Tommaso Stroffolini1, Evangelista Sagnelli2, Caterina Sagnelli2, Antonina Smedile3, Caterina Furlan1, Filomena Morisco4, Nicola Coppola2, Angelo Andriulli5, Piero Luigi Almasio6. 1. Department of Tropical and Infectious Diseases, Policlinico Umberto I, Rome, Italy. 2. Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy. 3. Department of Medical Sciences, University of Turin, Turin, Italy. 4. Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", Italy. 5. Gastroenterology Unit, Fondazione "Casa Sollievo della Sofferenza" IRCCS Hospital, San Giovanni Rotondo, Foggia, Italy. 6. Biomedical Department of Internal and Specialized Medicine (Di.Bi.M.I.S.), University of Palermo, Italy. Electronic address: piero.almasio@unipa.it.
Abstract
BACKGROUND: There is increasing awareness of HBV reactivation in HCV-RNA-positive/HBV-coinfected patients with chronic liver disease (CLD) treated with oral direct-acting antivirals (DAAs). AIM: To provide figures on the prevalence of HBV markers in HCV-RNA-positive subjects in Italy, where these findings are lacking. METHODS: All subjects aged ≥18 years with CLD consecutively referring to Italian liver units located throughout country were prospectively enrolled in two national surveys in 2001 and 2014. RESULTS: The total number of HCV-RNA-positive cases was 6984; 356 (5.1%) subjects vaccinated against HBV were excluded. A total of 6628 cases were evaluated. The prevalence rates of HBsAg, isolated anti-HBc and anti-HBc/anti-HBs-positivity were 2.9%, 8.1% and 14.7%, respectively. Among the estimated one million HCV-RNA-positive subjects in Italy, a substantial number of subjects are at risk of HBV reactivation due to DAA therapy. The prevalence of liver cirrhosis was higher than that of CLD in HBsAg-positive subjects (4.4% vs. 2.6%, p < 0.01) but not in those positive for other HBV markers. CONCLUSIONS: These findings outline the burden of HBV markers among HCV-RNA-positive subjects in Italy, where in 2017 reimbursement for DAA therapy by the National Health System became universal for all patients with chronic HCV infection. HBV vaccination coverage should be greatly extended, since nearly two thirds of subjects in this study resulted negative for any HBV marker.
BACKGROUND: There is increasing awareness of HBV reactivation in HCV-RNA-positive/HBV-coinfectedpatients with chronic liver disease (CLD) treated with oral direct-acting antivirals (DAAs). AIM: To provide figures on the prevalence of HBV markers in HCV-RNA-positive subjects in Italy, where these findings are lacking. METHODS: All subjects aged ≥18 years with CLD consecutively referring to Italian liver units located throughout country were prospectively enrolled in two national surveys in 2001 and 2014. RESULTS: The total number of HCV-RNA-positive cases was 6984; 356 (5.1%) subjects vaccinated against HBV were excluded. A total of 6628 cases were evaluated. The prevalence rates of HBsAg, isolated anti-HBc and anti-HBc/anti-HBs-positivity were 2.9%, 8.1% and 14.7%, respectively. Among the estimated one million HCV-RNA-positive subjects in Italy, a substantial number of subjects are at risk of HBV reactivation due to DAA therapy. The prevalence of liver cirrhosis was higher than that of CLD in HBsAg-positive subjects (4.4% vs. 2.6%, p < 0.01) but not in those positive for other HBV markers. CONCLUSIONS: These findings outline the burden of HBV markers among HCV-RNA-positive subjects in Italy, where in 2017 reimbursement for DAA therapy by the National Health System became universal for all patients with chronic HCV infection. HBV vaccination coverage should be greatly extended, since nearly two thirds of subjects in this study resulted negative for any HBV marker.
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Authors: H. Yasemin Balaban; Abdullah Tarık Aslan; Şefika Nur Ayar; Osman Dağ; Alpaslan Alp; Cem Şimşek; Cavanşir Vahabov; Tolga Yıldırım; Hakan Göker; Yahya Büyükaşık; Halis Şimşek Journal: Turk J Med Sci Date: 2021-06-28 Impact factor: 0.973