Geographical pattern of chronic liver diseases in Italy: Results from two pooled national surveys

Published:October 22, 2018DOI:


      • Alcohol-related CLD prevails in North/Central Italy (N/C) (p < .001).
      • HBV-CLD and HCV-CLD prevail in South Italy/Sicily/Sardinia (SI/S/S) (p = .02; p < .001)
      • Differences in aetiology were stable over time.
      • Cirrhosis was diagnosed more frequently in SI/S/S than in N/C (p < .01).
      • The proportion of cirrhosis increased overtime in N/C (p < .01) and SI/S/S (p < .01).



      The information on the geographical characteristics of chronic liver diseases (CLD) in Italy is out-dated.


      To provide up-dated information on the geographical pattern of patients with CLD born in Italy.


      Patients with CLD were enrolled in two national surveys performed in 2001 and 2014, which prospectively recruited subjects aged ≥18 years referring to Italian liver units located throughout the country that apply a similar clinical approach and analytical methods.


      The total number of patients enrolled was 11,676. Alcohol-related CLD was more frequently observed in northern/central areas (25.0% vs. 20.7%, p < .001), while HBV-related (15.4% vs. 13.3%, p = .02) and HCV-related (71.2% vs. 67.1%, p < .001) CLD prevailed in southern areas/main islands (Sicily and Sardinia). These differences were stable over time. Liver cirrhosis without HCC was diagnosed more frequently in southern area/islands than in northern/central areas (23.7% vs. 18.8%, p < .01). Moreover, an increased proportion over time of patients with cirrhosis without HCC was observed both in northern/central areas (17.3% vs. 27.4%, p < .01) and in southern area/islands (22.6% vs. 27.9%, p < .01).


      These up-dated findings show different geographical patterns of CLD in Italy, reflecting different behavioural habits and socio-economic conditions across the country. They may be useful to apply more adequate preventive measures and to allocate economic resources.


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