Evolving clinical landscape of chronic hepatitis B: A multicenter Italian study.
The aim of the study was to evaluate the characteristics of chronic hepatitis B with special reference to the geographical origin of the patients and to the prevalence of HBeAg and viral and non-viral co-factors of liver disease. A cross-sectional multicenter survey was undertaken, which enrolled 1,386 HBsAg chronic carriers observed consecutively in 21 referral centers over a 6-month period. The prevalence of HBeAg in patients was 11%; the presence of HBeAg was associated independently with a younger age and co-infection with HIV. Anti-HDV, anti-HCV, or anti-HIV antibodies were detected in 8.1%, 6.5%, and 2%, respectively. However, among the patients first diagnosed during the study period (incident cases), 14.3% were anti-HDV positive. Seven percent of the patients were immigrants; they were younger than Italian patients and 18% were HBeAg positive; no difference was observed in the prevalence of anti-HDV, anti-HCV, or anti-HIV antibodies. The presence of cirrhosis was associated independently with an age >52 years, the presence of anti-HDV or anti-HCV, alcohol use >4 drinks/day, and a high BMI. The clinical epidemiology of chronic hepatitis B virus (HBV) infection shows a dynamic profile, with the potential for re-emergence of cases with HBeAg or anti-HDV and an emerging impact of metabolic factors on the evolution of liver disease.
Department of Infectious and Tropical Diseases, University La Sapienza, Rome, Italy.
Tommaso
T
Stroffolini
Piero L
PL
Almasio
Evangelista
E
Sagnelli
Alfonso
A
Mele
Giovanni Battista
GB
Gaeta
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D005843:Geography; D006678:HIV / Q000276:immunology; D015658:HIV Infections / Q000150:complications / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D006525:Hepatitis, Viral, Human / Q000276:immunology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence
D000914:Antibodies, Viral