title: The impact of the hepatitis B mass immunisation campaign on the incidence and risk factors of acute hepatitis B in Italy.
abstract: 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.
authors.affiliation: Laboratorio di Epidemiologia, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Stroffolini
authors.forename: A
authors.initials: A
authors.lastname: Mele
authors.forename: M E
authors.initials: ME
authors.lastname: Tosti
authors.forename: G
authors.initials: G
authors.lastname: Gallo
authors.forename: E
authors.initials: E
authors.lastname: Balocchini
authors.forename: P
authors.initials: P
authors.lastname: Ragni
authors.forename: F
authors.initials: F
authors.lastname: Santonastasi
authors.forename: A
authors.initials: A
authors.lastname: Marzolini
authors.forename: M
authors.initials: M
authors.lastname: Ciccozzi
authors.forename: A
authors.initials: A
authors.lastname: Moiraghi
mesh_terms: 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