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The hepatitis D virus in Italy. A vanishing infection, not yet a vanished disease
Journal of Advanced Research ( IF 10.7 ) Pub Date : 2021-03-02 , DOI: 10.1016/j.jare.2021.02.009
Gian Paolo Caviglia 1 , Silvia Martini 2 , Alessia Ciancio 1, 2 , Grazia Anna Niro 3 , Antonella Olivero 1 , Rossana Fontana 3 , Francesco Tandoi 4 , Chiara Rosso 1 , Renato Romagnoli 4, 5 , Giorgio Maria Saracco 1, 2 , Antonina Smedile 1, 2 , Mario Rizzetto 1, 2
Affiliation  

Introduction

Hepatitis D Virus (HDV) infection is vanishing in Italy. It is therefore believed that hepatitis D is no longer a medical problem in the domestic population of the country but remains of concern only in migrants from HDV-endemic areas.

Objectives

To report the clinical features and the medical impact of the residual domestic HDV infections in Italy.

Methods

From 2010 to 2019, one hundred ninety-three first-time patients with chronic HDV liver disease attended gastroenterology units in Torino and San Giovanni Rotondo (Apulia); 121 were native Italians and 72 were immigrants born abroad. For this study, we considered the 121 native Italians in order to determine their clinical features and the impact of HDV disease in liver transplant programs.

Results

At the last observation the median age of the 121 native Italians was 58 years. At the end of the follow-up, the median liver stiffness was 12.0 kPa (95% CI 11.2–17.4), 86 patients (71.1%) had a diagnosis of cirrhosis; 80 patients (66.1%) remained HDV viremic. The ratio of HDV to total HBsAg transplants varied from 38.5% (139/361) in 2000–2009 to 50.2% (130/259) in 2010–2019, indicating a disproportionate role of hepatitis D in liver transplants compared to the minor prevalence of HDV infections in the current scenario of HBsAg-positive liver disorders in Italy.

Conclusion

Though HDV is vanishing in Italy, a legacy of ageing native-Italian patients with advanced HDV liver disease still represents an important medical issue and maintains an impact on liver transplantation.



中文翻译:

意大利的丁型肝炎病毒。一种正在消失的感染,还不是一种消失的疾病

介绍

丁型肝炎病毒 (HDV) 感染正在意大利消失。因此,人们认为丁型肝炎不再是该国国内人口的医疗问题,而仅在来自 HDV 流行地区的移民中仍然令人担忧。

目标

报告意大利国内残留 HDV 感染的临床特征和医学影响。

方法

从 2010 年到 2019 年,193 名首次患有慢性 HDV 肝病的患者就诊于都灵和圣乔瓦尼罗通多(普利亚)的胃肠病科;121 人是意大利本土人,72 人是在国外出生的移民。在这项研究中,我们考虑了 121 名本地意大利人,以确定他们的临床特征以及 HDV 疾病在肝移植计划中的影响。

结果

在最后一次观察中,121 名意大利原住民的平均年龄为 58 岁。随访结束时,中位肝硬度为 12.0 kPa(95% CI 11.2-17.4),86 名患者(71.1%)被诊断为肝硬化;80 名患者 (66.1%) 仍然存在 HDV 病毒血症。HDV 与 HBsAg 移植总数的比率从 2000-2009 年的 38.5% (139/361) 到 2010-2019 年的 50.2% (130/259)意大利目前 HBsAg 阳性肝病情况下的 HDV 感染。

结论

尽管 HDV 在意大利正在消失,但患有晚期 HDV 肝病的老年意大利原住民患者的遗留问题仍然是一个重要的医学问题,并继续对肝移植产生影响。

更新日期:2021-03-02
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