Author information
Collaborators
SEIEVA collaborating group:
Valeria Alfonsi, Franca D'Angelo, Carla Zotti, Erika Rainero, Noemi Marengo, Silvana Malaspina, Angela Gallone, Annalisa Castella, Maria Teresa Galati, Annamaria Scala, Paolo Castagna, Virginia Silano, Sebastiano D'Agosta, Maria Grazia Tacca, Silvia Iodice, Vilma Corvi, Maurizio Oddone, Daniela Rivetti, Paola Ravaschietto, Franco Giovanetti, Teresa Cappello, Alessandro Smaniotto, Mario Ruffier, Marina Verardo, Maria Gramegna, Sabrina Senatore, Danilo Cereda, Annalisa Donadini, Carla Nespoli, Livia Trezzi, Giorgio Gennati, Angelo Monteverdi, Liana Boldori, Franco Paolo Tortorella, Paola Elvira Merlini, Davide Di Caterina, Marino Faccini, Anna Lamberti, Eva Rossetti, Rita Brugnoli, Giulia Mainardi, Alessandra Vezzoli, Daniela Caso, Milena Testa, Alice Erba, Paola Senegaglia, Annamaria Spagna, Silvia Lodola, Marcello Tirani, Enza Giompapa, Luigi Guido Roveri, Gabriele Guardigli, Vanna Scalvinoni, Silvia Spertini, Sabine Gamper, Andrea Grünfelder, Barbara Ploner, Verena Runggatscher, Silvia Molinaro, Maria Grazia Zuccali, Silvia Franchini, Francesca Russo, Francesca Zanella, Donatella Rizzato, Graziella Carpene, Nadia Lamonato, Emanuela Destefani, Alessandra Dal Zotto, Rita Dal Zotto, Paola Casagrande, Felice Foglia, Gemma Zorzi, Ester Chermaz, Liana Gava, Luigi Nicolardi, Lorena Pavanetto, Cecilia Battiston, Francesco De Grandi, Laura Rizzato, Michele Tonon, Elisabetta Cannizzo, Maurizio Foroni, Laura Colucci, Monica Barbieri, Rosanna Ledri, Tolinda Gallo, Giulio Rocco, Rossana Stacul, Ariella Breda, Andrea Iob, Simonetta Micossi, Oriana Feltrin, Giuseppina Caernelos, Marco Mela, Virna Frumento, Anna Opisso, Alessandro Cuccu, Giorgio Zoppi, Patrizia Torracca, Armanda Capellini, Francesco Maddalo, Giovanna Mattei, Claudio Gualanduzzi, Erika Massimiliani, Anna Rita Sacchi, Laura Gardenghi, Anna Rosa Gianninoni, Elena Dalle Donne, Roberto Rangoni, Annalisa Califano, Chiara Reali, Emilia Biguzzi, Barbara Bondi, Anna Pecci, Bianca Maria Borrini, Lucia Pecori, Emanuela Balocchini, Costanza Pierozzi, Rosa Luzzoli, Paola Marchini, Lara Lucchesi, Alberto Tomasi, Elisabetta Raso, Nadia Olimpi, Cristiana Berti, Francesca Matarazzo, Nicoletta Galletti, Laura Puppa, Marinella Frasca, Alessandro Barbieri, Chiara Cinughi, Maria Bandini, Iorio Lezzi, Fabrizia Verdelli, Renzo Paradisi, Rita Bindi, Cinzia Monica Sansone, Maria Rosati, Federica Zacchini, Simonetta Baretti, Rossella Cecconi, Chiara Staderini, Poalo Filidei, Elisabetta Alfaroli, Franco Barghini, Marina Cadoni, Anna Tosti, Giovannini G, Giovanni Piattellini, Alessandra Buscosi, Anna Pasquale, Carla Ciani, Maria Claudia Paoloni, Franco Santocchia, Maria Laura Proietti, Daniel Fiacchini, Dzenana Hazurovic, Maria Sole Giamprini, Katia Gatti, Jacqueline Van Will, Alfredo Vaccaro, Maria Margherita Sbarbati, Alessandra Amelio, Daniela Cimini, Vania Moroni, Daniela Francoletti, Federica Scaccia, Elisabetta Branchesi, Selena Saracino, Catia Mezzanotte, Susanna Cimica, Vita Vitale, Franca Laici, Irene Petrelli, Barbara Airini, Gabriella Passarini, Lucia Ruffini, Anna Maria Lambertucci, Annarita Mogetta, Francesca Cioccoloni, Giuseppe Ciarrocchi, Marina Pistolesi, Erika Fratello, Francesca Picciotti, Claudio Angelini, Paola Scognamiglio, Francesco Vairo, Andreina Ercole, Antonio Salvatore Maglietta, Fabrizio Magrelli, Fabrizio Perrelli, Carlo Cerocchi, Paolo Grillo, Cristina Vazzoler, Maria Rosaria Loffredo, Alessio Pendenza, Maria Rosaria Nappi, Paola Bueti, Luigi Santucci, Franca Mangiagli, Donatella Varrenti, Silvia Aquilani, Pietro Dionette, Daniela Corpolongo, Giuseppe Di Luzio, Manuela Di Giacomo, Enrico Giansanti, Cristiana Mancini, Claudio Turchi, Carla Granchelli, Graziella Soldato, Felesina D'Eugenio, Ida Albanesi, Maria Antonietta Ferrara, Annarita Citarella, Elena Fossi, Rosa Alfieri, Milena Scotto, Anna Luisa Caiazzo, Rosa Prato, Maria Chironna, Domenico Martinelli, Francesca Fortunato, Maria Giovanna Cappelli, Daniela Loconsole, Anna Morea, Giulia Del Matto, Raffaele Angelillis, Marcello Antonazzo, Valerio Aprile, Grazia Maria Avella, Roberta Cambria, Giovanni Caputi, Rosati Cipriani, Carlo De Santis, Francesco Desiante, Marisa Ferraro, Vera Laforgia, Antonino Madaro, Maria Giuseppina Maluccio, Anna Maria Matera, Stefania Menolascina, Giuseppina Moffa, Maria Nesta, Rita Olivieri, Onofrio Pagone, Pasquale Pedote, Rosella Squicciarini, Stefano Termite, Viviana Vitale, Francesco Negrone, Manuela Maldini, Giovanni Laugello, Teresa Russo, Anna Domenica Mignuoli, Giuseppe Afflitto, Benedetto Caroleo, Maria Montesanti, Vincenzo De Giorgio, Antonio Maradei, Rocco Cataldo Romeo, Francesca Scrivano, Elisa Lazzarino, Vittoria Surace, Antonella Giordano, Alessandro Bisbano, Anita Arcuri, Ida Valentini, Rossana Mangione, Valentina Meli, Mario Cuccia, Elena Longhitano, Fiorenzo Delogu, Donatella Fracasso, Maria Vittoria Marceddu, Antonina Puggioni, Maria Valentina Eugenua Marras, Rita Serpi, Simonetta Santus, Valentina Marras
Affiliations
1Department of Tropical and Infectious Diseases, Policlinico Umberto I, Rome, Italy.
2Department of Clinical Medicine and Surgery, Gastroenterology and Hepatology Unit, University of Naples Federico II, Naples, Italy.
3National Center for Global Health, National Institute of Health (Istituto Superiore di Sanità ISS), Rome, Italy.
Abstract
Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come.