The importance of HCV on the burden of chronic liver disease in Italy: A multicenter prevalence study of 9,997 cases

• Published in: Journal of medical virology Vol. 75; no. 4; pp. 522 - 527
• Main Authors: Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Almasio, Piero, Coppola, Nicola, Ferrigno, Luigina, Scolastico, Carlo, Onofrio, Mirella, Imparato, Michele, Filippini, Pietro
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-04-2005; Wiley-Liss
• Subjects: Adult; Aged; alcohol abuse; Alcoholism - complications; Biological and medical sciences; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - etiology; Chronic Disease - epidemiology; Epidemiology; Female; Fundamental and applied biological sciences. Psychology; HBV; HCV; Hepacivirus; Hepatitis B - complications; Hepatitis B - epidemiology; Hepatitis B virus; Hepatitis C - complications; Hepatitis C - epidemiology; Human viral diseases; Humans; Incidence; Infectious diseases; Italy; Italy - epidemiology; Liver Cirrhosis - epidemiology; Liver Cirrhosis - etiology; Liver Diseases - epidemiology; Liver Diseases - etiology; Liver Neoplasms - epidemiology; Liver Neoplasms - etiology; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Prevalence; Risk Factors; Viral diseases; Viral hepatitis; Virology; Italy; Europe; Human; Prevalence; Chronic disease; alcohol abuse; Multicenter study; Hepatic disease; Epidemiology; Infection; Virus; Case study; Chronic; Viral hepatitis; Viral disease; Digestive diseases; Italy; HCV; Flaviviridae; Hepatitis C virus; Hepacivirus; HBV
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.20313

Knowledge of the current epidemiology of chronic liver disease in Italy is mostly obsolete and fragmentary for the lack of up‐to‐date consistent data. In 2001, a 6‐month prevalence study was undertaken in 79 hospitals to assess the characteristics of chronic liver disease in Italy. Both prevalent and incident cases were enrolled. A total of 9,997 patients were recruited, of whom 939 (9.4%) had normal liver biochemistry, 6,210 (62.1%) had chronic hepatitis, 1,940 (19.4%) had liver cirrhosis, and 341 (3.4%) had hepatocellular carcinoma (HCC). In 567 patients (5.7%) the diagnosis was not established. Hepatitis C virus (HCV) was found in 69.9% of the patients and was the only etiological factor in 56.3% of all the patients. Hepatitis B surface antigen (HBsAg) was present in the serum of 13.4% of the cases (in 10% it was the only etiological factor). A history of alcohol abuse was found in 23% of the cases (9.4% without viral infection). The prevalence of HCV‐related cases was significantly lower in incident than in prevalent cases (44.9% vs. 59.9%, P < 0.0001), while the proportion of patients with alcohol abuse was much higher in incident than in prevalent cases (18.1% vs. 6.6%, P < 0.0001). These findings indicate that nearly one quarter of patients with chronic liver diseases in Italy have a severe disease such as liver cirrhosis and HCC represents a not negligible burden for the national health system. Hepatitis B fell in importance as an etiological factor. Hepatitis C is the important pathogenic factor for chronic liver disease in Italy. However, a comparison between the prevalent and incident cases suggests that in future HCV infection will also play a progressively decreasing role, in part as a consequence of treatment. J. Med. Virol. 75:522–527, 2005. © 2005 Wiley‐Liss, Inc.