HBV Infection in Italian and Non-Italian Patients in Northern Italy
Massimo De Paschale *
Microbiology Unit, Hospital of Legnano, Legnano (Milan), Italy.
Maria Teresa Manco
Microbiology Unit, Hospital of Legnano, Legnano (Milan), Italy.
Luisa Belvisi
Microbiology Unit, Hospital of Legnano, Legnano (Milan), Italy.
Carlo Magnani
Infectious Diseases Department, Hospital of Legnano, Legnano (Milan), Italy.
Tiziana Re
Infectious Diseases Department, Hospital of Legnano, Legnano (Milan), Italy.
Paolo Viganò
Infectious Diseases Department, Hospital of Legnano, Legnano (Milan), Italy.
Sara Biagiotti
Division of Internal Medicine Hospital of Legnano, Legnano (Milan), Italy.
Francesca Capelli
Division of Internal Medicine Hospital of Legnano, Legnano (Milan), Italy.
Antonino Mazzone
Division of Internal Medicine Hospital of Legnano, Legnano (Milan), Italy.
Maria Pia Baldacci
Gastroenterology and Digestive Endoscopy Unit, Hospital of Legnano, Legnano (Milan), Italy.
Aldo Ferrara
Gastroenterology and Digestive Endoscopy Unit, Hospital of Legnano, Legnano (Milan), Italy.
Anna Lisa Neri
Nephrology Unit, Hospital of Legnano, Legnano (Milan), Italy.
Carlo Maria Guastoni
Nephrology Unit, Hospital of Legnano, Legnano (Milan), Italy.
Riccardo Armando Bonazzina
Occupational Medicine Unit, Hospital of Legnano, Legnano (Milan), Italy.
Bruno Brando
Blood Transfusion Centre, Hospital of Legnano, Legnano (Milan), Italy.
Pierangelo Clerici
Microbiology Unit, Hospital of Legnano, Legnano (Milan), Italy.
*Author to whom correspondence should be addressed.
Abstract
Aims: The introduction of HBV vaccination in Italy has reduced the incidence and prevalence of HBV infection. However, increasing immigration from countries in which HBV is endemic has led to a wave of new HBsAg-positive subjects and their clinical impact needs evaluation. We compared the serological, clinical and epidemiological data relating to Italian and non-Italian subjects referred to a hospital in Northern Italy.
Study Design: We retrospectively analysed the laboratory and clinical records of 488 subjects, including 107 (21.9%) non-Italians, in order to find data concerning clinical diagnoses, possible routes of infection, anti-HCV and anti-HDV antibodies.
Results: The differences in gender distribution and mean age between the non-Italian and Italian patients were statistically significant (p<.001). There were no significant differences in the prevalence of anti-HCV (2.9% vs 4.9%, p=.86) or anti-HDV (4.7% vs 5.0%, p=.89) co-infection, or the presence of HBeAg in chronic infection. There were no differences in the rates of acute (3.3% vs 5.1%; p=.68) or chronic infections (96.7% vs 94.9%; p=.68) infections, but there were statistically significant differences (p<.001) in the rates of prevalent (54.5% vs 85.3%) and incident cases (45.5% vs 14.7%). The differences in the rates of asymptomatic (70.6% vs 34.9%) and symptomatic patients (29.4% vs 65.1%) were also statistically significant (p<.001). The only significant differences in terms of risk factors related to transfusions (0% vs 6.8%; p=.04), and vertical/perinatal transmission (44.1% vs 6.8%; p<.001).
Conclusion: The non-Italian HBsAg-positive subjects were mainly women and younger than their Italian counterparts, and had a recent diagnosis. They were predominantly asymptomatic and probably considered themselves healthy and fit to emigrate. Perinatal transmission among non-Italians is still an important risk factor that reflects the epidemiological situation of their countries of origin.
Keywords: HBV, Italy, foreign origin, hepatitis