Evangelista Sagnelli1, Tommaso Stroffolini2, Caterina Sagnelli3, Antonina Smedile4, Filomena Morisco5, Caterina Furlan2, Sergio Babudieri6, Giuseppina Brancaccio7, Nicola Coppola8, Giovanni Battista Gaeta7, Piero Luigi Almasio9. 1. Department of Mental Health and Public Medicine, Second University of Naples, Italy. Electronic address: evangelista.sagnelli@unina2.it. 2. Department of Tropical and Infectious Diseases, Policlinico Umberto Primo, Rome, Italy. 3. Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Napoli, Italy. 4. Department of Medical Sciences, University of Turin, Turin, Italy. 5. Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", Napoli, Italy. 6. Clinic of Infectious Diseases, University of Sassari, Sassari, Italy. 7. Department of Clinical and Experimental Medicine and Surgery, Viral Hepatitis Unit, University of Naples, Napoli, Italy. 8. Department of Mental Health and Public Medicine, Second University of Naples, Italy. 9. Gastroenterology & Hepatology Unit, Di.Bi.MI.S. University of Palermo, Palermo, Italy.
Abstract
BACKGROUND: The last Italian prevalence survey on chronic liver diseases (CLD) was performed in 2001. The present study evaluated the changes occurring over thirteen years. METHODS: We enrolled 2,557 CLD consecutive patients in 16 Italian liver units in 2014. RESULTS: HBV etiology accounted for 513 (20.2%) cases, alone in 439 and associated with HCV and/or alcohol abuse in 74. Of these 513, 11.9% were anti-HDV-positive and 7.2% HBeAg-positive. HCV alone was responsible for 50.3% of CLD and with alcohol abuse for 5.9%. HCV RNA was detected in 64.0% of the anti-HCV-positive patients tested. HCV genotyping, performed for 899 patients, showed genotype-1a, 1b, 2, 3, 4 and 5 respectively in 16.5%, 45.5%, 15.4%, 8.2%, 15.1% and 0.2%. Alcohol abuse alone was responsible for 6.4% of cases and NAFLD/NASH for 6.3%. Liver cirrhosis (p<0.001) and HCC (p<0.001) were more frequent in alcoholic than viral etiologies. HCV and alcohol etiologies were more frequent in 2001 than 2014 (from 69.9% to 59.9% and from 23.0% to 12.3%, respectively). HBV showed a similar impact. In all etiologies, the 2001 CLD cases were 10 years younger and with a significantly lower rate of cirrhosis than the 2014 cases. CONCLUSION: The changes in HCV, HBV and alcohol etiologies may help apply more appropriate healthcare strategies.
BACKGROUND: The last Italian prevalence survey on chronic liver diseases (CLD) was performed in 2001. The present study evaluated the changes occurring over thirteen years. METHODS: We enrolled 2,557 CLD consecutive patients in 16 Italian liver units in 2014. RESULTS: HBV etiology accounted for 513 (20.2%) cases, alone in 439 and associated with HCV and/or alcohol abuse in 74. Of these 513, 11.9% were anti-HDV-positive and 7.2% HBeAg-positive. HCV alone was responsible for 50.3% of CLD and with alcohol abuse for 5.9%. HCV RNA was detected in 64.0% of the anti-HCV-positive patients tested. HCV genotyping, performed for 899 patients, showed genotype-1a, 1b, 2, 3, 4 and 5 respectively in 16.5%, 45.5%, 15.4%, 8.2%, 15.1% and 0.2%. Alcohol abuse alone was responsible for 6.4% of cases and NAFLD/NASH for 6.3%. Liver cirrhosis (p<0.001) and HCC (p<0.001) were more frequent in alcoholic than viral etiologies. HCV and alcohol etiologies were more frequent in 2001 than 2014 (from 69.9% to 59.9% and from 23.0% to 12.3%, respectively). HBV showed a similar impact. In all etiologies, the 2001 CLD cases were 10 years younger and with a significantly lower rate of cirrhosis than the 2014 cases. CONCLUSION: The changes in HCV, HBV and alcohol etiologies may help apply more appropriate healthcare strategies.
Authors: Ida Sperle; Gyde Steffen; Siv Aina Leendertz; Navina Sarma; Sandra Beermann; Roma Thamm; Yanita Simeonova; Markus Cornberg; Heiner Wedemeyer; Viviane Bremer; Ruth Zimmermann; Sandra Dudareva Journal: Front Public Health Date: 2020-08-28