학술논문

Trends in chronic hepatitis B virus infection in Italy over a 10-year period: Clues from the nationwide PITER and MASTER cohorts toward elimination.
Document Type
Article
Source
International Journal of Infectious Diseases. Apr2023, Vol. 129, p266-273. 8p.
Subject
*HEPATITIS B
*CHRONIC hepatitis B
*HEPATITIS associated antigen
*DISEASE prevalence
*HEPATITIS B virus
Language
ISSN
1201-9712
Abstract
• Patients with chronic hepatitis B virus are older than in the past. • About 22% of the patients are migrants; they are younger than Italians. • The widespread use of effective antivirals contributes to the infection prevention. • The cirrhosis likelihood was reduced by 40% than in the past. • Hepatitis Delta co-infection is present in about one-quarter of cirrhosis cases. The study measures trends in the profile of patients with chronic hepatitis B virus linked to care in Italy. A cross-sectional, multicenter, observational cohort (PITER cohort) of consecutive patients with hepatitis B surface antigen (HBsAg) over the period 2019-2021 from 46 centers was evaluated. The reference was the MASTER cohort collected over the years 2012-2015. Standard statistical methods were used. The PITER cohort enrolled 4583 patients, of whom 21.8% were non-Italian natives. Compared with those in MASTER, the patients were older and more often female. The prevalence of hepatitis B e antigen (HBeAg) declined (7.2% vs 12.3; P <0.0001) and that of anti-hepatitis D virus (HDV) remained stable (9.3% vs 8.3%). In both cohorts, about 25% of the patients had cirrhosis, and those in the PITER cohort were older. HBeAg-positive was 5.0% vs 12.6% (P <0.0001) and anti-HDV positive 24.8% vs 17.5% (P <0.0017). In the logistic model, the variables associated with cirrhosis were anti-HDV-positive (odds ratio = 10.08; confidence interval 7.63-13.43), age, sex, and body mass index; the likelihood of cirrhosis was reduced by 40% in the PITER cohort. Among non-Italians, 12.3% were HBeAg-positive (vs 23.4% in the MASTER cohort; P <0.0001), and 12.3% were anti-HDV-positive (vs 11.1%). Overall, the adherence to the European Association for the Study of the Liver recommendations for antiviral treatment increased over time. Chronic hepatitis B virus infection appears to be in the process of becoming under control in Italy; however, HDV infection is still a health concern in patients with cirrhosis and in migrants. [ABSTRACT FROM AUTHOR]