural.

Background — HFE-associated hemochromatosis is one of the most common inherited liver disease in Caucasian populations and refers to the association of increased iron stores with tissue damage (e.g., cirrhosis, diabetes, cardiomyopathy), which is progressive when diagnosis and treatment are delayed. Aims - Description of a case of hereditary hemochromatosis in an asymptomatic 44-years-old patient, whose diagnosis was made through casual identification of abnormal iron markers. We will also present a brief review of the literature about the topic. Conclusions - Hereditary hemochromatosis is an ideal disease for primary prevention since the disease can be detected well before serious complications develop. This intervention has been shown to prevent the manifestations of the disease, altering its natural history.