Epidemiological and clinical scenario of chronic liver diseases in Italy: Data from a multicenter nationwide survey.
BACKGROUND
The last Italian prevalence survey on chronic liver diseases (CLD) was performed in 2001. The present study evaluated the changes occurring over thirteen years.


METHODS
We enrolled 2,557 CLD consecutive patients in 16 Italian liver units in 2014.


RESULTS
HBV etiology accounted for 513 (20.2%) cases, alone in 439 and associated with HCV and/or alcohol abuse in 74. Of these 513, 11.9% were anti-HDV-positive and 7.2% HBeAg-positive. HCV alone was responsible for 50.3% of CLD and with alcohol abuse for 5.9%. HCV RNA was detected in 64.0% of the anti-HCV-positive patients tested. HCV genotyping, performed for 899 patients, showed genotype-1a, 1b, 2, 3, 4 and 5 respectively in 16.5%, 45.5%, 15.4%, 8.2%, 15.1% and 0.2%. Alcohol abuse alone was responsible for 6.4% of cases and NAFLD/NASH for 6.3%. Liver cirrhosis (p<0.001) and HCC (p<0.001) were more frequent in alcoholic than viral etiologies. HCV and alcohol etiologies were more frequent in 2001 than 2014 (from 69.9% to 59.9% and from 23.0% to 12.3%, respectively). HBV showed a similar impact. In all etiologies, the 2001 CLD cases were 10 years younger and with a significantly lower rate of cirrhosis than the 2014 cases.


CONCLUSIONS
The changes in HCV, HBV and alcohol etiologies may help apply more appropriate healthcare strategies.
Department of Mental Health and Public Medicine, Second University of Naples, Italy. Electronic address: evangelista.sagnelli@unina2.it.
Evangelista
E
Sagnelli
Department of Tropical and Infectious Diseases, Policlinico Umberto Primo, Rome, Italy.
Tommaso
T
Stroffolini
Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Napoli, Italy.
Caterina
C
Sagnelli
Department of Medical Sciences, University of Turin, Turin, Italy.
Antonina
A
Smedile
Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", Napoli, Italy.
Filomena
F
Morisco
Department of Tropical and Infectious Diseases, Policlinico Umberto Primo, Rome, Italy.
Caterina
C
Furlan
Clinic of Infectious Diseases, University of Sassari, Sassari, Italy.
Sergio
S
Babudieri
Department of Clinical and Experimental Medicine and Surgery, Viral Hepatitis Unit, University of Naples, Napoli, Italy.
Giuseppina
G
Brancaccio
Department of Mental Health and Public Medicine, Second University of Naples, Italy.
Nicola
N
Coppola
Department of Clinical and Experimental Medicine and Surgery, Viral Hepatitis Unit, University of Naples, Napoli, Italy.
Giovanni Battista
GB
Gaeta
Gastroenterology & Hepatology Unit, Di.Bi.MI.S. University of Palermo, Palermo, Italy.
Piero Luigi
PL
Almasio
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008113:Liver Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology; D010045:Outpatients / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
Chronic hepatitis; Chronic liver diseases; HCC; Liver cirrhosis