Characteristics of liver cirrhosis in Italy: Evidence for a decreasing role of HCV aetiology

Published:November 08, 2016DOI:https://doi.org/10.1016/j.ejim.2016.10.012

      Highlights

      • Liver cirrhosis accounts for more than one million deaths each year worldwide.
      • Of 2557 patients with chronic hepatitis observed in 2014, 32.6% had cirrhosis.
      • HCV was responsible of 58.6% of cases, HBV of 17.6% and alcohol abuse of 16.0%.
      • HCV and alcohol cases significantly decreased in the last two decades in Italy.

      Abstract

      Background

      Previous cross-sectional studies have shown that hepatitis C virus (HCV) infection had been the main agent associated with liver cirrhosis in Italy.

      Aim

      To assess epidemiological, laboratory and clinical features of liver cirrhosis in Italy in 2014.

      Patients

      Out of the 2557 consecutive subjects evaluated in 16 hospitals located throughout Italy in 2014, 832 (32.6%) had liver cirrhosis and were enrolled in this study.

      Results

      The mean age of subjects was 60.3 years, with a male/female ratio of 1.7; 74.9% of cases had Child A cirrhosis and 17.9% superimposed hepatocellular carcinoma. HCV infection, alone or in combination with other aetiologic agents, was responsible of 58.6% of cases, HBV aetiology accounted for the 17.6% and alcohol abuse for the 16.0%. Compared with virus-related cirrhotic patients, those alcohol-related more frequently showed decompensation (p = 0.02).

      Conclusions

      Compared to previous surveys performed in 1992 and in 2001, we observe a statistically significant (p < 0.05) decreasing role of both HCV infection and alcohol abuse as aetiologic agents of liver cirrhosis in Italy, explaining, at least in part, the slow, progressive decline of the mortality rate for liver cirrhosis in the last decades in this country (from 34.5 deaths/100,000 inhabitants in1980 to 10.8 in 2012).

      Abbreviations:

      HBV (hepatitis B virus), HCV (hepatitis C virus), HCC (hepatitis delta virus (HDV) hepatocellular carcinoma), ISTAT (Italian Institute of Statistic), NAFLD (non-alcoholic fatty liver disease), NASH (non-alcoholic steatohepatitis)

      Keywords

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