Chronic hepatitis B virus infection in Italy during the twenty-first century: an updated survey in 2019
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ORIGINAL ARTICLE
Chronic hepatitis B virus infection in Italy during the twenty-first century: an updated survey in 2019 Tommaso Stroffolini 1 & Alessia Ciancio 2 & Caterina Furlan 1 & Maria Vinci 3 & Grazia Anna Niro 4 & Maurizio Russello 5 & Guido Colloredo 6 & Filomena Morisco 7 & Nicola Coppola 8,9 & Sergio Babudieri 10 & Luigina Ferrigno 11 & Caterina Sagnelli 9 & Evangelista Sagnelli 9 & Collaborating group Received: 15 June 2020 / Accepted: 1 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The aim of this study is to provide updates on the characteristics of chronic HBsAg carriers in Italy before the advent of new drugs eliminating or functionally inactivating the genome HBV reservoirs. HBV endemicity has greatly decreased in Italy over the past decades. A not negligible number of chronic HBsAg carriers are still alive in the country. Chronic HBsAg carriers consecutively referring to 9 units in Italy were prospectively enrolled for a 6-month period in 2019. Multiple logistic regression analysis was performed to identify independent predictors of treatment. A total of 894 cases was recruited (sex ratio 1.6; mean age 53.7 ± 13.5 years). The proportion of subjects born abroad was 19.0%; only 1% of cases reported current heavy alcohol intake (> 4 units/ day). Chronic HBV infection, chronic HBV hepatitis, and subjects with liver cirrhosis and/or HCC represented 24.8%, 55%, and 19.3% of cases, respectively. After exclusion of the 222 subjects with chronic HBV infection, the proportion of subjects under therapy was as high as 89.3%. A more severe liver disease (OR 2.52; 95% CI = 1.25–5.14) resulted an independent predictor of the likelihood of treatment; male sex was marginally associated (OR 1.67; 95% CI = 1.02–2.76) to the chance of treatment. People born abroad had same chance than Italians native to be treated (OR 2.12; 95% CI = 0.9–4.97). The high proportion of subjects under treatment and the absence of gender and ethnic barrier against treatment sound good news. These updated figures may represent reference data for evaluating the potential impact of forthcoming new therapy against HBV-related disease. Keywords HBV infection . HBV endemicity . Antiviral treatment . HBsAg carriers . HBV vaccination programs
Introduction In industrialized countries, the incidence rate of acute hepatitis B virus (HBV) has decreased most likely reflecting the impact of national HBV vaccination programs [1]. Currently, acute HBV infection peaks in subjects 35–44 years old, mostly due to unsafe sexual intercourse [1]. A similar pattern has been
* Filomena Morisco [email protected] 1
Department of Tropical and Infectious Diseases, Policlinico Umberto I, Rome, Italy
2
Department of Gastroenterology, Ospedale Molinette, Torino, Italy
3
Department of Gastroenterology, Ospedale Niguarda, Milan, Italy
4
5
Gastroenterology Unit, Fondazione Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy Hepatology Unit, Ospedale Garibaldi, Catania, Italy
observed also in Italy [2]
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