Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication
Objectives: Here we investigate Hepatitis D virus (HDV)-prevalence in Italy and its fluctuations over time and we provide an extensive characterization of HDV-infected patients. Methods: The rate of HDV seroprevalence and HDV chronicity was assessed in 1579 hepatitis B surface antigen (HBsAg)+ patie...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S120197122300766X |
| _version_ | 1827583868663758848 |
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| author | Romina Salpini Lorenzo Piermatteo Giulia Torre Stefano D'Anna Sohaib Khan Leonardo Duca Ada Bertoli Simone La Frazia Vincenzo Malagnino Elisabetta Teti Marco Iannetta Pierpaolo Paba Marco Ciotti Ilaria Lenci Simona Francioso Caterina Paquazzi Miriam Lichtner Claudio Mastroianni Francesco Santopaolo Giuseppe De Sanctis Adriano Pellicelli Giovanni Galati Alessandra Moretti Katia Casinelli Luciano Caterini Nerio Iapadre Giustino Parruti Iacopo Vecchiet Maurizio Paoloni Massimo Marignani Francesca Ceccherini-Silberstein Leonardo Baiocchi Sandro Grelli Loredana Sarmati Valentina Svicher |
| author_facet | Romina Salpini Lorenzo Piermatteo Giulia Torre Stefano D'Anna Sohaib Khan Leonardo Duca Ada Bertoli Simone La Frazia Vincenzo Malagnino Elisabetta Teti Marco Iannetta Pierpaolo Paba Marco Ciotti Ilaria Lenci Simona Francioso Caterina Paquazzi Miriam Lichtner Claudio Mastroianni Francesco Santopaolo Giuseppe De Sanctis Adriano Pellicelli Giovanni Galati Alessandra Moretti Katia Casinelli Luciano Caterini Nerio Iapadre Giustino Parruti Iacopo Vecchiet Maurizio Paoloni Massimo Marignani Francesca Ceccherini-Silberstein Leonardo Baiocchi Sandro Grelli Loredana Sarmati Valentina Svicher |
| author_sort | Romina Salpini |
| collection | DOAJ |
| description | Objectives: Here we investigate Hepatitis D virus (HDV)-prevalence in Italy and its fluctuations over time and we provide an extensive characterization of HDV-infected patients. Methods: The rate of HDV seroprevalence and HDV chronicity was assessed in 1579 hepatitis B surface antigen (HBsAg)+ patients collected from 2005 to 2022 in Central Italy. Results: In total, 45.3% of HBsAg+ patients received HDV screening with an increasing temporal trend: 15.6% (2005-2010), 45.0% (2011-2014), 49.4% (2015-2018), 71.8% (2019-2022). By multivariable model, factors correlated with the lack of HDV screening were alanine-aminotransferase (ALT) less than two times of upper limit of normality (<2ULN) and previous time windows (P <0.002). Furthermore, 13.4% of HDV-screened patients resulted anti-HDV+ with a stable temporal trend. Among them, 80.8% had detectable HDV-ribonucleic acid (RNA) (median [IQR]:4.6 [3.6-5.6] log copies/ml) with altered ALT in 89.3% (median [IQR]:92 [62-177] U/L).Anti-HDV+ patients from Eastern/South-eastern Europe were younger than Italians (44 [37-54] vs 53 [47-62] years, P <0.0001), less frequently nucleos(t)ide analogs (NUC)-treated (58.5% vs 80%, P = 0.026) with higher HDV-RNA (4.8 [3.6-5.8] vs 3.9 [1.4-4.9] log copies/ml, P = 0.016) and HBsAg (9461 [4159-24,532] vs 4447 [737-13,336] IU/ml, P = 0.032). Phylogenetic analysis revealed the circulation of HDV subgenotype 1e (47.4%) and -1c (52.6%). Notably, subgenotype 1e correlated with higher ALT than 1c (168 [89-190] vs 58 [54-88] U/l, P = 0.015) despite comparable HDV-RNA. Conclusions: HDV-screening awareness is increasing over time even if some gaps persist to achieve HDV screening in all HBsAg+ patients. HDV prevalence in tertiary care centers tend to scarcely decline in native/non-native patients. Detection of subgenotypes, triggering variable inflammatory stimuli, supports the need to expand HDV molecular characterization. |
| first_indexed | 2024-03-08T23:13:54Z |
| format | Article |
| id | doaj.art-dfff0b10a44f46228c9d61eb4e68b98e |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-03-08T23:13:54Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-dfff0b10a44f46228c9d61eb4e68b98e2023-12-15T07:22:48ZengElsevierInternational Journal of Infectious Diseases1201-97122024-01-0113819Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replicationRomina Salpini0Lorenzo Piermatteo1Giulia Torre2Stefano D'Anna3Sohaib Khan4Leonardo Duca5Ada Bertoli6Simone La Frazia7Vincenzo Malagnino8Elisabetta Teti9Marco Iannetta10Pierpaolo Paba11Marco Ciotti12Ilaria Lenci13Simona Francioso14Caterina Paquazzi15Miriam Lichtner16Claudio Mastroianni17Francesco Santopaolo18Giuseppe De Sanctis19Adriano Pellicelli20Giovanni Galati21Alessandra Moretti22Katia Casinelli23Luciano Caterini24Nerio Iapadre25Giustino Parruti26Iacopo Vecchiet27Maurizio Paoloni28Massimo Marignani29Francesca Ceccherini-Silberstein30Leonardo Baiocchi31Sandro Grelli32Loredana Sarmati33Valentina Svicher34Tor Vergata University, Department of Biology, Rome, ItalyTor Vergata University, Department of Biology, Rome, ItalyTor Vergata University, Department of Biology, Rome, ItalyTor Vergata University, Department of Experimental Medicine, Rome, ItalyTor Vergata University, Department of Experimental Medicine, Rome, ItalyTor Vergata University, Department of Experimental Medicine, Rome, ItalyTor Vergata University, Department of Experimental Medicine, Rome, Italy; Tor Vergata University Hospital, Virology Unit, Rome, ItalyTor Vergata University, Department of Biology, Rome, ItalyTor Vergata University Hospital, Infectious Diseases Unit, Rome, ItalyTor Vergata University Hospital, Infectious Diseases Unit, Rome, ItalyTor Vergata University Hospital, Infectious Diseases Unit, Rome, ItalyTor Vergata University Hospital, Virology Unit, Rome, ItalyTor Vergata University Hospital, Virology Unit, Rome, ItalyTor Vergata University Hospital, Hepatology Unit, Rome, ItalyTor Vergata University Hospital, Hepatology Unit, Rome, ItalySant'Andrea Hospital, Clinical Infectious Diseases, Rome, ItalyLa Sapienza University, Department of Public Health and Infectious Disease, Rome, ItalyLa Sapienza University, Department of Public Health and Infectious Disease, Rome, ItalyFondazione Policlinico Universitario Agostino Gemelli IRCCS, Internal Medicine and Gastroenterology-Hepatology Unit, Rome, Italy“Umberto I” University Hospital, Infectious Diseases Unit,Rome, ItalySan Camillo Forlanini Hospital, Liver and Transplant Unit, Rome, ItalyUniversity Campus Bio-Medico, Internal Medicine and Hepatology Unit, Rome, ItalySan Filippo Neri Hospital, Gastroenterology Unit, Rome, ItalySpaziani Hospital, Infectious Disease Unit, Frosinone, ItalyBelcolle Hospital, Infectious Diseases Unit, Viterbo, ItalySan Salvatore Hospital, Infectious Diseases Unit, L'Aquila, ItalyPescara General Hospital, Infectious Disesases Unit, Pescara, ItalyUniversity “G. d'Annunzio” Chieti-Pescara, Clinic of Infectious Diseases, Department of Medicine and Science of Aging, Chieti, ItalyAvezzano General Hospital, Infectious Diseases Unit, Avezzano, ItalyRegina Apostolorum Hospital, Department of Gastroenterology and Hepatology, Albano Laziale, ItalyTor Vergata University, Department of Experimental Medicine, Rome, ItalyTor Vergata University Hospital, Hepatology Unit, Rome, ItalyTor Vergata University Hospital, Virology Unit, Rome, ItalyTor Vergata University Hospital, Infectious Diseases Unit, Rome, ItalyTor Vergata University, Department of Biology, Rome, Italy; Corresponding author.Objectives: Here we investigate Hepatitis D virus (HDV)-prevalence in Italy and its fluctuations over time and we provide an extensive characterization of HDV-infected patients. Methods: The rate of HDV seroprevalence and HDV chronicity was assessed in 1579 hepatitis B surface antigen (HBsAg)+ patients collected from 2005 to 2022 in Central Italy. Results: In total, 45.3% of HBsAg+ patients received HDV screening with an increasing temporal trend: 15.6% (2005-2010), 45.0% (2011-2014), 49.4% (2015-2018), 71.8% (2019-2022). By multivariable model, factors correlated with the lack of HDV screening were alanine-aminotransferase (ALT) less than two times of upper limit of normality (<2ULN) and previous time windows (P <0.002). Furthermore, 13.4% of HDV-screened patients resulted anti-HDV+ with a stable temporal trend. Among them, 80.8% had detectable HDV-ribonucleic acid (RNA) (median [IQR]:4.6 [3.6-5.6] log copies/ml) with altered ALT in 89.3% (median [IQR]:92 [62-177] U/L).Anti-HDV+ patients from Eastern/South-eastern Europe were younger than Italians (44 [37-54] vs 53 [47-62] years, P <0.0001), less frequently nucleos(t)ide analogs (NUC)-treated (58.5% vs 80%, P = 0.026) with higher HDV-RNA (4.8 [3.6-5.8] vs 3.9 [1.4-4.9] log copies/ml, P = 0.016) and HBsAg (9461 [4159-24,532] vs 4447 [737-13,336] IU/ml, P = 0.032). Phylogenetic analysis revealed the circulation of HDV subgenotype 1e (47.4%) and -1c (52.6%). Notably, subgenotype 1e correlated with higher ALT than 1c (168 [89-190] vs 58 [54-88] U/l, P = 0.015) despite comparable HDV-RNA. Conclusions: HDV-screening awareness is increasing over time even if some gaps persist to achieve HDV screening in all HBsAg+ patients. HDV prevalence in tertiary care centers tend to scarcely decline in native/non-native patients. Detection of subgenotypes, triggering variable inflammatory stimuli, supports the need to expand HDV molecular characterization.http://www.sciencedirect.com/science/article/pii/S120197122300766XHepatitis D virusHepatitis B virusHDV prevalenceHDV-RNA quantificationHDV chronic infection |
| spellingShingle | Romina Salpini Lorenzo Piermatteo Giulia Torre Stefano D'Anna Sohaib Khan Leonardo Duca Ada Bertoli Simone La Frazia Vincenzo Malagnino Elisabetta Teti Marco Iannetta Pierpaolo Paba Marco Ciotti Ilaria Lenci Simona Francioso Caterina Paquazzi Miriam Lichtner Claudio Mastroianni Francesco Santopaolo Giuseppe De Sanctis Adriano Pellicelli Giovanni Galati Alessandra Moretti Katia Casinelli Luciano Caterini Nerio Iapadre Giustino Parruti Iacopo Vecchiet Maurizio Paoloni Massimo Marignani Francesca Ceccherini-Silberstein Leonardo Baiocchi Sandro Grelli Loredana Sarmati Valentina Svicher Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication International Journal of Infectious Diseases Hepatitis D virus Hepatitis B virus HDV prevalence HDV-RNA quantification HDV chronic infection |
| title | Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication |
| title_full | Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication |
| title_fullStr | Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication |
| title_full_unstemmed | Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication |
| title_short | Prevalence of hepatitis D virus infection in Central Italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication |
| title_sort | prevalence of hepatitis d virus infection in central italy has remained stable across the last 2 decades with dominance of subgenotypes 1 and characterized by elevated viral replication |
| topic | Hepatitis D virus Hepatitis B virus HDV prevalence HDV-RNA quantification HDV chronic infection |
| url | http://www.sciencedirect.com/science/article/pii/S120197122300766X |
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