Abstract
Background: There is increasing awareness of HBV reactivation in HCV-RNA-positive/HBV-coinfected patients with chronic liver disease (CLD) treated with oral direct-acting antivirals (DAAs). Aim: To provide figures on the prevalence of HBV markers in HCV-RNA-positive subjects in Italy, where these findings are lacking. Methods: All subjects aged ≥18 years with CLD consecutively referring to Italian liver units located throughout country were prospectively enrolled in two national surveys in 2001 and 2014. Results: The total number of HCV-RNA-positive cases was 6984; 356 (5.1%) subjects vaccinated against HBV were excluded. A total of 6628 cases were evaluated. The prevalence rates of HBsAg, isolated anti-HBc and anti-HBc/anti-HBs-positivity were 2.9%, 8.1% and 14.7%, respectively. Among the estimated one million HCV-RNA-positive subjects in Italy, a substantial number of subjects are at risk of HBV reactivation due to DAA therapy. The prevalence of liver cirrhosis was higher than that of CLD in HBsAg-positive subjects (4.4% vs. 2.6%, p < 0.01) but not in those positive for other HBV markers. Conclusions: These findings outline the burden of HBV markers among HCV-RNA-positive subjects in Italy, where in 2017 reimbursement for DAA therapy by the National Health System became universal for all patients with chronic HCV infection. HBV vaccination coverage should be greatly extended, since nearly two thirds of subjects in this study resulted negative for any HBV marker.
| Original language | English |
|---|---|
| Journal | Digestive and Liver Disease |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2018 |
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Keywords
- Chronic HCV infection
- HBV reactivation
- HBV/HCV coinfection
- HCV therapy
ASJC Scopus subject areas
- Hepatology
- Gastroenterology
Cite this
The burden of HBV infection in HCV patients in Italy and the risk of reactivation under DAA therapy. / Stroffolini, Tommaso; Sagnelli, Evangelista; Sagnelli, Caterina; Smedile, Antonina; Furlan, Caterina; Morisco, Filomena; Coppola, Nicola; Andriulli, Angelo; Almasio, Piero Luigi.
In: Digestive and Liver Disease, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The burden of HBV infection in HCV patients in Italy and the risk of reactivation under DAA therapy
AU - Stroffolini, Tommaso
AU - Sagnelli, Evangelista
AU - Sagnelli, Caterina
AU - Smedile, Antonina
AU - Furlan, Caterina
AU - Morisco, Filomena
AU - Coppola, Nicola
AU - Andriulli, Angelo
AU - Almasio, Piero Luigi
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: There is increasing awareness of HBV reactivation in HCV-RNA-positive/HBV-coinfected patients with chronic liver disease (CLD) treated with oral direct-acting antivirals (DAAs). Aim: To provide figures on the prevalence of HBV markers in HCV-RNA-positive subjects in Italy, where these findings are lacking. Methods: All subjects aged ≥18 years with CLD consecutively referring to Italian liver units located throughout country were prospectively enrolled in two national surveys in 2001 and 2014. Results: The total number of HCV-RNA-positive cases was 6984; 356 (5.1%) subjects vaccinated against HBV were excluded. A total of 6628 cases were evaluated. The prevalence rates of HBsAg, isolated anti-HBc and anti-HBc/anti-HBs-positivity were 2.9%, 8.1% and 14.7%, respectively. Among the estimated one million HCV-RNA-positive subjects in Italy, a substantial number of subjects are at risk of HBV reactivation due to DAA therapy. The prevalence of liver cirrhosis was higher than that of CLD in HBsAg-positive subjects (4.4% vs. 2.6%, p < 0.01) but not in those positive for other HBV markers. Conclusions: These findings outline the burden of HBV markers among HCV-RNA-positive subjects in Italy, where in 2017 reimbursement for DAA therapy by the National Health System became universal for all patients with chronic HCV infection. HBV vaccination coverage should be greatly extended, since nearly two thirds of subjects in this study resulted negative for any HBV marker.
AB - Background: There is increasing awareness of HBV reactivation in HCV-RNA-positive/HBV-coinfected patients with chronic liver disease (CLD) treated with oral direct-acting antivirals (DAAs). Aim: To provide figures on the prevalence of HBV markers in HCV-RNA-positive subjects in Italy, where these findings are lacking. Methods: All subjects aged ≥18 years with CLD consecutively referring to Italian liver units located throughout country were prospectively enrolled in two national surveys in 2001 and 2014. Results: The total number of HCV-RNA-positive cases was 6984; 356 (5.1%) subjects vaccinated against HBV were excluded. A total of 6628 cases were evaluated. The prevalence rates of HBsAg, isolated anti-HBc and anti-HBc/anti-HBs-positivity were 2.9%, 8.1% and 14.7%, respectively. Among the estimated one million HCV-RNA-positive subjects in Italy, a substantial number of subjects are at risk of HBV reactivation due to DAA therapy. The prevalence of liver cirrhosis was higher than that of CLD in HBsAg-positive subjects (4.4% vs. 2.6%, p < 0.01) but not in those positive for other HBV markers. Conclusions: These findings outline the burden of HBV markers among HCV-RNA-positive subjects in Italy, where in 2017 reimbursement for DAA therapy by the National Health System became universal for all patients with chronic HCV infection. HBV vaccination coverage should be greatly extended, since nearly two thirds of subjects in this study resulted negative for any HBV marker.
KW - Chronic HCV infection
KW - HBV reactivation
KW - HBV/HCV coinfection
KW - HCV therapy
UR - http://www.scopus.com/inward/record.url?scp=85055095397&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055095397&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2018.09.010
DO - 10.1016/j.dld.2018.09.010
M3 - Article
AN - SCOPUS:85055095397
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
ER -