Clinical epidemiology of chronic viral hepatitis B: A Tuscany real-word large-scale cohort study.
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Stasi Cristina, Silvestri Caterina, Berni Roberto, Brunetto Maurizia Rossana, Zignego Anna Linda, Orsini Cristina, Milani Stefano, Ricciardi Liana, De Luca Andrea, Blanc Pierluigi, Nencioni Cesira, Aquilini Donatella, Bartoloni Alessandro, Bresci Giampaolo, Marchi Santino, Filipponi Franco, Colombatto Piero, Forte Paolo, Galli Andrea, Luchi Sauro, Chigiotti Silvia, Nerli Alessandro, Corti Giampaolo, Sacco Rodolfo, Carrai Paola, Ricchiuti Angelo, Giusti Massimo, Almi Paolo, Cozzi Andrea, Carloppi Silvia, Laffi Giacomo, Voller Fabio, Cipriani Francesco
Аннотация
METHODS: This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation.
RESULTS: Of 4015 chronic viral hepatitis patients, 1096 (27.3%) were HBV infected. The case report form was correctly completed for only 833 patients (64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years (only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures (23%), mother-to-child (17%) and sexual transmission (12%). The most represented HBV genotypes were D (72%) and A (14%). Of the patients, 24.7% of patients were HBeAg positive, and 75.3% were HBeAg negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic (35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic.
CONCLUSION: Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults.