1
|
Kondili LA, Brancaccio G, Tosti ME, Coco B, Quaranta MG, Messina V, Ciancio A, Morisco F, Cossiga V, Claar E, Rosato V, Ciarallo M, Cacciola I, Ponziani FR, Cerrito L, Coppola R, Longobardi F, Biliotti E, Rianda A, Barbaro F, Coppola N, Stanzione M, Barchiesi F, Fagiuoli S, Viganò M, Massari M, Russo FP, Ferrarese A, Laccabue D, Di Marco V, Blanc P, Marrone A, Morsica G, Federico A, Ieluzzi D, Rocco A, Foschi FG, Soria A, Maida I, Chessa L, Milella M, Rosselli Del Turco E, Madonia S, Chemello L, Gentile I, Toniutto P, Bassetti M, Surace L, Baiocchi L, Pellicelli A, De Santis A, Puoti M, Degasperi E, Niro GA, Zignego AL, Craxi A, Raimondo G, Santantonio TA, Brunetto MR, Gaeta GB. A holistic evaluation of patients with chronic Hepatitis D virus (HDV) infection enrolled in the Italian PITER-B and delta cohort. Int J Infect Dis 2024; 146:107115. [PMID: 38801968 DOI: 10.1016/j.ijid.2024.107115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND AND AIMS We aimed to characterize the epidemiologic and comorbidities profiles of patients with chronic Hepatitis D (CHD) followed in clinical practice in Italy and explored their interferon (IFN) eligibility. METHODS This was a cross-sectional study of the PITER cohort consisting of consecutive HBsAg-positive patients from 59 centers over the period 2019-2023. Multivariable analysis was performed by logistic regression model. RESULTS Of 5492 HBsAg-positive enrolled patients, 4152 (75.6%) were screened for HDV, 422 (10.2%) were anti-HDV positive. Compared with HBsAg mono-infected, anti-HDV positive patients were more often younger, non-Italians, with a history of drug use, had elevated alanine transaminase (ALT), cirrhosis, or hepatocellular carcinoma (HCC). Compared with Italians, anti-HDV positive non-Italians were younger (42.2% age ≤ 40 years vs. 2.1%; P < 0.001), more often females (males 43.0% vs. 68.6%; P < 0.001) with less frequent cirrhosis and HCC. HDV-RNA was detected in 63.2% of anti-HDV-positive patients, who were more likely to have elevated ALT, cirrhosis, and HCC. Extrahepatic comorbidities were present in 47.4% of anti-HDV positive patients and could affect the eligibility of IFN-containing therapies in at least 53.0% of patients in care. CONCLUSIONS CHD affects young, foreign-born patients and older Italians, of whom two-thirds had cirrhosis or HCC. Comorbidities were frequent in both Italians and non-Italians and impacted eligibility for IFN.
Collapse
Affiliation(s)
- Loreta A Kondili
- Center for Global Health, Istituto Superiore di Sanità, Rome, Italy; UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
| | - Giuseppina Brancaccio
- Department of Molecular Medicine, Infectious Diseases, University of Padua, Padua, Italy
| | | | - Barbara Coco
- Hepatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Vincenzo Messina
- Department of Infectious Diseases, Sant'Anna Hospital, Caserta, Italy
| | - Alessia Ciancio
- Gastroenterology Unit, Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Filomena Morisco
- Liver and Biliary System Unit, Department of Clinical Medicine and Surgery, University of Naples, Naples, Italy
| | - Valentina Cossiga
- Liver and Biliary System Unit, Department of Clinical Medicine and Surgery, University of Naples, Naples, Italy
| | | | | | | | - Irene Cacciola
- Department of Internal Medicine, University Hospital of Messina, Messina, Italy
| | - Francesca Romana Ponziani
- Liver Unit, Digestive Disease Center, CEMAD Division of Internal Medicine and Gastroenterology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Lucia Cerrito
- Liver Unit, Digestive Disease Center, CEMAD Division of Internal Medicine and Gastroenterology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberta Coppola
- Department of Hepatology, Gragnano Hospital, Gragnano (NA), Italy
| | | | - Elisa Biliotti
- National Institute for Infectious Diseases, Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Alessia Rianda
- National Institute for Infectious Diseases, Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Francesco Barbaro
- Department of Medicine, Infectious Diseases Unit, University Hospital of Padua, Padua, Italy
| | - Nicola Coppola
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Stanzione
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Barchiesi
- Clinical Infectious Diseases, Polytechnic University of Marche, Ancona, Italy
| | - Stefano Fagiuoli
- Department of Medicine, University of Milan Bicocca & Gastroenterology Hepatology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Mauro Viganò
- Department of Medicine, University of Milan Bicocca & Gastroenterology Hepatology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Marco Massari
- Malattie Infettive, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Paolo Russo
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, University of Padua, Padua, Italy
| | - Alberto Ferrarese
- Gastroenterology Unit, University Hospital Borgo Trento, Verona, Italy
| | - Diletta Laccabue
- Department of Medicine and Surgery, Università degli Studi di Parma, Parma, Italy
| | - Vito Di Marco
- Biomedical Department of Internal and Specialistic Medicine University of Palermo, Unit of Gastroenterology and Hepatology, Palermo, Italy
| | - Pierluigi Blanc
- Infectious Disease Unit, Santa Maria Annunziata Hospital, Florence, Italy
| | - Aldo Marrone
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giulia Morsica
- Unit of Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alessandro Federico
- Hepato-Gastroenterology Division, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Alba Rocco
- Department of Clinical Medicine and Surgery, Hepato-Gastroenterology Unit, University of Naples Federico II, Naples, Italy
| | | | - Alessandro Soria
- Clinic of Infectious Diseases, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Ivana Maida
- Infectious and Tropical Diseases Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Luchino Chessa
- Liver Unit, University Hospital, Monserrato, Cagliari, Italy
| | - Michele Milella
- Clinic of Infectious Diseases, University of Bari, University Hospital Policlinico, Bari, Italy
| | - Elena Rosselli Del Turco
- Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Salvatore Madonia
- Department of Internal Medicine Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Liliana Chemello
- Department of Medicine-DIMED, Padua University, University Hospital, Padua, Italy
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pierluigi Toniutto
- Hepatology and Liver Transplant Unit, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Matteo Bassetti
- Clinica Malattie Infettive, Università degli Studi di Genova, Policlinico S. Martino IRCCS, Genova, Italy
| | - Lorenzo Surace
- Ambulatorio di Epatologia e Infettivologia, Azienda Sanitaria Provinciale CZ-Distretto del Lametino, Lamezia Terme (CZ), Italy
| | | | | | - Adriano De Santis
- Department of Internal Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Massimo Puoti
- Infectious Disease Unit, Niguarda Hospital, Milan, Italy
| | | | - Grazia Anna Niro
- Division of Gastroenterology and Endoscopy, Fondazione IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Foggia, Italy
| | - Anna Linda Zignego
- Department of Experimental and Clinical Medicine, Interdepartmental Centre MASVE, University of Florence, Italy
| | - Antonio Craxi
- Gastroenterology and Hepatology Unit, PROMISE, University of Palermo, Palermo, Italy
| | - Giovanni Raimondo
- Department of Internal Medicine, University Hospital of Messina, Messina, Italy
| | | | | | | |
Collapse
|
2
|
Demirel A, Uraz S, Deniz Z, Daglilar E, Basar O, Tahan V, Ozaras R. Epidemiology of hepatitis D virus infection in Europe: Is it vanishing? J Viral Hepat 2024; 31:120-128. [PMID: 37964693 DOI: 10.1111/jvh.13899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/13/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023]
Abstract
Co-infection with hepatitis delta virus (HDV) is a challenging health care problem worldwide, estimated to occur in approximately 5%-10% of patients with chronic hepatitis B virus (HBV) infection. While HBV prevalence is decreasing globally, the prevalence of HDV infection is rising in some parts mainly due to injection drug use, sexual transmission and immigration from high endemicity areas. Eastern Europe and the Mediterranean are among the regions with high rates of endemicity for HDV and the immigration from high endemicity areas to Central and Western Europe has changed the HDV epidemiology. We aimed to review the prevalence of HDV infection in Europe. A paucity of publication appears in many European countries. Prevalence studies from some countries are old dated and some other countries did not report any prevalence studies. The studies are accumulated in few countries. Anti-HDV prevalence is high in Greenland, Norway, Romania, Sweden and Italy. Belgium, France, Germany, Spain, Switzerland, Turkey and United Kingdom reported decreasing prevalences. Among cirrhotic HBV patients, Germany, Italy and Turkey reported higher rates of HDV. The studies including centres across the Europe reported that HIV-HBV coinfected individuals have higher prevalence of HDV infection. The immigrants contribute the HDV infection burden in Greece, Italy, and Spain in an increasing rate. Previous studies revealed extremely high rates of HDV infection in Germany, Greece, Italy and Sweden. The studies report a remarkably high prevalence of hepatitis delta among HIV/HBV-coinfected individuals, individuals who inject drugs, immigrants and severe HBV infected patients across Europe. The HDV infection burden still appears to be significant. In the lack of an effective HDV therapy, prevention strategies and active screening of HBV/HDV appear as the most critical interventions for reducing the burden of liver disease related to HDV infection in Europe.
Collapse
Affiliation(s)
- Aslıhan Demirel
- Department of Infectious Diseases, School of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Suleyman Uraz
- Department of Gastroenterology, School of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Zeynep Deniz
- School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Ebubekir Daglilar
- Department of Gastroenterology, West Virginia University-Charleston Area Medical Center, Charleston, West Virginia, USA
| | - Omer Basar
- Division of Gastroenterology, Summa Health System, Akron, Ohio, USA
| | - Veysel Tahan
- Division of Gastroenterology, Summa Health System, Akron, Ohio, USA
- Division of Gastroenterology, Northeast Ohio Medical University, Rootstown, Ohio, USA
| | - Resat Ozaras
- Department of Infectious Diseases, Medilife Hospital, Istanbul, Turkey
| |
Collapse
|
3
|
Razavi-Shearer D, Child H, Razavi-Shearer K, Voeller A, Razavi H, Buti M, Tacke F, Terrault N, Zeuzem S, Abbas Z, Aghemo A, Akarca U, Al Masri N, Alalwan A, Blomé MA, Jerkeman A, Aleman S, Kamal H, Alghamdi A, Alghamdi M, Alghamdi S, Al-Hamoudi W, Ali E, Aljumah A, Altraif I, Amarsanaa J, Asselah T, Baatarkhuu O, Babameto A, Ben-Ari Z, Berg T, Biondi M, Braga W, Brandão-Mello C, Brown R, Brunetto M, Cabezas J, Cardoso M, Martins A, Chan H, Cheinquer H, Chen CJ, Yang HI, Chen PJ, Chien CH, Chuang WL, Garza LC, Coco B, Coffin C, Coppola N, Cornberg M, Craxi A, Crespo J, Cuko L, De Ledinghen V, Duberg AS, Etzion O, Ferraz M, Ferreira P, Forns X, Foster G, Fung J, Gaeta G, García-Samaniego J, Genov J, Gheorghe L, Gholam P, Gish R, Glenn J, Hamid S, Hercun J, Hsu YC, Hu CC, Huang JF, Idilman R, Jafri W, Janjua N, Jelev D, Jia J, Kåberg M, Kaita K, Kao JH, Khan A, Kim D, Kondili L, Lagging M, Lampertico P, Lázaro P, Lazarus J, Lee MH, Yang HI, Lim YS, Lobato C, Macedo G, Marinho R, Marotta P, Mendes-Correa M, Méndez-Sánchez N, Navas MC, Ning Q, Örmeci N, Orrego M, Osiowy C, Pan C, Pessoa M, Piracha Z, Pop C, Qureshi H, Raimondo G, Ramji A, Ribeiro S, Ríos-Hincapié C, Rodríguez M, Rosenberg W, Roulot D, Ryder S, Saeed U, Safadi R, Shouval D, Sanai F, Sanchez-Avila J, Santantonio T, Sarrazin C, Seto WK, Seto WK, Simonova M, Tanaka J, Tergast T, Tsendsuren O, Valente C, Villalobos-Salcedo J, Waheed Y, Wong G, Wong V, Yip T, Wong V, Wu JC, Yang HI, Yu ML, Yuen MF, Yurdaydin C, Zuckerman E. Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories. J Hepatol 2024; 80:232-242. [PMID: 38030035 DOI: 10.1016/j.jhep.2023.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND & AIMS Hepatitis delta virus (HDV) is a satellite RNA virus that requires the hepatitis B virus (HBV) for assembly and propagation. Individuals infected with HDV progress to advanced liver disease faster than HBV-monoinfected individuals. Recent studies have estimated the global prevalence of anti-HDV antibodies among the HBV-infected population to be 5-15%. This study aimed to better understand HDV prevalence at the population level in 25 countries/territories. METHODS We conducted a literature review to determine the prevalence of anti-HDV and HDV RNA in hepatitis B surface antigen (HBsAg)-positive individuals in 25 countries/territories. Virtual meetings were held with experts from each setting to discuss the findings and collect unpublished data. Data were weighted for patient segments and regional heterogeneity to estimate the prevalence in the HBV-infected population. The findings were then combined with The Polaris Observatory HBV data to estimate the anti-HDV and HDV RNA prevalence in each country/territory at the population level. RESULTS After adjusting for geographical distribution, disease stage and special populations, the anti-HDV prevalence among the HBsAg+ population changed from the literature estimate in 19 countries. The highest anti-HDV prevalence was 60.1% in Mongolia. Once adjusted for the size of the HBsAg+ population and HDV RNA positivity rate, China had the highest absolute number of HDV RNA+ cases. CONCLUSIONS We found substantially lower HDV prevalence than previously reported, as prior meta-analyses primarily focused on studies conducted in groups/regions that have a higher probability of HBV infection: tertiary care centers, specific risk groups or geographical regions. There is large uncertainty in HDV prevalence estimates. The implementation of reflex testing would improve estimates, while also allowing earlier linkage to care for HDV RNA+ individuals. The logistical and economic burden of reflex testing on the health system would be limited, as only HBsAg+ cases would be screened. IMPACT AND IMPLICATIONS There is a great deal of uncertainty surrounding the prevalence of hepatitis delta virus among people living with hepatitis B virus at the population level. In this study, we aimed to better understand the burden in 25 countries and territories, to refine techniques that can be used in future analyses. We found a lower prevalence in the majority of places studied than had been previously reported. These data can help inform policy makers on the need to screen people living with hepatitis B virus to find those coinfected with hepatitis delta virus and at high risk of progression, while also highlighting the pitfalls that other researchers have often fallen into.
Collapse
|
4
|
Marrone R, Mazzi C, Ouattara H, Cammilli M, Pontillo D, Perandin F, Bisoffi Z. Screening for Neglected Tropical Diseases and other infections in African refugees and asylum seekers in Rome and Lazio region, Italy. Travel Med Infect Dis 2023; 56:102649. [PMID: 37820947 DOI: 10.1016/j.tmaid.2023.102649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Few reliable data are available on Neglected Tropical Diseases (NTDs) and other infections among African refugees and asylum seekers in Italy. We aimed to estimate the prevalence of NTDs and other infections in a large cohort of African refugees and asylum seekers living in reception centers in Lazio, Italy. MATERIAL AND METHODS This is an observational, prospective prevalence study on infectious diseases in a large population of African refugees and asylum seekers (936 overall) consecutively enrolled for screening purpose at the Infectious and Tropical diseases outpatient clinic of the National Institute of Migrant and Poverty (INMP), Rome from August 2019 to December 2020. RESULTS We found a prevalence of 8.8 % and 31 % for Strongyloides and schistosoma infection, respectively, while the prevalence of human immunodeficiency virus (HIV) infection was 0.7 %, HCV antibodies 2.5%, hepatitis B virus surface antigen 10.8 % and syphilis serological tests 2.9 %. CONCLUSION Strongyloidiasis and schistosomiasis are highly prevalent among African refugees and asylum seekers in Italy, in contrast to communicable diseases (with the exception of hepatitis B). Raising awareness of NTDs among health professionals and implementing guidelines seems to be of paramount importance to prevent these diseases and their sufferers from becoming even more "neglected".
Collapse
Affiliation(s)
- R Marrone
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - C Mazzi
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - H Ouattara
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - M Cammilli
- National Institute for Health, Migration and Poverty, 00153 Roma, Italy.
| | - D Pontillo
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - F Perandin
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| | - Z Bisoffi
- Department of Infectious -Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024 Verona, Italy.
| |
Collapse
|
5
|
Razavi HA, Buti M, Terrault NA, Zeuzem S, Yurdaydin C, Tanaka J, Aghemo A, Akarca US, Al Masri NM, Alalwan AM, Aleman S, Alghamdi AS, Alghamdi S, Al-Hamoudi WK, Aljumah AA, Altraif IH, Asselah T, Ben-Ari Z, Berg T, Biondi MJ, Blach S, Braga WSM, Brandão-Mello CE, Brunetto MR, Cabezas J, Cheinquer H, Chen PJ, Cheon ME, Chuang WL, Coffin CS, Coppola N, Craxi A, Crespo J, De Ledinghen V, Duberg AS, Etzion O, Ferraz MLG, Ferreira PRA, Forns X, Foster GR, Gaeta GB, Gamkrelidze I, García-Samaniego J, Gheorghe LS, Gholam PM, Gish RG, Glenn J, Hercun J, Hsu YC, Hu CC, Huang JF, Janjua N, Jia J, Kåberg M, Kaita KDE, Kamal H, Kao JH, Kondili LA, Lagging M, Lázaro P, Lazarus JV, Lee MH, Lim YS, Marotta PJ, Navas MC, Naveira MCM, Orrego M, Osiowy C, Pan CQ, Pessoa MG, Raimondo G, Ramji A, Razavi-Shearer DM, Razavi-Shearer K, Ríos-Hincapié CY, Rodríguez M, Rosenberg WMC, Roulot DM, Ryder SD, Safadi R, Sanai FM, Santantonio TA, Sarrazin C, Shouval D, Tacke F, Tergast TL, Villalobos-Salcedo JM, Voeller AS, Yang HI, Yu ML, Zuckerman E. Hepatitis D double reflex testing of all hepatitis B carriers in low-HBV- and high-HBV/HDV-prevalence countries. J Hepatol 2023; 79:576-580. [PMID: 37030400 DOI: 10.1016/j.jhep.2023.02.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/19/2023] [Accepted: 02/24/2023] [Indexed: 04/10/2023]
Abstract
Hepatitis D virus (HDV) infection occurs as a coinfection with hepatitis B and increases the risk of hepatocellular carcinoma, decompensated cirrhosis, and mortality compared to hepatitis B virus (HBV) monoinfection. Reliable estimates of the prevalence of HDV infection and disease burden are essential to formulate strategies to find coinfected individuals more effectively and efficiently. The global prevalence of HBV infections was estimated to be 262,240,000 in 2021. Only 1,994,000 of the HBV infections were newly diagnosed in 2021, with more than half of the new diagnoses made in China. Our initial estimates indicated a much lower prevalence of HDV antibody (anti-HDV) and HDV RNA positivity than previously reported in published studies. Accurate estimates of HDV prevalence are needed. The most effective method to generate estimates of the prevalence of anti-HDV and HDV RNA positivity and to find undiagnosed individuals at the national level is to implement double reflex testing. This requires anti-HDV testing of all hepatitis B surface antigen-positive individuals and HDV RNA testing of all anti-HDV-positive individuals. This strategy is manageable for healthcare systems since the number of newly diagnosed HBV cases is low. At the global level, a comprehensive HDV screening strategy would require only 1,994,000 HDV antibody tests and less than 89,000 HDV PCR tests. Double reflex testing is the preferred strategy in countries with a low prevalence of HBV and those with a high prevalence of both HBV and HDV. For example, in the European Union and North America only 35,000 and 22,000 cases, respectively, will require anti-HDV testing annually.
Collapse
Affiliation(s)
- Homie A Razavi
- Center for Disease Analysis Foundation, Lafayette, United States.
| | - Maria Buti
- Liver Unit, Hospital Universitari Vall d Hebron and CIBEREHD del Insituto Carlos III. Universidad Autonoma de Barcelona, Barcelona, Spain
| | - Norah A Terrault
- Keck Medicine of University of Southern California, Los Angeles, United States
| | - Stefan Zeuzem
- Department of Medicine, University Hospital, Frankfurt, Germany
| | - Cihan Yurdaydin
- Department of Gastroenterology and Hepatology, Koç University Medical School, Istanbul, Turkey
| | - Junko Tanaka
- Epidemiology, Infectious Disease Control and Prevention, Hiroshima University, Hiroshima, Japan
| | - Alessio Aghemo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Department of Gastroenterology, Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - Ulus S Akarca
- Department of Gastroenterology, Ege University, Medical School, Izmir, Turkey
| | - Nasser M Al Masri
- Department of Gastroenterology & Hepatology, Prince Sultan Medical Military City (PSMMC), Riyadh, Saudi Arabia
| | - Abduljaleel M Alalwan
- Department of Hepatobiliary Science and Liver Transplantation King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Soo Aleman
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Abdullah S Alghamdi
- Gastroenterology Unit/Medical Department, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Saad Alghamdi
- Liver & Small Bowel Health Centre Department, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | | | - Abdulrahman A Aljumah
- Department of Clinical Sciences, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Ibrahim H Altraif
- Hepatology Division - Hepatobiliary Sciences and Organ Transplant Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Tarik Asselah
- Hepatology Department, University of Paris-Cité, Hôpital Beaujon, AP-HP, INSERM UMR1149, Paris, France
| | - Ziv Ben-Ari
- Liver Diseases Center, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Thomas Berg
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Mia J Biondi
- School of Nursing, York University, Toronto, Canada
| | - Sarah Blach
- Epidemiology, Center for Disease Analysis Foundation, Lafayette, United States
| | - Wornei S M Braga
- Virology Department, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| | - Carlos E Brandão-Mello
- Internal Medicine & Gastroenterology, University of Rio de Janeiro, Rio de Janeiro, Brazil; Clinica de Doenças do Fígado, Rio de Janeiro, Brazil
| | - Maurizia R Brunetto
- Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Integrated Department of Medical Specialties, University Hospital of Pisa, Pisa, Italy
| | - Joaquin Cabezas
- Gastroenterology and Hepatology Department, Marques de Valdecilla University Hospital, Santander, Spain; Clinical and Translational Research in Digestive Diseases, IDIVAL, Santander, Spain
| | - Hugo Cheinquer
- Department of Gastroenterology and Hepatology, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Pei-Jer Chen
- Hepatitis Research Center, National Taiwan University, Taipei, Taiwan
| | - Myeong-Eun Cheon
- Division of HIV/AIDS Prevention and Control, Korea Disease Control and Prevention Agency, Osong, Republic of Korea
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Carla S Coffin
- Medicine / Microbiology and Infectious Diseases Department, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nicola Coppola
- Mental Health and Public Medicine, University of Campania, Naples, Italy
| | - Antonio Craxi
- PROMISE, School of Medicine, University of Palermo, Palermo, Italy
| | - Javier Crespo
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain; School of Medicine, University of Cantabria, Santander, Spain
| | - Victor De Ledinghen
- Service d'hepatologie et de Transplantation Hepatique, CHU, Bordeaux, France
| | - Ann-Sofi Duberg
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ohad Etzion
- Department of Gastroenterology and Liver Diseases, Soroka University Medical Center, Beersheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheva, Israel
| | | | - Paulo R A Ferreira
- Division of Infectious Disease, Federal University of Sāo Paulo, Sāo Paulo, Brazil
| | - Xavier Forns
- Liver Unit, Hospital Clínic. IDIBAPS and CIBEREHD. University of Barcelona., Barcelona, Spain
| | - Graham R Foster
- Blizard Institute, Barts Liver Centre, Queen Mary University London, London, United Kingdom
| | | | | | - Javier García-Samaniego
- Liver Unit, Hospital Universitario La Paz, CIBERehd/IdiPAZ. Universidad Autónoma de Madrid, Madrid, Spain
| | - Liliana S Gheorghe
- Department of Gastroenterology & Hepatology, Carol Davila University of Medicine & Pharmacy, Bucharest, Romania; Department of Gastroenterology & Hepatology, Fundeni Clinical Institute, Bucharest, Romania
| | - Pierre M Gholam
- Medicine, Case Western Reserve University School of Medicine, Cleveland, United States
| | | | - Jeffrey Glenn
- Medicine and Microbiology & Immunology, Stanford University, Palo Alto, United States
| | - Julian Hercun
- Liver Unit, Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Yao-Chun Hsu
- Department of Medical Research, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Ching-Chih Hu
- Gastroenterology and Hepatology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Jee-Fu Huang
- Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China, Mainland
| | - Martin Kåberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Kelly D E Kaita
- Internal Medicine, Section of Hepatology, University of Manitoba, Winnipeg, Canada
| | - Habiba Kamal
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Jia-Horng Kao
- Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Loreta A Kondili
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Martin Lagging
- Department of Infectious Diseases / Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Microbiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Pablo Lázaro
- Independent Health Services Researcher, Madrid, Spain
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Mei-Hsuan Lee
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Young-Suk Lim
- Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Paul J Marotta
- Department of Medicine, Western University, London, Canada
| | - Maria-Cristina Navas
- Grupo de Gastrohepatología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Mauricio Orrego
- Gastroenterología y Hepatología, Clínica Las Americas AUNA, Medellín, Colombia; Hepatology Department, Clinica Las Vegas Quiron, Medellin, Colombia
| | - Carla Osiowy
- Viral Hepatitis and Bloodborne Pathogens Department, National Microbiology Lab, Public Health Agency of Canada, Winnipeg, Canada
| | - Calvin Q Pan
- Division of Gastroenterology and Hepatology, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, United States
| | - Mário G Pessoa
- Division of Gastroenterology and Hepatology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Giovanni Raimondo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alnoor Ramji
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | | | | | - Cielo Y Ríos-Hincapié
- Dirección de Promoción y Prevención, Ministerio de Salud y Protección Social, Bogotá, Colombia
| | - Manuel Rodríguez
- Liver Unit. Division of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - William M C Rosenberg
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, United Kingdom
| | - Dominique M Roulot
- APHP, Hopital Avicenne, Unité d'Hépatologie, Université Sorbonne Paris Nord, Bobigny, France
| | - Stephen D Ryder
- Hepatology, NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Rifaat Safadi
- The Liver Institute, Hadassah Medical Organization, Jerusalem, Israel
| | - Faisal M Sanai
- Gastroenterology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Teresa A Santantonio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Christoph Sarrazin
- Medizinische Klinik 2, St. Josefs-Hospital, Wiesbaden, Germany; Medizinische Klinik 1, Goethe-University, Frankfurt Am Main, Germany
| | - Daniel Shouval
- The Liver Institute, Hadassah Medical Organization, Jerusalem, Israel
| | - Frank Tacke
- Department of Hepatology & Gastroenterology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tammo L Tergast
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | | | - Alexis S Voeller
- Center for Disease Analysis Foundation, Lafayette, United States
| | - Hwai-I Yang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Biomedical Translation Research Center, Academia Sinica, Taipei, Taiwan
| | - Ming-Lung Yu
- School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, Taiwan; Hepatobiliary Section, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Eli Zuckerman
- Liver Unit, Carmel Medical Center, Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| |
Collapse
|
6
|
Brancaccio G, Coco B, Nardi A, Quaranta MG, Tosti ME, Ferrigno L, Cacciola I, Messina V, Chessa L, Morisco F, Milella M, Barbaro F, Ciancio A, Russo FP, Coppola N, Blanc P, Claar E, Verucchi G, Puoti M, Zignego AL, Chemello L, Madonia S, Fagiuoli S, Marzano A, Ferrari C, Lampertico P, Di Marco V, Craxì A, Santantonio TA, Raimondo G, Brunetto MR, Gaeta GB, Kondili LA. Trends in chronic hepatitis B virus infection in Italy over a 10-year period: Clues from the nationwide PITER and MASTER cohorts toward elimination. Int J Infect Dis 2023; 129:266-273. [PMID: 36791877 DOI: 10.1016/j.ijid.2023.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVES The study measures trends in the profile of patients with chronic hepatitis B virus linked to care in Italy. METHODS A cross-sectional, multicenter, observational cohort (PITER cohort) of consecutive patients with hepatitis B surface antigen (HBsAg) over the period 2019-2021 from 46 centers was evaluated. The reference was the MASTER cohort collected over the years 2012-2015. Standard statistical methods were used. RESULTS The PITER cohort enrolled 4583 patients, of whom 21.8% were non-Italian natives. Compared with those in MASTER, the patients were older and more often female. The prevalence of hepatitis B e antigen (HBeAg) declined (7.2% vs 12.3; P <0.0001) and that of anti-hepatitis D virus (HDV) remained stable (9.3% vs 8.3%). In both cohorts, about 25% of the patients had cirrhosis, and those in the PITER cohort were older. HBeAg-positive was 5.0% vs 12.6% (P <0.0001) and anti-HDV positive 24.8% vs 17.5% (P <0.0017). In the logistic model, the variables associated with cirrhosis were anti-HDV-positive (odds ratio = 10.08; confidence interval 7.63-13.43), age, sex, and body mass index; the likelihood of cirrhosis was reduced by 40% in the PITER cohort. Among non-Italians, 12.3% were HBeAg-positive (vs 23.4% in the MASTER cohort; P <0.0001), and 12.3% were anti-HDV-positive (vs 11.1%). Overall, the adherence to the European Association for the Study of the Liver recommendations for antiviral treatment increased over time. CONCLUSION Chronic hepatitis B virus infection appears to be in the process of becoming under control in Italy; however, HDV infection is still a health concern in patients with cirrhosis and in migrants.
Collapse
Affiliation(s)
- Giuseppina Brancaccio
- Department of Molecular Medicine, Infectious Diseases Unit, University of Padua, Padua, Italy
| | - Barbara Coco
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Alessandra Nardi
- Department of Mathematics, University of Rome Tor Vergata, Rome, Italy
| | | | | | - Luigina Ferrigno
- Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Irene Cacciola
- Department of Internal Medicine, University Hospital of Messina, Messina, Italy
| | - Vincenzo Messina
- Department of Infectious Diseases, Sant'Anna Hospital, Caserta, Italy
| | - Luchino Chessa
- Liver Unit, University Hospital, Monserrato, Cagliari, Italy
| | - Filomena Morisco
- Liver and Biliary System Unit, Department of Clinical Medicine and Surgery, University of Naples, Federico II, Naples, Italy
| | - Michele Milella
- Clinic of Infectious Diseases, University of Bari, University Hospital Policlinico, Bari, Italy
| | - Francesco Barbaro
- Department of Medicine, Infectious Diseases Unit, University Hospital of Padua, Padua, Italy
| | - Alessia Ciancio
- Gastroenterology Unit, Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Francesco Paolo Russo
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, University of Padua, Padua, Italy
| | - Nicola Coppola
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pierluigi Blanc
- Infectious Disease Unit, Santa Maria Annunziata Hospital, Florence, Italy
| | | | - Gabriella Verucchi
- Clinic of Infectious Diseases and Microbiology Unit, Alma Mater Studiorum Bologna University, Bologna, Italy
| | - Massimo Puoti
- Infectious Disease Unit, Niguarda Hospital, Milan, Italy
| | - Anna Linda Zignego
- Center for Systemic Manifestations of Hepatitis Viruses, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Liliana Chemello
- Department of Medicine, Unit of Internal Medicine & Hepatology, University of Padua, Padua, Italy
| | - Salvatore Madonia
- Department of Internal Medicine, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Stefano Fagiuoli
- Gastroenterology, Department of Medicine, University of Milan Bicocca, Milan, Italy; Gastroenterology Hepatology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Carlo Ferrari
- Department of Medicine and Surgery, University of Parma, Unit of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Pietro Lampertico
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, Milan, Italy; CRC "A. M. and A. Migliavacca" Center for Liver Disease, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Vito Di Marco
- Unit of Gastroenterology and Hepatology, Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, Italy
| | - Antonio Craxì
- Gastroenterology and Hepatology Unit, PROMISE, University of Palermo, Palermo, Italy
| | | | - Giovanni Raimondo
- Department of Internal Medicine, University Hospital of Messina, Messina, Italy
| | - Maurizia R Brunetto
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | | | - Loreta A Kondili
- Center for Global Health, Istituto Superiore di Sanità, Rome, Italy; UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
| | | |
Collapse
|
7
|
Screening of Schistosomiasis, Strongyloidiasis and Sexually Transmitted Infections in Nigerian Female Sex Workers Living in Rome. Pathogens 2023; 12:pathogens12020274. [PMID: 36839546 PMCID: PMC9961054 DOI: 10.3390/pathogens12020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Female Sex Workers (FSWs) are at high risk for acquisition and transmission of sexually transmission infections (STIs). Although several studies investigated the diffusion of STIs in this population, none of them investigated the occurrence of helminth infections in FSW coming from endemic regions. This study aims to assess the prevalence of STIs and helminth infections in a cohort of FSWs. METHOD authors conducted a prevalent, observational, and descriptive study on 97 Nigerian FSWs aged 17 to 52 years from January to December 2020. RESULTS a total of 97 FSWs were recruited. Of these, only 82 had completed screening for hepatitis B, C, syphilis, and HIV, while all 97 were screened for schistosomiasis and strongyloidiasis. The prevalence of STIs among FSWs in Rome was lower than in other European countries. The overall prevalence of HIV and HBsAg were 1.2%, (1/82) and 2.4% (2/82), respectively, while no case of hepatitis C and syphilis was found. Regarding parasitological screening, the overall prevalence of schistosoma species was 4.1% (4/97) while 5.15% (5/97) were positive for strongyloidiasis. CONCLUSIONS our study shows a low prevalence of STIs in Nigerian FSWs except for Hepatitis B and a higher prevalence of schistosomiasis and strongyloidiasis. The permanent monitoring of STI and parasitic infections in sex workers coming from Africa is strongly warranted, especially for hepatitis B, schistosomiasis and strongyloidiasis, to allow a timely diagnosis and treatment, and to plan preventive strategies.
Collapse
|
8
|
Manzia TM, Trapani S, Nardi A, Ricci A, Lenci I, Milana M, Angelico R, De Feo TM, Agnes S, Andorno E, Baccarani U, Carraro A, Cescon M, Cillo U, Colledan M, De Carlis L, De Simone P, Di Benedetto F, Ettorre GM, Gruttadauria S, Lupo LG, Mazzaferro V, Romagnoli R, Rossi G, Rossi M, Spada M, Vennarecci G, Vivarelli M, Zamboni F, Tisone G, Cardillo M, Angelico M. Temporal trends of waitlistings for liver transplantation in Italy: The ECALITA (Evolution of IndiCAtion in LIver transplantation in ITAly) registry study. Dig Liver Dis 2022; 54:1664-1671. [PMID: 36096992 DOI: 10.1016/j.dld.2022.08.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/15/2022] [Accepted: 08/20/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Over the last decades relevant epidemiological changes of liver diseases have occurred, together with greatly improved treatment opportunities. AIM To investigate how the indications for elective adult liver transplantation and the underlying disease etiologies have evolved in Italy. METHODS We recruited from the National Transplant Registry a cohort comprising 17,317 adults patients waitlisted for primary liver transplantation from January-2004 to December-2020. Patients were divided into three Eras:1(2004-2011),2(2012-2014) and 3(2015-2020). RESULTS Waitlistings for cirrhosis decreased from 65.9% in Era 1 to 46.1% in Era 3, while those for HCC increased from 28.7% to 48.7%. Comparing Eras 1 and 3, waitlistings for HCV-related cirrhosis decreased from 35.9% to 12.1%, yet those for HCV-related HCC increased from 8.5% to 26.7%. Waitlistings for HBV-related cirrhosis remained almost unchanged (13.2% and 12.4%), while those for HBV-related HCC increased from 4.0% to 11.6%. ALD-related cirrhosis decreased from 16.9% to 12.9% while ALD-related HCC increased from 1.9% to 3.9%. CONCLUSIONS A sharp increase in liver transplant waitlisting for HCC and a concomitant decrease of waitlisting for cirrhosis have occurred In Italy. Despite HCV infection has noticeably decreased, still remains the primary etiology of waitlisting for HCC, while ALD and HBV represent the main causes for cirrhosis.
Collapse
Affiliation(s)
- Tommaso Maria Manzia
- Department of Surgery Science, University of Rome Tor Vergata, U.O.C. HepatoBiliary and Transplantation, Policlinico Tor Vergata, Rome, Italy
| | - Silvia Trapani
- Italian National Transplant Centre, National Institute of Health, Rome, Italy
| | - Alessandra Nardi
- Department of Mathematics, University of Rome Tor Vergata, Italy.
| | - Andrea Ricci
- Italian National Transplant Centre, National Institute of Health, Rome, Italy
| | - Ilaria Lenci
- Hepatology and Transplant Unit, Fondazione Policlinico Tor Vergata, Italy
| | - Martina Milana
- Hepatology and Transplant Unit, Fondazione Policlinico Tor Vergata, Italy
| | - Roberta Angelico
- Department of Surgery Science, University of Rome Tor Vergata, U.O.C. HepatoBiliary and Transplantation, Policlinico Tor Vergata, Rome, Italy
| | - Tullia Maria De Feo
- North Italy Transplant program (NITp), U.O.C. Coordinamento Trapianti, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Salvatore Agnes
- Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Foundation A. Gemelli Hospital, Rome, Italy
| | - Enzo Andorno
- Department of Hepatobiliarypancreatic Surgery and Liver Transplantation Unit, A.O.U. S. Martino, Genova, Italy
| | - Umberto Baccarani
- Department of Medicine, Università Degli Studi Di Udine, Udine, Italy
| | - Amedeo Carraro
- Liver Transplant Unit, Department of Surgical Science, University and Hospital Trust of Verona, Azienda Ospedaliera Verona, Verona, Italy
| | - Matteo Cescon
- Hepato-Biliary and Transplant Unit, AOU Sant'Orsola IRCCS, Department of Medical and Surgical Sciences - University of Bologna, Italy
| | - Umberto Cillo
- Hepatobiliary Surgery and Liver Transplantation Unit, University of Padova, Padova, Italy
| | - Michele Colledan
- Department of Organ Failure and Transplantation, Ospedale Papa Giovanni XXIII, Bergamo, University of Milano-Bicocca, Milano, Italy
| | - Luciano De Carlis
- Division of General Surgery & Abdominal Transplantation, ASST Grande Ospedale Metropolitano Niguarda, University of Milano-Bicocca, Milano, Italy
| | - Paolo De Simone
- Hepatobiliary Surgery and Liver Transplantation AOU Pisana, Pisa, Italy
| | - Fabrizio Di Benedetto
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit Azienda Ospedaliera Policlinico, University of Modena and Reggio Emilia Modena, Italy
| | - Giuseppe Maria Ettorre
- Division of General Surgery and Liver Transplantation, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Salvatore Gruttadauria
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneoper i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center), Palermo, Italy; Department of Surgery and Medical and Surgical Specialties, University of Catania, Catania, Italy
| | - Luigi Giovanni Lupo
- General Surgery and Liver transplantation Unit, University of Bari, Bari, Italy
| | - Vincenzo Mazzaferro
- HPB Surgery and Liver Transplantation Unit, Department of Oncology University of Milan and Department of Surgery, Fondazione IRCCS, Istituto Nazionale Tumori, IRCCS Milan, Italy
| | - Renato Romagnoli
- Liver Transplant Center, General Surgery 2U, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giorgio Rossi
- Division of General Surgery and Liver Transplantation, Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
| | - Massimo Rossi
- General Surgery and Organ Transplantation, Sapienza University of Rome, Umberto I Polyclinic of Rome, Rome, Italy
| | - Marco Spada
- Department of Specialized Surgery, Division of Hepatobiliopancreatic Surgery and of Liver and Kidney Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Vennarecci
- Unit of Hepatobiliary Surgery and Liver Transplant Center, Department of Gastroenterology and Transplantation, "A. Cardarelli" Hospital, Naples, Italy
| | - Marco Vivarelli
- Hepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Aou Ospedali Riuniti, Ancona, Italy
| | - Fausto Zamboni
- Department of Surgery, General and Hepatic Transplantation Surgery Unit, A.O.B. Brotzu, Cagliari, Italy
| | - Giuseppe Tisone
- Department of Surgery Science, University of Rome Tor Vergata, U.O.C. HepatoBiliary and Transplantation, Policlinico Tor Vergata, Rome, Italy
| | - Massimo Cardillo
- Italian National Transplant Centre, National Institute of Health, Rome, Italy
| | - Mario Angelico
- Hepatology and Transplant Unit, Fondazione Policlinico Tor Vergata, Italy
| |
Collapse
|
9
|
Ricco G, Coco B, Colombatto P, Oliveri F, Cavallone D, Bleve P, Vianello B, Romagnoli V, Salvati A, Surace L, Bonino F, Brunetto MR. Highly dynamic changes of regional HBV epidemiology over two decades. Dig Liver Dis 2022; 55:519-526. [PMID: 36404234 DOI: 10.1016/j.dld.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIM HBV epidemiology is highly heterogeneous and rapidly evolving worldwide: we studied its last two-decades dynamics in a large single center cohort. METHODS In all consecutive HBsAg-positive subjects firstly admitted (2000-2019) at the Pisa-University-Hospital Hepatology-Referral-Center, demographic, virologic and clinical variables were analyzed by admission decade (2000-2009 vs 2010-2019) and origin (Italian vs non-Italian natives). RESULTS Of 2003, 1878 (93.7%) subjects were eligible: 1798(95.7%) with HBV-chronic [126(7%) HDV, 72(4%) HCV, 11(0.6%) HIV co-infected] and 80(4.3%) HBV-primary infections (93.7% Italians). Among 1589(88.4%) mono-infected, 496(31.2%) were immigrants, younger than Italians [34.0(5.1-77.1)-52.5(10.0-87.2) years], with female prevalence [204/496(41.1%)-340/1093(31.1%); p<0.001] increasing overtime (14.6-45.0%; p<0.001). Italians aged across decades [50.3(11.1-87.2)-56.2(10.0-86.7) years; p<0.001], HBeAg-positivity remained stable (12.3-14.5%) and acute hepatitis increased (4.0-8.0%; p = 0.003). CHB declined [439/721(60.9%)-320/868(36.9%); p<0.001] whereas HBeAg-negative infection increased [277/626(44.2%)-538/755(71.3%); p<0.001]. Cirrhosis declined [195/721(27.0%)-125/868(14.4%); p<0.001], except in anti-HDV-patients [93/126(73.8%); 42(45.1%) non-Italians], younger than HBV-mono-infected (47.4-57.6 years; p<0.001). CONCLUSION Effective preventive health care policies and immigration flows account for increasing prevalence of HBeAg-negative infection across the last two decades. Antiviral therapy mitigated disease progression in aging Italian CHB but not in CHD patients, mainly young immigrants, emphasizing the unmet need of effective CHD therapies; HBeAg-positive CHB and acute hepatitis B persist in non-vaccinated Italian adults, prompting vaccination in the elderly with risky behaviors.
Collapse
Affiliation(s)
- Gabriele Ricco
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Barbara Coco
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Piero Colombatto
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Filippo Oliveri
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Daniela Cavallone
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Patrizia Bleve
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Barbara Vianello
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Veronica Romagnoli
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Antonio Salvati
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Lidia Surace
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Ferruccio Bonino
- Institute of Biostructure and Bioimaging, National Research Council, Via De Amicis 95, 80145 Naples, Italy
| | - Maurizia Rossana Brunetto
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy; Institute of Biostructure and Bioimaging, National Research Council, Via De Amicis 95, 80145 Naples, Italy.
| |
Collapse
|
10
|
Jachs M, Binter T, Schmidbauer C, Hartl L, Strasser M, Laferl H, Hametner‐Schreil S, Lindorfer A, Dax K, Stauber RE, Kessler HH, Bernhofer S, Maieron A, Loacker L, Bota S, Santonja I, Munda P, Mandorfer M, Peck‐Radosavljevic M, Holzmann H, Gschwantler M, Zoller H, Ferenci P, Reiberger T. Hepatitis D virus (HDV) prevalence in Austria is low but causes considerable morbidity due to fast progression to cirrhosis. United European Gastroenterol J 2021; 9:1119-1127. [PMID: 34873866 PMCID: PMC8672089 DOI: 10.1002/ueg2.12163] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/19/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hepatitis D virus (HDV) coinfection aggravates the course of hepatitis B virus (HBV). The prevalence of HDV in Austria is unknown. OBJECTIVE This national study aimed at (i) recording the prevalence of HDV-infection in Austria and (ii) characterizing the "active" HDV cohort in Austria. METHODS A total of 10 hepatitis treatment centers in Austria participated in this multicenter study and retrospectively collected their HDV patients between Q1/2010 and Q4/2020. Positive anti-HDV and/or HDV-RNA-polymerase chain reaction (PCR) results were retrieved from local database queries. Disease severity was assessed by individual chart review. Viremic HDV patients with clinical visits in/after Q1/2019 were considered as the "active" HDV cohort. RESULTS A total of 347 anti-HDV positive patients were identified. In 202 (58.2%) patients, HDV-RNA-PCR test was performed, and 126/202 (62.4%) had confirmed viremia. Hepatocellular carcinoma was diagnosed in 7 (5.6%) patients, 7 (5.6%) patients underwent liver transplantation, and 11 (8.7%) patients died during follow-up. The "active" Austrian HDV cohort included 74 (58.7%) patients: Evidence for advanced chronic liver disease (ACLD, i.e., histological F3/F4 fibrosis, liver stiffness ≥10 kPa, varices, or hepatic venous pressure gradient ≥6 mmHg) was detected in 38 (51.4%) patients, including 2 (5.3%) with decompensation (ascites/hepatic encephalopathy). About 37 (50.0%) patients of the "active" HDV cohort had previously received interferon treatment. Treatment with the sodium-taurocholate cotransporting polypeptide inhibitor bulevirtide was initiated in 20 (27.0%) patients. CONCLUSION The number of confirmed HDV viremic cases in Austria is low (<1% of HBV patients) but potentially underestimated. Testing all HBV patients will increase the diagnostic yield. More than half of viremic HDV patients had ACLD. Improved HDV testing and workup strategies will facilitate access to novel antiviral therapies.
Collapse
Affiliation(s)
- Mathias Jachs
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
- HIV and Liver Disease Study GroupMedical University of ViennaViennaAustria
| | - Teresa Binter
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
- HIV and Liver Disease Study GroupMedical University of ViennaViennaAustria
| | - Caroline Schmidbauer
- HIV and Liver Disease Study GroupMedical University of ViennaViennaAustria
- Division of Gastroenterology and HepatologyDepartment of Medicine IIKlinik OttakringViennaAustria
| | - Lukas Hartl
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
- HIV and Liver Disease Study GroupMedical University of ViennaViennaAustria
| | - Michael Strasser
- First Department of MedicineParacelsus Medical UniversitySalzburgAustria
| | - Hermann Laferl
- Department of Infectious Diseases and Tropical MedicineKlinik FavoritenViennaAustria
| | | | - Alexander Lindorfer
- Department of Gastroenterology and HepatologyOrdensklinikum Linz Barmherzige SchwesternLinzAustria
| | - Kristina Dax
- Department of Internal Medicine and Gastroenterology and HepatologyKepler UniversitätsklinikumLinzAustria
| | - Rudolf E. Stauber
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineMedical University of GrazGrazAustria
| | - Harald H. Kessler
- Institute for Hygiene, Microbiology and Environmental MedicineMedical University of GrazGrazAustria
| | - Sebastian Bernhofer
- Department of Internal Medicine IIUniversity Hospital St. PöltenSt. PöltenAustria
| | - Andreas Maieron
- Department of Internal Medicine IIUniversity Hospital St. PöltenSt. PöltenAustria
| | - Lorin Loacker
- Central Institute for Medical and Chemical Laboratory DiagnosticsMedical University of InnsbruckInnsbruckAustria
| | - Simona Bota
- Department of Internal Medicine and Gastroenterology, Hepatology, Endocrinology, Rheumatology and NephrologyKlinikum Klagenfurt am WörtherseeKlagenfurtAustria
| | - Isabel Santonja
- Center for VirologyMedical University of ViennaViennaAustria
| | - Petra Munda
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Mattias Mandorfer
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
- HIV and Liver Disease Study GroupMedical University of ViennaViennaAustria
| | - Markus Peck‐Radosavljevic
- Department of Internal Medicine and Gastroenterology, Hepatology, Endocrinology, Rheumatology and NephrologyKlinikum Klagenfurt am WörtherseeKlagenfurtAustria
| | | | - Michael Gschwantler
- HIV and Liver Disease Study GroupMedical University of ViennaViennaAustria
- Division of Gastroenterology and HepatologyDepartment of Medicine IIKlinik OttakringViennaAustria
| | - Heinz Zoller
- Department of Internal Medicine IMedical University of InnsbruckInnsbruckAustria
| | - Peter Ferenci
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Thomas Reiberger
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
- HIV and Liver Disease Study GroupMedical University of ViennaViennaAustria
| |
Collapse
|
11
|
Rizzetto M, Hamid S, Negro F. The changing context of hepatitis D. J Hepatol 2021; 74:1200-1211. [PMID: 33484770 DOI: 10.1016/j.jhep.2021.01.014] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 12/18/2022]
Abstract
The global epidemiology of hepatitis D is changing with the widespread implementation of vaccination against hepatitis B. In high-income countries that achieved optimal control of HBV, the epidemiology of hepatitis D is dual, consisting of an ageing cohort of domestic patients with advanced liver fibrosis who represent the end stage of the natural history of HDV, and of a younger generation of immigrants from endemic countries who account for the majority of new infections. As observed in Europe in the 1980s, the distinctive clinical characteristic of chronic hepatitis D in endemic countries is the accelerated progression to cirrhosis and hepatocellular carcinoma. Despite some recent progress, the therapeutic management of HDV remains unsatisfactory, as most patients are not cured of HDV with currently available medicines. This review article describes the current epidemiology and clinical features of chronic hepatitis D, based on the literature published in the last 10 years.
Collapse
Affiliation(s)
- Mario Rizzetto
- Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Saeed Hamid
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Franco Negro
- Division of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland; Division of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
12
|
Vieira Barbosa J, Sahli R, Aubert V, Chaouch A, Moradpour D, Fraga M. Demographics and outcomes of hepatitis B and D: A 10-year retrospective analysis in a Swiss tertiary referral center. PLoS One 2021; 16:e0250347. [PMID: 33905426 PMCID: PMC8078781 DOI: 10.1371/journal.pone.0250347] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 04/05/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) is a major global health challenge with approximately 250-350 million chronically infected individuals. An improved understanding of the demographic features and outcomes of chronic HBV infection and hepatitis D virus (HDV) infection in low-endemic areas may improve prevention, early identification and management both at individual and community levels. Here, we retrospectively analyzed the demographic and clinical characteristics, treatment rates and outcomes of adult patients with chronic HBV infection with or without HDV coinfection examined at Lausanne University Hospital, Switzerland over a 10-year period. METHODS We analyzed the medical records of all adult patients with chronic HBV and HDV infection examined in our center between 2007 and 2016. Liver-related outcome was defined as the occurrence of cirrhosis, hepatocellular carcinoma, liver transplantation or liver-related death. Analyses were performed using logistic regression and results were reported as odds ratio (OR) and 95% confidence interval (CI). RESULTS Of 672 consecutive patients, 421 (62.6%) were male, median age was 36 years (interquartile range, 28-46 years), and 233 (34.7%) were of African origin. The prevalence of HDV coinfection was 7.1% and the proportion of anti-HDV-positive patients with detectable HDV RNA was 70.0%. In multivariate analysis, HDV coinfection was the strongest predictor for liver-related outcome (OR 6.06, 95% CI 2.93-12.54, p<0.001), followed by HBeAg positivity (OR 2.47, 95% CI 1.30-4.69, p = 0.006), age (OR per 10-year increase 2.03, 95% CI 1.63-2.52, p<0.001) and sex (OR for female 0.39, 95% CI 0.22-0.71, p = 0.002). The predictive accuracy of the multivariate model was high (receiver operator characteristic area under the curve 0.81). CONCLUSION This retrospective study underscores the importance of migration in the epidemiology of chronic hepatitis B in low-endemic areas. HDV coinfection, HBeAg positivity and age predicted liver-related outcomes while female sex had a protective effect.
Collapse
Affiliation(s)
- Joana Vieira Barbosa
- Division of Gastroenterology and Hepatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Roland Sahli
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vincent Aubert
- Division of Immunology and Allergy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Aziz Chaouch
- Division of Biostatistics, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Darius Moradpour
- Division of Gastroenterology and Hepatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Montserrat Fraga
- Division of Gastroenterology and Hepatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- * E-mail:
| |
Collapse
|
13
|
González R, Barea L, Arruga A, Richart A, Soriano V. Overt and occult hepatitis B among immigrants and native blood donors in Madrid, Spain. Ther Adv Infect Dis 2021; 7:2049936120982122. [PMID: 33489121 PMCID: PMC7768837 DOI: 10.1177/2049936120982122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/20/2020] [Indexed: 12/20/2022] Open
Abstract
Background: The risk of transfusion-transmitted viral infections is very low in developed countries. Recent massive migration flows from highly hepatitis B virus (HBV), hepatitis C virus (HCV) and/or HIV endemic regions to Europe may have changed this scenario. Methods: During 2017 and 2018, a total of 491,753 blood donations (291,762 donors) were evaluated at the Madrid Regional Transfusion Center. All were tested for hepatitis B surface antigen (HBsAg), anti-HCV and anti-HIV, as well as for HBV-DNA, HCV-RNA and HIV-RNA. Results: Overall, 35 donors were positive for HIV-RNA and 26 for HCV-RNA. HBV markers were found in 111 (0.022%) donors, split out into three categories: HBsAg+ (n = 93; 0.019%), occult B infection (OBI) (n = 17; 0.003%), and acute HBV window period (n = 1; 0.0002%). All 17 OBI donors were positive for anti-HBc and confirmed as viremic in repeated testing. Viral load amounts were uniformly below 100 IU/mL. Ten OBI donors were repeated donors and look-back studies could be completed for eight of them. Fortunately, none of all prior recipients experienced transfusion transmitted hepatitis B. Compared with HBsAg+ donors, OBI donors were more frequently native Spaniards (76% versus 40%) and older (median age 52 versus 42 years old). Conclusion: Active HBV infection is currently found in 0.022% of blood donations (0.038% of donors) in Madrid. This rate is 3-fold greater than for HIV and/or HCV. On the other hand, HBsAg+ donors are 3-fold more frequent than OBI donors and more often immigrants than native Spaniards. No transfusion-transmitted HBV infections were identified during the study period, including retrospective checking of former recipients of OBI donors.
Collapse
Affiliation(s)
| | | | - Ana Arruga
- Regional Transfusion Center, Madrid, Spain
| | | | - Vicente Soriano
- UNIR Health Sciences School & Medical Center, Calle Almansa 101, Madrid 28040, Spain
| |
Collapse
|
14
|
Brancaccio G, Vitale A, Signoriello G, Gaeta GB, Cillo U. Changing indications for liver transplant: slow decline of hepatitis viruses in Italy. Infect Dis (Lond) 2020; 52:557-562. [PMID: 32401092 DOI: 10.1080/23744235.2020.1763453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: The indications to LT are changing rapidly in Europe and the U.S. mainly due to the extensive use of direct-acting antiviral agents (DAA) against HCV. Italy was an endemic area for viral hepatitis.Methods: The study reviewed liver transplant registry of a leading Italian centre from the year 2014 (the year before the extensive use of DAA in Italy) to December 2018, with the scope of recording trends in indications. The indications were categorised as: HCV; HBV ± HDV; alcohol-dependent liver disease (ALD); NASH; mescellaneous. Transplants for decompensation or hepatocellular carcinoma were analysed separately. The data were analysed using standard statistical methods.Results: During the study period 463 LTs were accomplished. For the scope of the present study second transplants and transplant in patients <18 years were eliminated; in all, 397 patients were analysed. Overall, HCV infection was the main aetiological factor leading to transplant (139/397, 35%) followed by alcohol use (20.9%), HBV ± HDV (15.8%) and NASH (12.8%). In the decompensation group HCV decreased from 41.9% in 2014 to 14.3% in 2018 while alcohol increased (p < .001); in the HCC group, HCV decreased from 52.6% to 34% and alcohol and NASH increased; the number and proportion of HBV infections remained stable over time, with a 56% prevalence of HDV among decompensated patients.Conclusion: LT landscape is rapidly evolving; hepatitis virus infections still maintain a remarkable proportion among the indications for LT in an area that reached in the past high endemic levels for hepatitis C and B.
Collapse
Affiliation(s)
| | - Alessandro Vitale
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
| | - Giuseppe Signoriello
- Biostatistics, Department of Mental and Physical Health and Preventive Medicine, Campania University L. Vanvitelli, Naples, Italy
| | - Giovanni B Gaeta
- Infectious Diseases, Department of Mental and Physical Health and Preventive Medicine, Campania University L. Vanvitelli, Naples, Italy
| | - Umberto Cillo
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
| |
Collapse
|
15
|
Brancaccio G, Gaeta GB. Letter: clinical outcomes of patients with hepatitis D infection in the liver transplant setting-authors' reply. Aliment Pharmacol Ther 2020; 51:484. [PMID: 31990394 DOI: 10.1111/apt.15625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Giuseppina Brancaccio
- Department of Molecular Medicine, University of Padua, Padua, Italy.,Department of Mental and Physical Health and Preventive Medicine, University L. Vanvitelli, Naples, Italy
| | - Giovanni B Gaeta
- Department of Mental and Physical Health and Preventive Medicine, University L. Vanvitelli, Naples, Italy
| |
Collapse
|
16
|
Brancaccio G, Gaeta GB. Treatment of chronic hepatitis due to hepatitis B and hepatitis delta virus coinfection. Int J Antimicrob Agents 2019; 54:697-701. [PMID: 31541699 DOI: 10.1016/j.ijantimicag.2019.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/07/2019] [Accepted: 09/15/2019] [Indexed: 02/07/2023]
Abstract
An estimated 20-40 million individuals worldwide are infected with hepatitis delta virus (HDV), mostly with rapidly evolving liver disease. Therapy of chronic HDV infection remains an unmet need. To date, only interferon (IFN)-based therapy is recommended for HDV infection and response rates are unsatisfactory; in addition, many patients are intolerant to or ineligible for IFN treatment. In recent years, innovative approaches have been in development, including the following: targeting virus entry into hepatocytes; inhibition of the host enzyme farnesyltransferase by prenylation inhibitors, leading to inhibition of complete virion formation and release; blockade of hepatitis B surface antigen (HBsAg) secretion, inhibiting virus release; and IFN-lambda, which causes fewer adverse effects than IFN-alfa. Clinical trials are ongoing with encouraging preliminary results.
Collapse
Affiliation(s)
- Giuseppina Brancaccio
- Infectious Diseases, Department of Molecular Medicine, University of Padua, Padua, Italy
| | - Giovanni B Gaeta
- Infectious Diseases, Department of Mental and Physical Health, Campania University, Naples, Italy.
| |
Collapse
|