Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence 50141, Italy.
Web Solutions, Data Visualization and Scientific Documentation, Regional Health Agency of Tuscany, Florence 50141, Italy.
Hepatology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa 56100, Italy.
Center for Systemic Manifestations of Hepatitis Viruses (MaSVE), Internal Medicine and Liver Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence 50134, Italy.
Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Careggi University Hospital, Florence 50134, Italy.
Infectious Disease Unit, Hospital of Lucca, Lucca 55100, Italy.
Infectious Diseases Unit, Department of Medical Biotechnologies, Siena University Hospital, Siena 53100, Italy.
Infectious Disease Unit, "S. Maria Annunziata" Hospital, Ponte a Niccheri 50012, Italy.
Infectious Disease Unit, Hospital of Grosseto, Grosseto 58100, Italy.
Infectious Disease Unit, Hospital of Prato, Prato 59100, Italy.
Infectious and Tropical Diseases Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence 50134, Italy.
Gastroenterology and Metabolic Disorders, Department of Surgery, Cisanello University Hospital, Pisa 56100, Italy.
Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, Cisanello University Hospital of Pisa, Pisa 56100, Italy.
Liver Surgery and Transplantation Unit, Department of Surgical Pathology, Medicine, Molecular and Critical Area, Cisanello University Hospital, Pisa 56100, Italy.
Internal Medicine Unit, "San Jacopo" Hospital, Pistoia 51100, Italy.
Infectious Diseases and Hepatology Unit, Department of Internal and Specialized Medicine, University Hospital of Siena, Siena 53100, Italy.
Gastroenterology Unit, San Giuseppe Hospital, Empoli 50053, Italy.
Internal Medicine and Liver Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence 50135, Italy.
Department of Prevention, Central Tuscany Local Unit, Florence 50100, Italy.
To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus (HBV)-infected patients in the Tuscan public health care system.
This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation.
Of 4015 chronic viral hepatitis patients, 1096 (27.3%) were HBV infected. The case report form was correctly completed for only 833 patients (64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years (only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures (23%), mother-to-child (17%) and sexual transmission (12%). The most represented HBV genotypes were D (72%) and A (14%). Of the patients, 24.7% of patients were HBeAg positive, and 75.3% were HBeAg negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic (35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic.
Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults.