Characteristics of liver cirrhosis in Italy: Evidence for a decreasing role of HCV aetiology.
BACKGROUND
Previous cross-sectional studies have shown that hepatitis C virus (HCV) infection had been the main agent associated with liver cirrhosis in Italy.


OBJECTIVE
To assess epidemiological, laboratory and clinical features of liver cirrhosis in Italy in 2014.


METHODS
Out of the 2557 consecutive subjects evaluated in 16 hospitals located throughout Italy in 2014, 832 (32.6%) had liver cirrhosis and were enrolled in this study.


RESULTS
The mean age of subjects was 60.3years, with a male/female ratio of 1.7; 74.9% of cases had Child A cirrhosis and 17.9% superimposed hepatocellular carcinoma. HCV infection, alone or in combination with other aetiologic agents, was responsible of 58.6% of cases, HBV aetiology accounted for the 17.6% and alcohol abuse for the 16.0%. Compared with virus-related cirrhotic patients, those alcohol-related more frequently showed decompensation (p=0.02).


CONCLUSIONS
Compared to previous surveys performed in 1992 and in 2001, we observe a statistically significant (p<0.05) decreasing role of both HCV infection and alcohol abuse as aetiologic agents of liver cirrhosis in Italy, explaining, at least in part, the slow, progressive decline of the mortality rate for liver cirrhosis in the last decades in this country (from 34.5 deaths/100,000 inhabitants in1980 to 10.8 in 2012).
Department of Tropical and Infectious Diseases, Policlinico Umberto Primo, Rome, Italy.
Tommaso
T
Stroffolini
Department of Mental Health and Public Medicine, Second University of Naples, Italy.
Evangelista
E
Sagnelli
Infectious Diseases, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Italy.
Giovanni Battista
GB
Gaeta
Department of Mental Health and Public Medicine, Second University of Naples, Italy.
Caterina
C
Sagnelli
Gastroenterology Unit, Fondazione "Casa Sollievo della Sofferenza" IRCCS Hospital, San Giovanni Rotondo, Foggia, Italy.
Angelo
A
Andriulli
Infectious Diseases, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Italy.
Giuseppina
G
Brancaccio
Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
Mario
M
Pirisi
Department of Internal Medicine, San Pietro Hospital, Ponte San Pietro, Italy.
Guido
G
Colloredo
Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Naples "Federico II", Naples, Italy.
Filomena
F
Morisco
Department of Tropical and Infectious Diseases, Policlinico Umberto Primo, Rome, Italy.
Caterina
C
Furlan
Gastroenterology & Hepatology Unit, Di. Bi.MI. S., University of Palermo, Italy. Electronic address: piero.almasio@unipa.it.
Piero Luigi
PL
Almasio
D000368:Aged; D000437:Alcoholism / Q000150:complications*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000209:etiology* / Q000401:mortality; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
Alcohol abuse; HBV; HCV; Liver cirrhosis; Liver cirrhosis epidemiology