Etiology of chronic liver diseases in the Northwest of Italy, 1998 through 2014.
OBJECTIVE
To assess the etiology of chronic liver diseases (CLD) from 1998 to 2014 at the outpatient clinic of Gastroenterology of the main hospital in Northwest of Italy among those dedicated to hepatology.


METHODS
A random sample of charts of patients referred to for increased liver enzymes between January 1998 and December 2006, and between January 2012 and December 2014 were reviewed. Etiology search included testing for hepatitis B virus (HBV), hepatitis C virus (HCV), autoimmune hepatitis, primary biliary cirrhosis, Wilson's disease and hereditary hemocromatosis. A risky alcohol consumption was also considered. Non-alcoholic fatty liver disease (NAFLD) was diagnosed in patients with histological and/or ultrasound evidence of steatosis/steatohepatitis, and without other causes of CLD.


RESULTS
The number of patients included was 1163. Of them, 528 (45%) had positivity for HCV and 85 (7%) for HBV. Among the virus-free patients, 417 (36%) had metabolic disorders whereas the remaining had history of alcohol abuse, less prevalent causes of CLD or concomitant conditions. In comparison to 1998-2000 (41%), a reduction of HCV alone-related cases was detected during the periods 2001-2003 (35%, OR = 0.75, 95%CI: 0.53-1.06), 2004-2006 (33%, OR = 0.70, 95%CI: 0.50-0.97) and 2012-2014 (31%, OR = 0.64, 95%CI: 0.46-0.91). On the contrary, in comparison to 1998-2000 (31%), metabolic-alone disorders increased in the period 2004-2006 (39%, OR = 1.37, 95%CI: 0.99-1.91) and 2012-2014 (41%, OR = 1.53, 95%CI: 1.09-2.16). The other etiologies remained stable. The increase of incidence of metabolic-alone etiology during the period 2004-2006 and 2012-2014 tended to be higher in older patients (≥ 50 years) compared to younger (P = 0.058).


CONCLUSIONS
In the Northwest of Italy, during this study period, the prevalence of HCV infection decreased notably whereas that of NAFLD increased.
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Giorgio Maria
GM
Saracco
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Andrea
A
Evangelista
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Sharmila
S
Fagoonee
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Giovannino
G
Ciccone
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Elisabetta
E
Bugianesi
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Gian Paolo
GP
Caviglia
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Maria Lorena
ML
Abate
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Mario
M
Rizzetto
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Rinaldo
R
Pellicano
Giorgio Maria Saracco, Department of Oncology, University of Turin, 10123 Turin, Italy.
Antonina
A
Smedile
D000328:Adult; D000428:Alcohol Drinking; D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006432:Hemochromatosis / Q000209:etiology; D006509:Hepatitis B / Q000209:etiology; D006526:Hepatitis C / Q000209:etiology; D019693:Hepatitis, Autoimmune / Q000209:etiology*; D006527:Hepatolenticular Degeneration / Q000209:etiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008105:Liver Cirrhosis, Biliary / Q000209:etiology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000209:etiology; D012189:Retrospective Studies
Chronic liver diseases; Cirrhosis; Hepatitis B virus; Hepatitis C virus; Nonalcoholic steatohepatitis
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