The impact of the hepatitis B mass immunisation campaign on the incidence and risk factors of acute hepatitis B in Italy.
OBJECTIVE
This study aimed to evaluate the impact of the campaign for hepatitis B mass immunisation of children and teenagers, introduced in 1991, on the incidence of and risk factors for hepatitis B in Italy.


METHODS
Hepatitis B cases reported to the surveillance system for type-specific acute viral hepatitis (SEIEVA) during the period 1987-1997 were used to estimate incidence. To assess the association between potential risk factors and hepatitis B cases, hepatitis A cases generated by the same surveillance system were used as controls.


RESULTS
During the period 1987-1997, 8275 acute hepatitis B cases were reported to SEIEVA. Hepatitis B incidence declined from 10.4/100,000 in 1987 to 2.9/100,000 in 1997. The fall was more evident before than after the introduction of compulsory vaccination against hepatitis B. The results of multivariate analysis showed that during the years 1995-1997, blood transfusion, intravenous drug use, surgical intervention, dental therapy, other parenteral exposures, multiple sexual partners, and being in the household of a chronic HBsAg carrier were all exposures independently associated with hepatitis B.


CONCLUSIONS
The strong association linking acute hepatitis B with iatrogenic exposures, which are more common in adults, suggests that the present immunisation strategy should be combined with the implementation of non-immunologic preventive measures.
Stroffolini
T
T
Laboratorio di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy.
Mele
A
A
Tosti
M E
ME
Gallo
G
G
Balocchini
E
E
Ragni
P
P
Santonastasi
F
F
Marzolini
A
A
Ciccozzi
M
M
Moiraghi
A
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D012307:Risk Factors; D014611:Vaccination