Author information

Collaborators

• PITER collaborating investigators: Luisa Pasulo ³⁰, Carmine Coppola ³¹, Federica Pisano ³¹, Mariarosaria Romano ⁶, Carmen Porcu ⁷, Irene Francesca Bottalico ²⁷, Valentina Cossiga ³², Xhimi Tata ⁴, Caterina Sagnelli ¹³, Piera Pierotti ¹⁴, Elisabetta Degasperi ³³, Valerio Rosato ¹⁵, Lorenzo Badia ¹⁶, Dontella Ieluzzi ³⁴, Monica Monti ³⁵, Maria Grazia Bavetta ²⁰, Luisa Cavalletto ³⁶, Pierluigi Toniutto ³⁷, Ezio Fornasiere ³⁷, Antonio Colecchia ³⁸, Alberto Ferrarese ³⁸, Gerardo Nardone ³⁹, Alba Rocco ³⁹, Mauro Viganò ⁴⁰, Francesco Giuseppe Foschi ⁴¹, Fabio Conti ⁴¹, Giulia Morsica ⁴², Stefania Salpietro ⁴², Carlo Torti ⁴³, Chiara Costa ⁴³, Alessandro Federico ⁴⁴, Marcello Dallio ⁴⁴, Alessia Giorgini ⁴⁵, Marco Anselmo ⁴⁶, Pasqualina De Leo ⁴⁶, Serena Zaltron ⁴⁷, Anna Cambianica ⁴⁷, Fabio Piscaglia ⁴⁸, Ilaria Serio ⁴⁸, Simona Schivazappa ⁴⁹, Antonio Mastroianni ⁵⁰, Luciana Chidichimo ⁵⁰, Marco Massari ⁵¹, Cesare Mazzaro ⁵², Aldo Marrone ⁵³, Francesca Maria D'Amore ⁵³, Gianpiero D'Offizi ⁵⁴, Anna Licata ⁵⁵, Grazia Anna Niro ⁵⁶, Teresa Pollicino ⁵, Alessio Aghemo ⁵⁷

Affiliations

• ¹Department of Molecular Medicine, Infectious Diseases Unit, University of Padua, Padua, Italy.
• ²Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy.
• ³Department of Mathematics, University of Rome Tor Vergata, Rome, Italy.
• ⁴Center for Global Health, Istituto Superiore di Sanità, Rome, Italy.
• ⁵Department of Internal Medicine, University Hospital of Messina, Messina, Italy.
• ⁶Department of Infectious Diseases, Sant'Anna Hospital, Caserta, Italy.
• ⁷Liver Unit, University Hospital, Monserrato, Cagliari, Italy.
• ⁸Liver and Biliary System Unit, Department of Clinical Medicine and Surgery, University of Naples, Federico II, Naples, Italy.
• ⁹Clinic of Infectious Diseases, University of Bari, University Hospital Policlinico, Bari, Italy.
• ¹⁰Department of Medicine, Infectious Diseases Unit, University Hospital of Padua, Padua, Italy.
• ¹¹Gastroenterology Unit, Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy.
• ¹²Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, University of Padua, Padua, Italy.
• ¹³Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
• ¹⁴Infectious Disease Unit, Santa Maria Annunziata Hospital, Florence, Italy.
• ¹⁵Hepatology Unit, Betania Hospital, Naples, Italy.
• ¹⁶Clinic of Infectious Diseases and Microbiology Unit, Alma Mater Studiorum Bologna University, Bologna, Italy.
• ¹⁷Infectious Disease Unit, Niguarda Hospital, Milan, Italy.
• ¹⁸Center for Systemic Manifestations of Hepatitis Viruses, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
• ¹⁹Department of Medicine, Unit of Internal Medicine & Hepatology, University of Padua, Padua, Italy.
• ²⁰Department of Internal Medicine, Villa Sofia-Cervello Hospital, Palermo, Italy.
• ²¹Gastroenterology, Department of Medicine, University of Milan Bicocca, Milan, Italy; Gastroenterology Hepatology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy.
• ²²Gastroenterology Unit, Molinette Hospital, Turin, Italy.
• ²³Department of Medicine and Surgery, University of Parma, Unit of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
• ²⁴Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, Milan, Italy; CRC "A. M. and A. Migliavacca" Center for Liver Disease, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
• ²⁵Unit of Gastroenterology and Hepatology, Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, Italy.
• ²⁶Gastroenterology and Hepatology Unit, PROMISE, University of Palermo, Palermo, Italy.
• ²⁷Infectious Diseases Unit, Ospedali Riuniti, Foggia, Italy.
• ²⁸Infectious Disease Unit, University L. Vanvitelli, Naples, Italy. Electronic address: giovannibattista.gaeta@unicampania.it.
• ²⁹Center for Global Health, Istituto Superiore di Sanità, Rome, Italy; UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy. Electronic address: loreta.kondili@iss.it.
• ³⁰Gastroenterology and Transplant Hepatology, Papa Giovanni XXIII Hospital, Bergamo, Italy.
• ³¹Department of Hepatology, Gragnano Hospital, Gragnano (NA), Italy.
• ³²Gastroenterology Unit, Federico II University, Naples, Italy.
• ³³Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
• ³⁴Liver Unit, University Hospital of Verona, Verona, Italy.
• ³⁵Department of Experimental and Clinical Medicine, Interdepartmental Centre MASVE, University of Florence, Italy.
• ³⁶Department of Medicine, Unit of Internal Medicine & Hepatology, University of Padua, Italy.
• ³⁷Hepatology and Liver Transplant Unit, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
• ³⁸Gastroenterology Unit, University Hospital Borgo Trento, Verona, Italy.
• ³⁹Department of Clinical Medicine and Surgery, Hepato-Gastroenterology Unit, University of Napoli "Federico II", Napoli, Italy.
• ⁴⁰Hepatology Unit, San Giuseppe Hospital, Milano.
• ⁴¹Internal Medicine, Hospital of Faenza, A.U.S.L. of Romagna, Italy.
• ⁴²Department of Infectious Diseases, San Raffaele Hospital, Milan Italy.
• ⁴³Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy.
• ⁴⁴Department of Hepato-Gastroenterology, University of Campania Luigi Vanvitelli, Naples, Italy.
• ⁴⁵Gastroenterology and Hepatology Unit, San Paolo Hospital, University of Milan, Italy.
• ⁴⁶Infectious Disease Unit, San Paolo Hospital, Savona, Italy.
• ⁴⁷Department of Infectious and Tropical Diseases, Spedali Civili and University of Brescia, Brescia, Italy.
• ⁴⁸Division of Internal Medicine Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy.
• ⁴⁹Department of Medicine and Surgery, University of Parma, Unit of Hematology, Azienda Ospedaliero-Universitaria di Parma, Italy.
• ⁵⁰Department of Infectious and Tropical Diseases, SS Annunziata Hospital, Cosenza Italy.
• ⁵¹Malattie Infettive, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy.
• ⁵²Unit of Clinical of Experimental Onco-Hematology, IRCCS Centro di Riferimento Oncologico, Aviano, Pordenone, Italy.
• ⁵³Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.
• ⁵⁴National Institute for Infectious Diseases, Lazzaro Spallanzani-IRCCS, Rome, Italy.
• ⁵⁵Infectious Diseases Clinic, Department of Biomedical Sciences and Public Health, DIBIMIS, University of Palermo, Palermo, Italy.
• ⁵⁶Unità Operativa di Gastroenterologia ed Endoscopia Digestiva. Fondazione Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo (FG), Italy
• ⁵⁷Department of Gastroenterology, IRCCS Humanitas Research Hospital IRCCS, Rozzano, Italy

Abstract

Objectives: The study measures trends in the profile of patients with chronic hepatitis B virus linked to care in Italy.

Methods: A cross-sectional, multicenter, observational cohort (PITER cohort) of consecutive patients with hepatitis B surface antigen (HBsAg) over the period 2019-2021 from 46 centers was evaluated. The reference was the MASTER cohort collected over the years 2012-2015. Standard statistical methods were used.

Results: The PITER cohort enrolled 4583 patients, of whom 21.8% were non-Italian natives. Compared with those in MASTER, the patients were older and more often female. The prevalence of hepatitis B e antigen (HBeAg) declined (7.2% vs 12.3; P <0.0001) and that of anti-hepatitis D virus (HDV) remained stable (9.3% vs 8.3%). In both cohorts, about 25% of the patients had cirrhosis, and those in the PITER cohort were older. HBeAg-positive was 5.0% vs 12.6% (P <0.0001) and anti-HDV positive 24.8% vs 17.5% (P <0.0017). In the logistic model, the variables associated with cirrhosis were anti-HDV-positive (odds ratio = 10.08; confidence interval 7.63-13.43), age, sex, and body mass index; the likelihood of cirrhosis was reduced by 40% in the PITER cohort. Among non-Italians, 12.3% were HBeAg-positive (vs 23.4% in the MASTER cohort; P <0.0001), and 12.3% were anti-HDV-positive (vs 11.1%). Overall, the adherence to the European Association for the Study of the Liver recommendations for antiviral treatment increased over time.

Conclusion: Chronic hepatitis B virus infection appears to be in the process of becoming under control in Italy; however, HDV infection is still a health concern in patients with cirrhosis and in migrants.