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. 2021 Mar 2:33:183-187.
doi: 10.1016/j.jare.2021.02.009. eCollection 2021 Nov.

The hepatitis D virus in Italy. A vanishing infection, not yet a vanished disease

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
Affiliations

The hepatitis D virus in Italy. A vanishing infection, not yet a vanished disease

Gian Paolo Caviglia et al. J Adv Res. .

Abstract

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.

Keywords: Epidemiology; HDV; Liver transplantation; hepatitis D.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Age distribution of the 121 native-Italians patients at the last follow-up.
See this image and copyright information in PMC

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