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

Abstract

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.

Southern Europe as an example of interaction between various environmental factors: a systematic review of the epidemiologic evidence

“…A multicentre case-control study on the aetiology of symptomatic cirrhosis showed that alcohol intake was responsible for the highest proportion of cases, followed by HCV and HBV infection, and the three risk factors together accounted for 85.5% of the total cases (Corrao et al, 1998c). In agreement with these results, the population-based Dionysos study showed that the same factors were responsible for 92.4% of all the cases of cirrhosis and HCC in the area, considering >30 g/day of ethanol as a risk factor for liver diseases (Bellentani and Tiribelli, 2001), and a recent multicentre Italian study found that only 6.4% of 341 HCC cases had neither HBV or HCV infection nor alcoholic liver disease (Sagnelli et al, 2005).…”

“…The role of alcohol intake may be lower in other Mediterranean areas, however, as shown by the different proportions of HCC cases with alcoholic liver disease in various parts of Italy in the mentioned multicentre Italian study (Sagnelli et al, 2005), and by the lower proportion of HCC cases with alcohol intake >60 g/day in the Greek study (Kuper et al, 2000b) compared to the Brescia HCC study.…”

Use of epoetin beta during combination therapy of infection with hepatitis c virus with ribavirin improves a sustained viral response

“…HCV is the most important cause of chronic liver disease in Italy and is found in nearly 70% of cases [Sagnelli et al, 2005]. Infection with HCV persists in about 75% of cases and causes various degrees of liver inflammation and fibrosis; in time it may lead to cirrhosis and hepatocellular carcinoma [Poynard et al, 2003;Kumada et al, 2009].…”

Seropositivity and pattern of viral hepatitis in clinically suspected cases of hepatitis in Dhaka city

“…The mean age of the seropositive cases is 44.9 years also indicating active part of life and like HBV it is also true that this positivity will create reduction in activity, induce economic and social burden for the patient and his family. This seropositivity for HCV is less than that of Pakistan 9 , Kenya 13 , Thialnd 15 and same in Italy 14 where the prevalence of HCV is 6%, 7.1%, 7.8% and 5.7% respectively. This difference may be due to small sample number, not done in general population.…”

“…Our seropositivity is less than that of Pakistan 9 and Kenya 13 where the seropositivity found is 10% and 26.2% respectively. The prevalence is also higher in Italy where the prevalence of HBsAg is 13.4% 14 .…”