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Influence of universal HBV vaccination on chronic HBV infection in Italy: Results of a cross‐sectional multicenter study
Author(s) -
Sagnelli Evangelista,
Stroffolini Tommaso,
Sagnelli Caterina,
Morisco Filomena,
Coppola Nicola,
Smedile Antonina,
Pisaturo Mariantonietta,
Colloredo Guido,
Babudieri Sergio,
Licata Anna,
Brancaccio Giuseppina,
Andriulli Angelo,
Almasio Piero L.,
Gaeta Giovani B.
Publication year - 2017
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24873
Subject(s) - medicine , vaccination , hbsag , cirrhosis , hepatitis b , immunology , chronic hepatitis , hepatitis b virus , pediatrics , virology , virus
Background and Aim The universal hepatitis B vaccination for infants and 12‐year‐old adolescents (the latter limited to the first 12 years of application) was launched in Italy in 1991. Twenty‐three years later we evaluated the impact of the vaccination campaign on the burden of HBsAg‐positive chronic liver diseases (CLD). Material and Methods A total of 513 HBsAg‐positive chronic carriers referring to 16 Italian liver units were investigated and compared with HBsAg carriers enrolled in previous surveys. Results The proportion of inactive carriers decreased from 20.0% in 2001 to 3.3% in 2014, while that of cirrhotic patients increased from 22.6% to 33.2%. Regarding the age class 0‐33 (fully covered by HBV vaccination in 2014), the rate of inactive carriers decreased from the 21.7% in 2001 to 5.9% in 2014, that of chronic hepatitis from 17.5% to 5.2% and that of cirrhosis cases from 26.4% to 4.1%. Instead, in the over‐60 age group the rate of inactive carriers increased from 22.8% to 41.2% and that of chronic hepatitis from 16.8% to 46%; the rate of patients with cirrhosis ranged from 5% to 8% in different studies. Conclusion Twenty‐three years after the introduction universal HBV vaccination in Italy, the clinical presentation of CLD had shown a shift toward older ages and more severe diseases.