title: The aetiology of chronic hepatitis in Italy: results from a multicentre national study.
abstract: BACKGROUND
  No recent national-level data on the aetiology of chronic hepatitis are available in Italy.
  
  
  OBJECTIVE
  To evaluate the current aetiology of chronic hepatitis in Italy.
  
  
  METHODS
  A total of 6210 chronic hepatitis patients (both prevalence and incident cases) consecutively admitted to 79 hospitals located throughout Italy were enrolled over a 6-month period in 2001. The hospitals were randomly selected through systematic cluster sampling.
  
  
  RESULTS
  The main agent associated with chronic hepatitis was hepatitis C virus, which was found in 76.5% of the patients (in 62.6% it was the only aetiologic factor). Hepatitis B surface antigen was present in the serum of 12.2% of the cases (in 9.2% it was the only aetiologic factor). Hepatitis B e antigen and hepatitis Delta were detected in 16.6% and 7.0%, respectively, of hepatitis B surface antigen-positive patients. A history of alcohol abuse was found in 19.2% of the cases (5.5% without viral infection). Autoimmune hepatitis and inborn metabolic disorders were extremely rare. The prevalence of hepatitis C virus-related cases was significantly lower in incident cases, compared to prevalent cases (55.1% versus 65.0%; p < 0.01). The mean alanine aminotransferase level was significantly higher in hepatitis B surface antigen-positive patients, compared to hepatitis B surface antigen-negative patients. The histology was less severe in non-viral-related cases.
  
  
  CONCLUSIONS
  Hepatitis C virus is the most important pathogenic factor for chronic hepatitis in Italy; however, the comparison between prevalent and incident cases suggests that this infection will play a less important role in the future. A comparison with previous reports shows that both hepatitis B virus-related and hepatitis Delta virus-related cases are decreasing.
authors.affiliation: Laboratory of Epidemiology, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome 00161, Italy. wenzel@iss.it
authors.forename: T
authors.initials: T
authors.lastname: Stroffolini
authors.forename: E
authors.initials: E
authors.lastname: Sagnelli
authors.forename: A
authors.initials: A
authors.lastname: Mele
authors.forename: A
authors.initials: A
authors.lastname: Craxì
authors.forename: P
authors.initials: P
authors.lastname: Almasio
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000453:epidemiology; D005260:Female; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D019701:Hepatitis D, Chronic / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence