Evolving clinical landscape of chronic hepatitis B: A multicenter Italian study

Tommaso Stroffolini, Piero L. Almasio, Evangelista Sagnelli, Alfonso Mele, Giovanni Battista Gaeta, Pietro Andreone, Alessandra Scuteri, Giorgio Antonucci, Fabio Iacomi, Sergio Babudieri, Antonio Pintus, Gianfranca Stornaiuolo, Giuseppina Brancaccio, Maurizia Brunetto, Rodolfo Sasso, Nicola Caporaso, Filomena Morisco, Maria Chiaramonte, Emiliano Lattanzi, Vito Di MarcoGiovanna Venezia, Stefano Fagiuoli, Sara Boninsegna, Giovanna Fattovich, Nicola Olivari, Carlo Ferrari, Tiziana Giuberti, Luigina Ferrigno, Giacomo Magnani, Marco Massari, Carmelo Mangano, Carmelo Caserta, Vincenzo Messina, Giuseppe Pastore, Stefania Palattella, Felice Piccinino, Maria Stanzione, Giovanbattista Pinzello, Maria Vinci, Giovanni Raimondo, Gaia Caccamo, Luigi Roffi, Valentina Bellia, Mario Rizzetto, Antonina Smedile, Alessia Ciancio

Research output: Contribution to journalArticlepeer-review


The aim of the study was to evaluate the characteristics of chronic hepatitis B with special reference to the geographical origin of the patients and to the prevalence of HBeAg and viral and non-viral co-factors of liver disease. A cross sectional multicenter survey was undertaken, which enrolled 1,386 HBsAg chronic carriers observed consecutively in 21 referral centers over a 6-month period. The prevalence of HBeAg in patients was 11%; the presence of HBeAg was associated independently with a younger age and co-infection with HIV. Anti-HDV, anti-HCV, or anti-HIV antibodies were detected in 8.1%, 6.5%, and 2%, respectively. However, among the patients first diagnosed during the study period (incident cases), 14.3% were anti-HDV positive. Seven percent of the patients were immigrants; they were younger than Italian patients and 18% were HBeAg positive; no difference was observed in the prevalence of anti-HDV, anti-HCV, or anti-HIV antibodies. The presence of cirrhosis was associated independently with an age >52 years, the presence of anti-HDV or anti-HCV, alcohol use >4 drinks/day, and a high BMI. The clinical epidemiology of chronic hepatitis B virus (HBV) infection shows a dynamic profile, with the potential for re-emergence of cases with HBeAg or anti-HDV and an emerging impact of metabolic factors on the evolution of liver disease.

Original languageEnglish
Pages (from-to)1999-2006
Number of pages8
JournalJournal of Medical Virology
Issue number12
Publication statusPublished - Dec 2009


  • Cirrhosis
  • HBeAg
  • HDV
  • Hepatitis B

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases


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