AI Article Synopsis

  • The study analyzed trends in chronic hepatitis B patients in Italy through a multicenter observational cohort (PITER) from 2019-2021, comparing it to an earlier cohort (MASTER) from 2012-2015.
  • Key findings revealed that the PITER cohort had older patients and a higher percentage of females, with a significant decline in HBeAg prevalence compared to MASTER, while rates of anti-HD virus remained stable.
  • The study concludes that while chronic hepatitis B infection is becoming better managed in Italy, HDV remains a concern, particularly among patients with cirrhosis and non-Italian migrants.

Article 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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http://dx.doi.org/10.1016/j.ijid.2023.02.006DOI Listing

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