Epidemiological and clinical scenario of chronic liver diseases in Italy: Data from a multicenter nationwide survey

Dig Liver Dis. 2016 Sep;48(9):1066-71. doi: 10.1016/j.dld.2016.05.014. Epub 2016 May 26.

Abstract

Background: The last Italian prevalence survey on chronic liver diseases (CLD) was performed in 2001. The present study evaluated the changes occurring over thirteen years.

Methods: We enrolled 2,557 CLD consecutive patients in 16 Italian liver units in 2014.

Results: HBV etiology accounted for 513 (20.2%) cases, alone in 439 and associated with HCV and/or alcohol abuse in 74. Of these 513, 11.9% were anti-HDV-positive and 7.2% HBeAg-positive. HCV alone was responsible for 50.3% of CLD and with alcohol abuse for 5.9%. HCV RNA was detected in 64.0% of the anti-HCV-positive patients tested. HCV genotyping, performed for 899 patients, showed genotype-1a, 1b, 2, 3, 4 and 5 respectively in 16.5%, 45.5%, 15.4%, 8.2%, 15.1% and 0.2%. Alcohol abuse alone was responsible for 6.4% of cases and NAFLD/NASH for 6.3%. Liver cirrhosis (p<0.001) and HCC (p<0.001) were more frequent in alcoholic than viral etiologies. HCV and alcohol etiologies were more frequent in 2001 than 2014 (from 69.9% to 59.9% and from 23.0% to 12.3%, respectively). HBV showed a similar impact. In all etiologies, the 2001 CLD cases were 10 years younger and with a significantly lower rate of cirrhosis than the 2014 cases.

Conclusion: The changes in HCV, HBV and alcohol etiologies may help apply more appropriate healthcare strategies.

Keywords: Chronic hepatitis; Chronic liver diseases; HCC; Liver cirrhosis.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alcoholism / epidemiology*
  • Carcinoma, Hepatocellular / epidemiology*
  • Female
  • Genotype
  • Hepatitis B / epidemiology*
  • Hepatitis C / epidemiology*
  • Humans
  • Inpatients / statistics & numerical data
  • Italy / epidemiology
  • Liver Cirrhosis / epidemiology*
  • Liver Neoplasms / epidemiology*
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Outpatients / statistics & numerical data
  • Surveys and Questionnaires
  • Young Adult