Evangelista Sagnelli1, Tommaso Stroffolini2, Caterina Sagnelli1, Filomena Morisco3, Nicola Coppola1, Antonina Smedile4, Mariantonietta Pisaturo5, Guido Colloredo6, Sergio Babudieri7, Anna Licata8, Giuseppina Brancaccio9, Angelo Andriulli10, Piero L Almasio8, Giovani B Gaeta9. 1. Department of Mental Health and Public Medicine, Second University of Naples, Naples, Italy. 2. Department of Tropical and Infectious Diseases, Policlinico Umberto Primo, Rome, Italy. 3. Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", via Sergio Pansini, Naples, Italy. 4. Department of Medical Sciences, University of Turin, Turin, Italy. 5. Unit of Infectious Diseases, S. Anna and S. Sebastian Hospital, Caserta, Italy. 6. Department of Internal Medicine, San Pietro Hospital, Ponte San Pietro, Italy. 7. Clinic of Infectious Diseases, University of Sassari, Sassari, Italy. 8. Gastroenterology and Hepatology Unit, Di.Bi.MI.S. University of Palermo, Palermo, Italy. 9. Infectious Diseases, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Caserta, Italy. 10. Gastroenterology Unit, Fondazione "Casa Sollievo della Sofferenza" IRCCS Hospital, San Giovanni Rotondo, Foggia, Italy.
Abstract
BACKGROUND AND AIM: The universal hepatitis B vaccination for infants and 12-year-old adolescents (the latter limited to the first 12 years of application) was launched in Italy in 1991. Twenty-three years later we evaluated the impact of the vaccination campaign on the burden of HBsAg-positive chronic liver diseases (CLD). MATERIAL AND METHODS: A total of 513 HBsAg-positive chronic carriers referring to 16 Italian liver units were investigated and compared with HBsAg carriers enrolled in previous surveys. RESULTS: The proportion of inactive carriers decreased from 20.0% in 2001 to 3.3% in 2014, while that of cirrhotic patients increased from 22.6% to 33.2%. Regarding the age class 0-33 (fully covered by HBV vaccination in 2014), the rate of inactive carriers decreased from the 21.7% in 2001 to 5.9% in 2014, that of chronic hepatitis from 17.5% to 5.2% and that of cirrhosis cases from 26.4% to 4.1%. Instead, in the over-60 age group the rate of inactive carriers increased from 22.8% to 41.2% and that of chronic hepatitis from 16.8% to 46%; the rate of patients with cirrhosis ranged from 5% to 8% in different studies. CONCLUSION: Twenty-three years after the introduction universal HBV vaccination in Italy, the clinical presentation of CLD had shown a shift toward older ages and more severe diseases.
BACKGROUND AND AIM: The universal hepatitis B vaccination for infants and 12-year-old adolescents (the latter limited to the first 12 years of application) was launched in Italy in 1991. Twenty-three years later we evaluated the impact of the vaccination campaign on the burden of HBsAg-positive chronic liver diseases (CLD). MATERIAL AND METHODS: A total of 513 HBsAg-positive chronic carriers referring to 16 Italian liver units were investigated and compared with HBsAg carriers enrolled in previous surveys. RESULTS: The proportion of inactive carriers decreased from 20.0% in 2001 to 3.3% in 2014, while that of cirrhotic patients increased from 22.6% to 33.2%. Regarding the age class 0-33 (fully covered by HBV vaccination in 2014), the rate of inactive carriers decreased from the 21.7% in 2001 to 5.9% in 2014, that of chronic hepatitis from 17.5% to 5.2% and that of cirrhosis cases from 26.4% to 4.1%. Instead, in the over-60 age group the rate of inactive carriers increased from 22.8% to 41.2% and that of chronic hepatitis from 16.8% to 46%; the rate of patients with cirrhosis ranged from 5% to 8% in different studies. CONCLUSION: Twenty-three years after the introduction universal HBV vaccination in Italy, the clinical presentation of CLD had shown a shift toward older ages and more severe diseases.