medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2012, Number 6

<< Back Next >>

Ann Hepatol 2012; 11 (6)

Epidemiological, clinical and laboratory features of chronic hepatitis B infection in a cohort of immigrant and Italian patients from Ferrara, Italy

Contini C, Badia L, Cultrera R, Grilli A, De Togni A

Language: English
References: 23
Page: 862-869
PDF size: 117.29 Kb.


ABSTRACT

Background. Italy has recently become a land of immigration. Two hundred and fifty thousand carriers are immigrants and chronic HBV infection is the prevalent form. Considering the elevated number of foreigners resident in our province and the potential risk of transmission to local people, we retrospectively investigated the patterns of chronic hepatitis B (CHB) in 154 patients (76 foreigners, 78 Italians) observed in our Institution, with regard to demographic and clinical/laboratory characteristics. Results. The immigrants were younger (mean age 31 years) compared to Italians (51.5) and mainly came from East Europe. Regarding exposure to HBV, the intra-familial risk factor was most frequently observed in foreigners, compared to Italians (p = 0.03). Foreigners also showed a higher prevalence of HBeAg positive forms, HDV co-infection (7.9%) and abnormal ALT and/or HBV-DNA values, compared to Italians. HBeAg positivity was more associated with increased ALT (OR = 36.6, p = 0.001) than with elevated HBV viremia (OR = 6.5, p = 0.049); age was a protective factor (OR = 0.1; p = 0.014). No significant association was found between increased ALT and foreign nationality. The simultaneous presence of increased ALT and viremia was more frequent among foreigners, (OR = 7.6, p = 0,014) and increased with age (OR = 1.06, p = 0.013). Antiviral therapy was given in 7.8% of foreign citizens. Conclusion. Immigrants constitute a vulnerable population subgroup that would benefit from a more active approach regarding doctor-patient relationship for early recognition of HBV and treatment programmes.


REFERENCES

  1. Stroffolini T. The changing pattern of hepatitis B virus infection over the past three decades in Italy. Dig Liver Dis 2005; 37: 622-7.

  2. Gaeta GB, Stornaiuolo G, Precone DF, Lobello S, Chiaramonte M, Stroffolini T, Colucci G, et al. Epidemiological and clinical burden of chronic hepatitis B virus/hepatitis C virus infection. A multicenter Italian study. J Hepatol 2003; 39: 1036-41.

  3. Majori S, Baldo V, Tommasi I, Malizia M, Floreani A, Monteiro G, Ferrari A, et al. Hepatitis A, B and C infection in a community of Sub-Saharan immigrants living in Verona (Italy). J Trav Med 2008; 15: 323-27.

  4. Chiaramonte M, Pupo A, Menegon T, Baldo V, Malatesta R, Trivello R. HBV and HCV infection among non-European Union immigrants in North-East Italy. Epidemiol Infect 1998; 121: 179-83.

  5. Fabris P, Baldo V, Baldovin T, Bellotto E, Rassu M, Trivello R, Tramarin A, et al. Changing epidemiology of HCV and HBV infections in Northern Italy: a survey in the general population. J Clin Gastroenterol 2008; 42: 527-32.

  6. Osservatorio sull’immigrazione della Provincia di Ferrara, Rapporto 2009; 3-101.

  7. Hochberger S, Althof D, Gallegos de Schrott R, Nachbaur N, Röck H, Leying H. Fully automated quantitation of hepatitis B virus (HBV) DNA in human plasma by the COBAS AmpliPrep/COBAS TaqMan system. J Clin Virol 2006; 35: 373-80.

  8. Stuyver L, De Gendt S, Van Geyt C, Zoulim F, Fried M, Schinazi RF, Rossau R. A new genotype of hepatitis B virus: complete genome and phylogenetic relatedness. J General Virology 2000; 81: 67-74.

  9. Lok ASF, Zoulim F, Locarnini S, Mangia A, Niro G, Decraemer H, Maertens G, et al. Monitoring drug resistance in chronic hepatitis B virus (HBV)-infected patients during lamivudine therapy: evaluation of performance of INNOLiPA HBV DR assay. J Clin Microbiol 2000; 40: 3729-34.

  10. Ishak KG, Zimmerman HJ. Morphologic spectrum of drug-induced hepatic disease. Gastroenterol Clin North Am 1995; 24: 759-86.

  11. European Association for the Study of the Liver EASL clinical practice guidelines: management of chronic hepatitis B. J Hepatol 2009; 50: 227-42.

  12. Gaiani S, Gramantieri L, Venturoli N, Piscaglia F, Siringo S, D’Errico A, Zironi G, et al. What is the criterion for differentiating chronic hepatitis from compensated cirrhosis? A prospective study comparing ultrasonography and percutaneous liver biopsy. J Hepatol 1997; 27: 979-85.

  13. Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, Christensen E, et al. Clinical management of hepatocellular carcinoma: conclusions of the Barcelona- 2000 EASL conference. European Association for the Study of the Liver. J Hepatol 2001; 35: 421-30.

  14. Mele A, Tosti ME, Spada E, Mariano A, Bianco E and SEIEVA Collaborative Group. Epidemiology of acute viral hepatitis: twenty years of surveillance through SEIEVA in Italy and a review of the literature. Rapporti ISTISAN: 06/ 122006; 11-14.

  15. Palumbo E. Immigration and hepatitis B virus in Italy. Current state and perspectives. Recenti Prog Med 2007; 98(11): 548-52.

  16. Hadziyannis SJ. Natural history of chronic hepatitis B in Euro-Mediterranean and African countries. J Hepatol 2011; 55: 183-91.

  17. Palumbo E, Scotto G, Faleo G, Cibelli DC, Saracino A, Angarano G. Prevalence of HBV-genotypes in immigrants affected by HBV-related chronic active hepatitis. Arch Gastroenterol 2007; 44: 54-7.

  18. Scotto G, Martinelli D, Di Tullio R, Fazio V. Epidemiological and Clinical Features of Hepatitis B Virus Genotypes among Immigrants in Southern Italy. Hepat Res Treat 2010; 2010: 878356. Epub 2010 Apr 22.

  19. Fattovich G, Bortolotti F, Donato F. Natural history of chronic hepatitis B: Special emphasis on disease progression and prognostic factors. J Hepatol 2008; 48: 335-52.

  20. Carosi G, Rizzetto M, Alberti A, Cariti G, Colombo M, Craxì A, Filice G, et al. Treatment of chronic hepatitis B: update of the recommendations from the 2007 Italian Workshop. Dig Liver Dis 2011; 43: 259-65. Epub 2011 Jan 26.

  21. Gaeta GB, Stroffolini T, Smedile A, Niro G, Mele A. Hepatitis delta in Europe: vanishing or refreshing? Hepatology 2007; 46: 1312-3.

  22. Rizzetto M. Hepatitis D: the comeback? Liver Int 2009; 29: 140-2.

  23. Coppola N, Masiello A, Tonziello G, Pisapia R, Pisaturo M, Sagnelli C, Messina V, et al. Factors affecting the changes in molecular epidemiology of acute hepatitis B in a Southern Italian area. J Viral Hepat 2010; 17: 493-500.




2020     |     www.medigraphic.com