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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.
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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
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Gan X, Li X, Cai Y, Yin B, Pan Q, Teng T, He Y, Tang H, Wang T, Li J, Zhu Z, Zhou X, Li J. Metabolic features of adolescent major depressive disorder: A comparative study between treatment-resistant depression and first-episode drug-naive depression. Psychoneuroendocrinology 2024; 167:107086. [PMID: 38824765 DOI: 10.1016/j.psyneuen.2024.107086] [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: 03/03/2024] [Revised: 04/12/2024] [Accepted: 05/21/2024] [Indexed: 06/04/2024]
Abstract
Major depressive disorder (MDD) is a psychiatric illness that can jeopardize the normal growth and development of adolescents. Approximately 40% of adolescent patients with MDD exhibit resistance to conventional antidepressants, leading to the development of Treatment-Resistant Depression (TRD). TRD is associated with severe impairments in social functioning and learning ability and an elevated risk of suicide, thereby imposing an additional societal burden. In this study, we conducted plasma metabolomic analysis on 53 adolescents diagnosed with first-episode drug-naïve MDD (FEDN-MDD), 53 adolescents with TRD, and 56 healthy controls (HCs) using hydrophilic interaction liquid chromatography-mass spectrometry (HILIC-MS) and reversed-phase liquid chromatography-mass spectrometry (RPLC-MS). We established a diagnostic model by identifying differentially expressed metabolites and applying cluster analysis, metabolic pathway analysis, and multivariate linear support vector machine (SVM) algorithms. Our findings suggest that adolescent TRD shares similarities with FEDN-MDD in five amino acid metabolic pathways and exhibits distinct metabolic characteristics, particularly tyrosine and glycerophospholipid metabolism. Furthermore, through multivariate receiver operating characteristic (ROC) analysis, we optimized the area under the curve (AUC) and achieved the highest predictive accuracy, obtaining an AUC of 0.903 when comparing FEDN-MDD patients with HCs and an AUC of 0.968 when comparing TRD patients with HCs. This study provides new evidence for the identification of adolescent TRD and sheds light on different pathophysiologies by delineating the distinct plasma metabolic profiles of adolescent TRD and FEDN-MDD.
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Affiliation(s)
- Xieyu Gan
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuping Cai
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai, China
| | - Bangmin Yin
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiyuan Pan
- The First People's Hospital of Zaoyang City, Hubei, China
| | - Teng Teng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuqian He
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Han Tang
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Wang
- Department of Psychology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhengjiang Zhu
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai, China; Shanghai Key Laboratory of Aging Studies, Shanghai, China.
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Jinfang Li
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Caviglia GP, Casalone E, Olivero A, Birolo G, Ciancio A, Matullo G, Rizzetto M. MiRNome Profiling of Circulating Extracellular Vesicles in Patients With Chronic Hepatitis D Undergoing Pegylated Interferon Alpha Treatment. J Viral Hepat 2024. [PMID: 39129189 DOI: 10.1111/jvh.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 07/24/2024] [Accepted: 07/31/2024] [Indexed: 08/13/2024]
Abstract
Micro-RNAs (miRNAs) are involved in the modulation of viral replication and host immune antiviral response. Using next-generation sequencing, we investigated the miRNome profile of circulating extracellular vesicles in 20 patients with chronic hepatitis D virus (HDV) infection undergoing pegylated interferon alpha (Peg-IFNα) treatment. Circulating miRNAs' expression was analysed according to virologic response (i.e., HDV RNA clearance maintained at least 6 months after the end of therapy). Overall, 8 patients (40%) achieved a virologic response to Peg-IFNα treatment. At baseline, 14 miRNAs were differentially expressed between responders and non-responders; after 6 months of Peg-IFNα treatment, 7 miRNAs (miR-155-5p, miR-1246, miR-423-3p, miR-760, miR-744-5p, miR-1307-3p and miR-146a-5p) were consistently de-regulated. Among de-regulated miRNAs, miR-155-5p showed an inverse correlation with HDV RNA (at baseline: rs = -0.39, p = 0.092; at 6 months: rs = -0.53, p = 0.016) and hepatitis B surface antigen (HBsAg) (at baseline: rs = -0.49, p = 0.028; at 6 months: rs-0.71, p < 0.001). At logistic regression analysis, both miR-155-5p (at baseline: OR = 4.52, p = 0.022; at 6 months: OR = 5.30, p = 0.029) and HDV RNA (at baseline: OR = 0.19, p = 0.022; at 6 months: OR = 0.38, p = 0.018) resulted significantly associated to virologic response. Considering that Peg-IFNα still has a relevant role in the treatment of patients with chronic hepatitis D infection, the assessment of EV miR-155-5p may represent an additional valuable tool for the management of HDV patients undergoing Peg-IFNα treatment.
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Affiliation(s)
- Gian Paolo Caviglia
- Liver Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Elisabetta Casalone
- Medical Genetics Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Antonella Olivero
- Liver Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- A.O.U. Città della Salute e della Scienza, Molinette Hospital, Turin, Italy
| | - Giovanni Birolo
- Medical Genetics Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Alessia Ciancio
- Liver Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- A.O.U. Città della Salute e della Scienza, Molinette Hospital, Turin, Italy
| | - Giuseppe Matullo
- Medical Genetics Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- A.O.U. Città della Salute e della Scienza, Molinette Hospital, Turin, Italy
| | - Mario Rizzetto
- Liver Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- A.O.U. Città della Salute e della Scienza, Molinette Hospital, Turin, Italy
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4
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Giannini EG, Pasta A, Pieri G, Plaz Torres MC, Marseglia M, Pelizzaro F, Sangiovanni A, Cabibbo G, Ghittoni G, Di Marco M, Foschi FG, Guarino M, Biasini E, Saitta C, Campani C, Svegliati-Baroni G, Gasbarrini A, Brunetto MR, Magalotti D, Azzaroli F, Mega A, Sacco R, Nardone G, Sacerdoti D, Masotto A, Vidili G, Bucci L, Vitale A, Trevisani F. Characteristics and outcome of anti-hepatitis D virus positive patients with hepatocellular carcinoma. Liver Int 2024; 44:1588-1599. [PMID: 38426262 DOI: 10.1111/liv.15855] [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: 12/06/2023] [Revised: 12/20/2023] [Accepted: 01/07/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND & AIMS Chronic hepatitis D virus (HDV) often leads to end-stage liver disease and hepatocellular carcinoma (HCC). Comprehensive data pertaining to large populations with HDV and HCC are missing, therefore we sought to assess the characteristics, management, and outcome of these patients, comparing them to patients with hepatitis B virus (HBV) infection. METHODS We analysed the Italian Liver Cancer database focusing on patients with positivity for HBV surface antigen and anti-HDV antibodies (HBV/HDV, n = 107) and patients with HBV infection alone (n = 588). Clinical and oncological characteristics, treatment, and survival were compared in the two groups. RESULTS Patients with HBV/HDV had worse liver function [Model for End-stage Liver Disease score: 11 vs. 9, p < .0001; Child-Turcotte-Pugh score: 7 vs. 5, p < .0001] than patients with HBV. HCC was more frequently diagnosed during surveillance (72.9% vs. 52.4%, p = .0002), and the oncological stage was more frequently Milan-in (67.3% vs. 52.7%, p = .005) in patients with HBV/HDV. Liver transplantation was more frequently performed in HBV/HDV than in HBV patients (36.4% vs. 9.5%), while the opposite was observed for resection (8.4% vs. 20.1%, p < .0001), and in a competing risk analysis, HBV/HDV patients had a higher probability of receiving transplantation, independently of liver function and oncological stage. A trend towards longer survival was observed in patients with HBV/HDV (50.4 vs. 44.4 months, p = .106). CONCLUSIONS In patients with HBV/HDV, HCC is diagnosed more frequently during surveillance, resulting in a less advanced cancer stage in patients with more deranged liver function than HBV alone. Patients with HBV/HDV have a heightened benefit from liver transplantation, positively influencing survival.
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Affiliation(s)
- Edoardo G Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Pasta
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Pieri
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Corina Plaz Torres
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mariarosaria Marseglia
- Division of Internal Medicine, Hepatobiliary Diseases and Immunoallergology, University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Filippo Pelizzaro
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, University of Padua, Padua, Italy
| | - Angelo Sangiovanni
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale maggiore Policlinico and C.R.C. "A.M. & A. Migliavacca Center for Liver Disease", Milan, Italy
| | - Giuseppe Cabibbo
- Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Italy
| | | | | | | | - Maria Guarino
- Department of Clinical Medicine and Surgery, Diseases of the Liver and Biliary System Unit, University of Naples "Federico II", Naples, Italy
| | - Elisabetta Biasini
- Infectious Diseases and Hepatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Carlo Saitta
- Department of Clinical and Experimental Medicine, Clinical and Molecular Hepatology Unit, University of Messina, Messina, Italy
| | - Claudia Campani
- Department of Experimental and Clinical Medicine, Internal Medicine and Hepatology Unit, University of Florence, Florence, Italy
| | | | - Antonio Gasbarrini
- Liver Unit, CEMAD - Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | - Maurizia Rossana Brunetto
- Department of Clinical and Experimental Medicine, Hepatology and Liver Physiopathology Laboratory, University Hospital of Pisa, Pisa, Italy
| | - Donatella Magalotti
- Division of Internal Medicine, Neurovascular and Hepatometabolic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Azzaroli
- Gastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Mega
- Gastroenterology Unit, Bolzano Regional Hospital, Bolzano, Italy
| | - Rodolfo Sacco
- Gastroenterology and Digestive Endoscopy Unit, Foggia University Hospital, Foggia, Italy
| | - Gerardo Nardone
- Department of Clinical Medicine and Surgery, Hepato-Gastroenterology Unit, University of Naples "Federico II", Naples, Italy
| | - David Sacerdoti
- Liver Unit, Department of Medicine, University of Verona, Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Alberto Masotto
- Gastroenterology Unit, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Gianpaolo Vidili
- Department of Medical, Surgical and Experimental Sciences, Clinica Medica Unit, University of Sassari, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Laura Bucci
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Unit of Semeiotics, Liver and Alcohol-related Diseases, University of Bologna, Bologna, Italy
| | - Alessandro Vitale
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Franco Trevisani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Unit of Semeiotics, Liver and Alcohol-related Diseases, University of Bologna, Bologna, Italy
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5
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Crobu MG, Ravanini P, Impaloni C, Martello C, Bargiacchi O, Di Domenico C, Faolotto G, Macaluso P, Mercandino A, Riggi M, Quaglia V, Andreoni S, Pirisi M, Smirne C. Hepatitis C Virus as a Possible Helper Virus in Human Hepatitis Delta Virus Infection. Viruses 2024; 16:992. [PMID: 38932284 PMCID: PMC11209499 DOI: 10.3390/v16060992] [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: 05/16/2024] [Revised: 06/13/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Previous studies reported that the hepatitis C virus (HCV) could help disseminate the hepatitis D virus (HDV) in vivo through the unrelated hepatitis B virus (HBV), but with essentially inconclusive results. To try to shed light on this still-debated topic, 146 anti-HCV-positive subjects (of whom 91 HCV/HIV co-infected, and 43 with prior HCV eradication) were screened for anti-HDV antibodies (anti-HD), after careful selection for negativity to any serologic or virologic marker of current or past HBV infection. One single HCV/HIV co-infected patient (0.7%) tested highly positive for anti-HD, but with no positive HDV-RNA. Her husband, in turn, was a HCV/HIV co-infected subject with a previous contact with HBV. While conducting a thorough review of the relevant literature, the authors attempted to exhaustively describe the medical history of both the anti-HD-positive patient and her partner, believing it to be the key to dissecting the possible complex mechanisms of HDV transmission from one subject to another, and speculating that in the present case, it may have been HCV itself that behaved as an HDV helper virus. In conclusion, this preliminary research, while needing further validation in large prospective studies, provided some further evidence of a role of HCV in HDV dissemination in humans.
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Affiliation(s)
- Maria Grazia Crobu
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Paolo Ravanini
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Clotilde Impaloni
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Claudia Martello
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Olivia Bargiacchi
- Unit of Infectious Diseases, Maggiore della Carità Hospital, 28100 Novara, Italy;
| | - Christian Di Domenico
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Giulia Faolotto
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Paola Macaluso
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Alessio Mercandino
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Miriam Riggi
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Vittorio Quaglia
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Stefano Andreoni
- Laboratory of Molecular Virology, Maggiore della Carità Hospital, 28100 Novara, Italy; (M.G.C.); (P.R.); (C.I.); (C.M.); (C.D.D.); (G.F.); (P.M.); (A.M.); (M.R.); (V.Q.); (S.A.)
| | - Mario Pirisi
- Internal Medicine Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Carlo Smirne
- Internal Medicine Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy;
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Buti M, Gonzalez A, Riveiro-Barciela M, Bourliere M. Management of chronic HBV-HDV patients chronic HBV-HDV infection: A review on new management options. United European Gastroenterol J 2024; 12:210-218. [PMID: 38041549 PMCID: PMC10954430 DOI: 10.1002/ueg2.12494] [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: 07/21/2023] [Accepted: 09/01/2023] [Indexed: 12/03/2023] Open
Abstract
Hepatitis D virus was first described by Mario Rizzeto in 1977, and it is considered chronic viral hepatitis with the poorest prognosis. Despite its discovery almost 50 years ago, progress in its diagnosis and treatment has been scarce until recent years. The approval of bulevirtide has shed some light for patients with Chronic Hepatitis D, although important gaps regarding its use in therapy as well as about the epidemiology and diagnosis of the disease need to be addressed.
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Affiliation(s)
- María Buti
- Liver Unit, Internal Medicine Department, Hospital Universitari Valld'Hebron, Valld'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBERehd, Instituto Carlos III, Barcelona, Spain
| | | | - Mar Riveiro-Barciela
- Liver Unit, Internal Medicine Department, Hospital Universitari Valld'Hebron, Valld'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBERehd, Instituto Carlos III, Barcelona, Spain
| | - Marc Bourliere
- Liver Unit, Saint Joseph Hopital, Marseille, France
- Aix Marseille University, Inserm, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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7
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Cossiga V, Brusa S, Montalti R, De Conte A, Jannuzzi G, Ranieri L, Sorrentino R, Vallefuoco L, Pignata L, Guarino M, Portella G, Morisco F. Anti-HDV reflex testing in HBsAg-positive subjects: An efficacious strategy to identify HDV infection. Liver Int 2024; 44:148-154. [PMID: 37789576 DOI: 10.1111/liv.15746] [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: 03/17/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND AIMS The prevalence of HDV infection in HBsAg carriers is about 9.9% in Italy. However, the real prevalence is underestimated because the anti-HDV test is not performed routinely in all HBsAg carriers. The aim of this study was to compare the prevalence and the absolute number of HDV infection identified in HBsAg-positive subjects tested at University Hospital Federico II before and after the introduction of anti-HDV reflex testing. METHODS From January to December 2022, reflex test for the detection of total HDV antibodies was performed in all HBsAg-positive subjects tested at University Hospital Federico II. The control group consisted of all the HBsAg-positive subjects tested at the same laboratory in 2019, before the implementation of anti-HDV reflex testing. Sera were evaluated with ADVIA Centaur HBsAgII Qualitative, Liaison Murex HBsAg Quantitative and Liaison Murex Total Anti-HDV Qualitative. RESULTS Before reflex testing, anti-HDV had been tested in 16.4% (84/512) of HBsAg-positive subjects, while after its implementation, 100% (484/484) of HBsAg-positive patients was tested for anti-HDV. The anti-HDV positive prevalence was lower than before the introduction of reflex test (10.7% vs. 16.6%) but the absolute number of anti-HDV positive patients increased (14 vs. 52 subjects). HDV-RNA was detectable in 26 (53%) of 49 tested subjects. CONCLUSIONS Our data showed that the implementation of anti-HDV reflex testing increased the diagnoses of HDV infection. In this setting, due to the approval of specific anti-HDV drugs, a reflex test for anti-HDV should be implemented to early identify patients with HBV/HDV infection.
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Affiliation(s)
- Valentina Cossiga
- Department of Clinical Medicine and Surgery, Diseases of the Liver and Biliary System Unit, University of Naples "Federico II", Naples, Italy
| | - Stefano Brusa
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Roberto Montalti
- Department of Public Health, Division of Hepato-Bilio-Pancreatic, Minimally Invasive and Robotic Surgery, University of Naples "Federico II", Naples, Italy
| | - Annachiara De Conte
- Department of Clinical Medicine and Surgery, Diseases of the Liver and Biliary System Unit, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Jannuzzi
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Luisa Ranieri
- Department of Clinical Medicine and Surgery, Diseases of the Liver and Biliary System Unit, University of Naples "Federico II", Naples, Italy
| | - Rosanna Sorrentino
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Luca Vallefuoco
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Luca Pignata
- Department of Clinical Medicine and Surgery, Diseases of the Liver and Biliary System Unit, University of Naples "Federico II", Naples, Italy
| | - Maria Guarino
- Department of Clinical Medicine and Surgery, Diseases of the Liver and Biliary System Unit, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Portella
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Filomena Morisco
- Department of Clinical Medicine and Surgery, Diseases of the Liver and Biliary System Unit, University of Naples "Federico II", Naples, Italy
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Salpini R, Piermatteo L, Torre G, D'Anna S, Khan S, Duca L, Bertoli A, La Frazia S, Malagnino V, Teti E, Iannetta M, Paba P, Ciotti M, Lenci I, Francioso S, Paquazzi C, Lichtner M, Mastroianni C, Santopaolo F, De Sanctis G, Pellicelli A, Galati G, Moretti A, Casinelli K, Caterini L, Iapadre N, Parruti G, Vecchiet I, Paoloni M, Marignani M, Ceccherini-Silberstein F, Baiocchi L, Grelli S, Sarmati L, Svicher V. Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication. Int J Infect Dis 2024; 138:1-9. [PMID: 37944585 DOI: 10.1016/j.ijid.2023.11.005] [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: 08/01/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVES Here we investigate Hepatitis D virus (HDV)-prevalence in Italy and its fluctuations over time and we provide an extensive characterization of HDV-infected patients. METHODS The rate of HDV seroprevalence and HDV chronicity was assessed in 1579 hepatitis B surface antigen (HBsAg)+ patients collected from 2005 to 2022 in Central Italy. RESULTS In total, 45.3% of HBsAg+ patients received HDV screening with an increasing temporal trend: 15.6% (2005-2010), 45.0% (2011-2014), 49.4% (2015-2018), 71.8% (2019-2022). By multivariable model, factors correlated with the lack of HDV screening were alanine-aminotransferase (ALT) less than two times of upper limit of normality (<2ULN) and previous time windows (P <0.002). Furthermore, 13.4% of HDV-screened patients resulted anti-HDV+ with a stable temporal trend. Among them, 80.8% had detectable HDV-ribonucleic acid (RNA) (median [IQR]:4.6 [3.6-5.6] log copies/ml) with altered ALT in 89.3% (median [IQR]:92 [62-177] U/L). Anti-HDV+ patients from Eastern/South-eastern Europe were younger than Italians (44 [37-54] vs 53 [47-62] years, P <0.0001), less frequently nucleos(t)ide analogs (NUC)-treated (58.5% vs 80%, P = 0.026) with higher HDV-RNA (4.8 [3.6-5.8] vs 3.9 [1.4-4.9] log copies/ml, P = 0.016) and HBsAg (9461 [4159-24,532] vs 4447 [737-13,336] IU/ml, P = 0.032). Phylogenetic analysis revealed the circulation of HDV subgenotype 1e (47.4%) and -1c (52.6%). Notably, subgenotype 1e correlated with higher ALT than 1c (168 [89-190] vs 58 [54-88] U/l, P = 0.015) despite comparable HDV-RNA. CONCLUSIONS HDV-screening awareness is increasing over time even if some gaps persist to achieve HDV screening in all HBsAg+ patients. HDV prevalence in tertiary care centers tend to scarcely decline in native/non-native patients. Detection of subgenotypes, triggering variable inflammatory stimuli, supports the need to expand HDV molecular characterization.
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Affiliation(s)
- Romina Salpini
- Tor Vergata University, Department of Biology, Rome, Italy
| | | | - Giulia Torre
- Tor Vergata University, Department of Biology, Rome, Italy
| | - Stefano D'Anna
- Tor Vergata University, Department of Experimental Medicine, Rome, Italy
| | - Sohaib Khan
- Tor Vergata University, Department of Experimental Medicine, Rome, Italy
| | - Leonardo Duca
- Tor Vergata University, Department of Experimental Medicine, Rome, Italy
| | - Ada Bertoli
- Tor Vergata University, Department of Experimental Medicine, Rome, Italy; Tor Vergata University Hospital, Virology Unit, Rome, Italy
| | | | | | - Elisabetta Teti
- Tor Vergata University Hospital, Infectious Diseases Unit, Rome, Italy
| | - Marco Iannetta
- Tor Vergata University Hospital, Infectious Diseases Unit, Rome, Italy
| | - Pierpaolo Paba
- Tor Vergata University Hospital, Virology Unit, Rome, Italy
| | - Marco Ciotti
- Tor Vergata University Hospital, Virology Unit, Rome, Italy
| | - Ilaria Lenci
- Tor Vergata University Hospital, Hepatology Unit, Rome, Italy
| | | | | | - Miriam Lichtner
- La Sapienza University, Department of Public Health and Infectious Disease, Rome, Italy
| | - Claudio Mastroianni
- La Sapienza University, Department of Public Health and Infectious Disease, Rome, Italy
| | - Francesco Santopaolo
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Internal Medicine and Gastroenterology-Hepatology Unit, Rome, Italy
| | | | | | - Giovanni Galati
- University Campus Bio-Medico, Internal Medicine and Hepatology Unit, Rome, Italy
| | | | - Katia Casinelli
- Spaziani Hospital, Infectious Disease Unit, Frosinone, Italy
| | | | - Nerio Iapadre
- San Salvatore Hospital, Infectious Diseases Unit, L'Aquila, Italy
| | - Giustino Parruti
- Pescara General Hospital, Infectious Disesases Unit, Pescara, Italy
| | - Iacopo Vecchiet
- University "G. d'Annunzio" Chieti-Pescara, Clinic of Infectious Diseases, Department of Medicine and Science of Aging, Chieti, Italy
| | - Maurizio Paoloni
- Avezzano General Hospital, Infectious Diseases Unit, Avezzano, Italy
| | - Massimo Marignani
- Regina Apostolorum Hospital, Department of Gastroenterology and Hepatology, Albano Laziale, Italy
| | | | | | - Sandro Grelli
- Tor Vergata University Hospital, Virology Unit, Rome, Italy
| | - Loredana Sarmati
- Tor Vergata University Hospital, Infectious Diseases Unit, Rome, Italy
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Salichos L, Minosse C, Visco-Comandini U, Taibi C, Zulian V, D’Offizi G, Pallothu N, McPhee F, Garbuglia AR. Phylogenetic and Phylodynamic Analysis of Delta Strains Circulating in Italy. Viruses 2023; 15:1791. [PMID: 37766200 PMCID: PMC10537423 DOI: 10.3390/v15091791] [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: 07/28/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
The hepatitis delta virus (HDV) exhibits high genetic and evolutionary variability and is classified into eight genotypes (HDV-1 to -8). HDV-1 is the most widespread genotype worldwide and includes several subtypes. It predominates mainly in Europe, the Middle East, North America, and Northern Africa, and is associated with both severe and mild forms of liver disease. In this study, we performed phylogenetic and phylodynamic analyses of HDV strains circulating in Regione Lazio, Italy, to understand when these strains were introduced into the Lazio region and to define their genetic variability in Italy. Fifty HDV RNA positive patient samples were amplified using a nested RT-PCR approach targeting the HDV R0 region and sequenced. A phylogenetic tree of patient-derived sequences and reference sequences representing HDV-1 to -8 was constructed using the GTRGAMMA model in RAxML v8. The results indicated that HDV-1 was the predominant genotype with HDV-1d being the most frequently inferred subtype. HDV-1 sequences clustering with subtypes 1b and 1e were also identified. A phylodynamic analysis of HDV-1 sequences employing a Bayesian birth-death model inferred a clock rate of 3.04 × 10-4 substitutions per site per million years, with a 95% Highest Posterior Density (HPD) interval of 3.45 × 10-5 to 5.72 × 10-4. A Bayesian birth-death analysis with tree calibration based on a sample dating approach indicated multiple original sources of infection (from the late 1950s to late 1980s). Overall, these results suggest that HDV sequences from the native Italian and non-Italian patients analyzed in this study represent multiple lineages introduced across a wide period. A common ancestral origin should be excluded.
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Affiliation(s)
- Leonidas Salichos
- Biological and Chemical Sciences, New York Institute of Technology, Manhattan, NY 10023, USA; (L.S.); (N.P.)
| | - Claudia Minosse
- Virology Laboratory, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (C.M.); (V.Z.)
| | - Ubaldo Visco-Comandini
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (U.V.-C.); (C.T.); (G.D.)
| | - Chiara Taibi
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (U.V.-C.); (C.T.); (G.D.)
| | - Verdiana Zulian
- Virology Laboratory, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (C.M.); (V.Z.)
| | - Gianpiero D’Offizi
- Infectious Diseases and Hepatology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (U.V.-C.); (C.T.); (G.D.)
| | - Nayan Pallothu
- Biological and Chemical Sciences, New York Institute of Technology, Manhattan, NY 10023, USA; (L.S.); (N.P.)
| | | | - Anna Rosa Garbuglia
- Virology Laboratory, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (C.M.); (V.Z.)
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Affiliation(s)
- Tarik Asselah
- From Université de Paris-Cité, Hôpital Beaujon, Department of Hepatology, Assistance Publique-Hôpitaux de Paris, and INSERM Unité Mixte de Recherche 1149, Clichy, France (T.A.); and the Department of Medical Sciences, University of Turin, Turin, Italy (M.R.)
| | - Mario Rizzetto
- From Université de Paris-Cité, Hôpital Beaujon, Department of Hepatology, Assistance Publique-Hôpitaux de Paris, and INSERM Unité Mixte de Recherche 1149, Clichy, France (T.A.); and the Department of Medical Sciences, University of Turin, Turin, Italy (M.R.)
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11
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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.
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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.
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12
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Xie J, Zhong Q, Wu WT, Chen JJ. Multi-omics data reveals the important role of glycerophospholipid metabolism in the crosstalk between gut and brain in depression. J Transl Med 2023; 21:93. [PMID: 36750892 PMCID: PMC9903503 DOI: 10.1186/s12967-023-03942-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Gut microbiota plays a critical role in the onset and development of depression, but the underlying molecular mechanisms are unclear. This study was conducted to observe the characteristics of gut microbiota, lipid metabolism and neurotransmitters in Gut-Liver-Brain axis in depressed mice (DM), and identify some novel perceptions on relationships between gut microbiota and depression. METHODS A mouse model of depression was built used chronic unpredictable mild stress (CUMS). Fecal samples (measuring gut microbiota compositions, microbial genes and lipid metabolites), liver samples (measuring lipid metabolites), and hippocampus (measuring neurotransmitters) were collected. Both univariate and multivariate statistical analyses were used to identify the differential gut microbiota, metabolic signatures and neurotransmitters in DM. RESULTS There were significant differences on both microbial and metabolic signatures between DM and control mice (CM): 71 significantly changed operational taxonomic units (OTUs) (60.56% belonged to phylum Firmicutes) and 405 differential lipid metabolites (51.11% belonged to Glycerophospholipid (GP) metabolism) were identified. Functional analysis showed that depressive-like behaviors (DLB)-related differential microbial genes were mainly enriched in GP metabolism. Weighted correlation network analysis (WGCNA) showed that DLB-related differential metabolites mainly belonged to GPs. Meanwhile, seven differential neurotransmitters were identified. Comprehensive analysis found that Lachnospiraceae and gamma-aminobutyric acid (GABA) were significantly correlated with 94.20% and 53.14% differential GPs, respectively, and GABA was significantly correlated with three main DLB phenotypes. CONCLUSION Our results provided novel perceptions on the role of Gut-Liver-Brain axis in the onset of depression, and showed that GP metabolism might be the bridge between gut microbiota and depression. "Lachnospiraceae-GP metabolism-GABA" held the promise as a potential way between gut microbiota and brain functions in DM.
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Affiliation(s)
- Jing Xie
- grid.190737.b0000 0001 0154 0904Chongqing Emergency Medical Center, Central Hospital of Chongqing University, Chongqing, 400010 China
| | - Qi Zhong
- grid.203458.80000 0000 8653 0555Institute of Life Sciences, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
| | - Wen-tao Wu
- grid.203458.80000 0000 8653 0555Institute of Life Sciences, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
| | - Jian-jun Chen
- grid.203458.80000 0000 8653 0555Institute of Life Sciences, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
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13
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Salpini R, D'Anna S, Piermatteo L, Svicher V. Novel concepts on mechanisms underlying Hepatitis Delta virus persistence and related pathogenesis. J Viral Hepat 2022; 29:1038-1047. [PMID: 36256499 DOI: 10.1111/jvh.13755] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/07/2022] [Indexed: 12/09/2022]
Abstract
Hepatitis Delta virus is the smallest known human virus, exploiting the HBV surface proteins (HBsAg) for the release of its progeny and de novo entry into hepatocytes. Ever growing evidence have highlighted the existence of multiple mechanisms underlying HDV persistence including integrated HBV-DNA as a source of HBsAg production and the capability of the HDV genome to propagate through cell proliferation, thus supporting a potential HDV persistence even in the absence of HBV. Chronic HDV-infection causes the most severe form of viral hepatitis, leading to the development of cirrhosis in 15% of cases within 1-2 years and in 50%-60% of cases within 5-10 years. The rates of hepatocellular carcinoma and hepatic decompensation are also 2-3-fold higher than for HBV mono-infection. There is the evidence that persistent viral replication plays a key role in triggering liver injury, suggesting the existence of direct viral cytopathic properties that can modulate, synergistically with immune-responses, the progression towards end-stage liver diseases. All these aspects can be further exacerbated by the extraordinary degree of viral genetic variability that can promote HDV evasion from immune responses and has enabled viral differentiation into genotypes and subgenotypes with potential different pathobiological properties. In this light, this review aims at providing comprehensive insights of mechanisms (with a focus on virological factors) underlying HDV persistence and pathogenesis, critical in shaping the clinical outcome of the infection. Dissecting these mechanisms is pivotal to optimize therapeutic strategies aimed at fully counteracting this fascinating and fearsome virus.
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Affiliation(s)
- Romina Salpini
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Stefano D'Anna
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Valentina Svicher
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Biology, University of Rome Tor Vergata, Rome, Italy
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A Review of HDV Infection. Viruses 2022; 14:v14081749. [PMID: 36016371 PMCID: PMC9414459 DOI: 10.3390/v14081749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 01/04/2023] Open
Abstract
Hepatitis D is the most severe viral hepatitis. Hepatitis D virus (HDV) has a very small RNA genome with unique biological properties. It requires for infection the presence of hepatitis B virus (HBV) and is transmitted parenterally, mainly by superinfection of HBsAg carriers who then develop chronic hepatitis D. HDV has been brought under control in high-income countries by the implementation of HBV vaccination, and the clinical pattern has changed to a chronic hepatitis D seen in ageing patients with advanced fibrotic disease; the disease remains a major health concern in developing countries of Africa and Asia. Every HBsAg-positive subject should be tested for HDV serum markers by reflex testing, independently of clinical status. Vaccination against HBV provides the best prophylaxis against hepatitis D. The only therapy available so far has been the poorly performing Interferon alfa; however, several new and promising therapeutic approaches are under study.
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15
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Liver Transplantation in Hepatitis B/Hepatitis D (Delta) Virus Coinfected Recipients. Transplantation 2022; 106:1935-1939. [DOI: 10.1097/tp.0000000000004138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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16
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Clinical Application of Droplet Digital PCR for Hepatitis Delta Virus Quantification. Biomedicines 2022; 10:biomedicines10040792. [PMID: 35453541 PMCID: PMC9029565 DOI: 10.3390/biomedicines10040792] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 02/04/2023] Open
Abstract
Droplet digital PCR (ddPCR) is a novel developed PCR technology providing the absolute quantification of target nucleic acid molecules without the need for a standard curve and regardless PCR amplification efficiency. Our aim was to develop a ddPCR assay for Hepatitis Delta virus (HDV)-RNA viremia quantification and then evaluate its performance in relation to real-time PCR methods. Primers and probe were designed from conserved regions of HDV genome to detect all the 8 HDV genotypes; the World Health Organization (WHO)-HDV international standard was used to calculate the conversion factor transforming results from copies/mL to IU/mL. To evaluate the clinical performance of ddPCR assay, plasma specimens of HDV-infected patients were tested and results were compared with data obtained with two real-time quantitative PCR (RT-qPCR) assays (i.e., in-house assay and commercial RoboGene assay). Analyzing by linear regression a series of 10-fold dilutions of the WHO-HDV International Standard, ddPCR assay showed good linearity with a slope coefficient of 0.966 and R2 value of 0.980. The conversion factor from copies to international units was 0.97 and the quantitative linear dynamic range was from 10 to 1 × 106 IU/mL. Probit analysis estimated at 95% an LOD of 9.2 IU/mL. Data from the evaluation of HDV-RNA in routine clinical specimen of HDV patients exhibited strong agreement with results obtained by RT-qPCR showing a concordance correlation coefficient of 0.95. Overall ddPCR and RT-qPCR showed highly comparable technical performance. Moreover, ddPCR providing an absolute quantification method may allow the standardization of HDV-RNA measurement thus improving the clinical and diagnostic management of delta hepatitis.
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Rizzetto M, Stroffolini T. Forty-Five Years after the Discovery of the Hepatitis D Virus: Where Do We Stand? Viruses 2021; 13:555. [PMID: 33810224 PMCID: PMC8066537 DOI: 10.3390/v13040555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 12/16/2022] Open
Abstract
The discovery of the Australia Antigen in the mid-1960s led, in a few years, to the identification of the virus of Hepatitis B [...].
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Affiliation(s)
- Mario Rizzetto
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Tommaso Stroffolini
- Department of Tropical and Infectious Diseases, Policlinico Umberto I, University of Rome, 00161 Rome, Italy;
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