Changing pattern of chronic hepatitis D in Southern Europe
Background & Aims: The aim of this study was to assess changes in the clinical pattern of hepatitis D virus (HDV) infection in Italy, brought about by improved control of hepatitis B and D viruses, and to establish the natural history of chronic hepatitis D. Methods: Histological diagnosis and c...
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| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 1999-07, Vol.117 (1), p.161-166 |
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| creator | Rosina, Floriano Conoscitore ‡, Pasquale Cuppone §, Renato Rocca, Giuseppe Giuliani ‡, Arcangela Cozzolongo §, Raffaele Niro ‡, Grazia Smedile, Antonina Saracco, Giorgio Andriulli ‡, Angelo Manghisi §, Onofrio Giuseppe Rizzetto, Mario |
| description | Background & Aims: The aim of this study was to assess changes in the clinical pattern of hepatitis D virus (HDV) infection in Italy, brought about by improved control of hepatitis B and D viruses, and to establish the natural history of chronic hepatitis D.
Methods: Histological diagnosis and clinical features of 122 patients with HDV recruited from 1987 to 1996 in three Italian tertiary referral centers (Torino, northern Italy; San Giovanni Rotondo and Castellana Grotte, southern Italy) were compared with those of 162 patients collected in the same centers in the previous decade. Patients from both groups with at least 6 months of follow-up were included in a new subgroup to assess the natural history of the disease.
Results: Among 162 patients referred from 1977 to 1986, 9 (6%) had mild hepatitis at histology vs. 9 (8%) of 122 patients referred in the second decade; 105 (65%) vs. 21 (17%) had severe hepatitis; 46 (28%) vs. 38 (31%) had histological asymptomatic cirrhosis; and 2 (1%) vs. 54 (44%) had clinically overt cirrhosis. For 159 patients (121 men and 38 women; mean age, 34 ± 11), a follow-up of more than 6 months was documented, and they were included in the natural history subgroup. After 78 ± 59 months of follow-up, 112 (70%) survived free of liver transplantation: 9 underwent transplantation, 32 died of liver failure, and 6 of acquired immunodeficiency syndrome. Estimated 5- and 10-year probability of survival free of orthotopic liver transplantation was 100% and 100% for patients with mild hepatitis, 90% and 90% for severe hepatitis, 81% and 58% for histological asymptomatic cirrhosis, and 49% and 40% for clinical cirrhosis (
P < 0.01), respectively.
Conclusions: Occurrence of fresh and severe forms of hepatitis D has diminished greatly in Italy. Contemporary patients represent cohorts infected years ago who survived the immediate medical impact of hepatitis D. The disease has been asymptomatic and nonprogressive in a minority; in the majority, it rapidly advanced to cirrhosis but thereafter subsided with stable clinical conditions for more than a decade.
GASTROENTEROLOGY 1999;117:161-166 |
| doi_str_mv | 10.1016/S0016-5085(99)70563-9 |
| format | Article |
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Methods: Histological diagnosis and clinical features of 122 patients with HDV recruited from 1987 to 1996 in three Italian tertiary referral centers (Torino, northern Italy; San Giovanni Rotondo and Castellana Grotte, southern Italy) were compared with those of 162 patients collected in the same centers in the previous decade. Patients from both groups with at least 6 months of follow-up were included in a new subgroup to assess the natural history of the disease.
Results: Among 162 patients referred from 1977 to 1986, 9 (6%) had mild hepatitis at histology vs. 9 (8%) of 122 patients referred in the second decade; 105 (65%) vs. 21 (17%) had severe hepatitis; 46 (28%) vs. 38 (31%) had histological asymptomatic cirrhosis; and 2 (1%) vs. 54 (44%) had clinically overt cirrhosis. For 159 patients (121 men and 38 women; mean age, 34 ± 11), a follow-up of more than 6 months was documented, and they were included in the natural history subgroup. After 78 ± 59 months of follow-up, 112 (70%) survived free of liver transplantation: 9 underwent transplantation, 32 died of liver failure, and 6 of acquired immunodeficiency syndrome. Estimated 5- and 10-year probability of survival free of orthotopic liver transplantation was 100% and 100% for patients with mild hepatitis, 90% and 90% for severe hepatitis, 81% and 58% for histological asymptomatic cirrhosis, and 49% and 40% for clinical cirrhosis (
P < 0.01), respectively.
Conclusions: Occurrence of fresh and severe forms of hepatitis D has diminished greatly in Italy. Contemporary patients represent cohorts infected years ago who survived the immediate medical impact of hepatitis D. The disease has been asymptomatic and nonprogressive in a minority; in the majority, it rapidly advanced to cirrhosis but thereafter subsided with stable clinical conditions for more than a decade.
GASTROENTEROLOGY 1999;117:161-166</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1016/S0016-5085(99)70563-9</identifier><identifier>PMID: 10381923</identifier><identifier>CODEN: GASTAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; AIDS/HIV ; Biological and medical sciences ; Cohort Studies ; Female ; Follow-Up Studies ; Hepatitis D, Chronic - complications ; Hepatitis D, Chronic - metabolism ; Hepatitis D, Chronic - pathology ; Hepatitis D, Chronic - physiopathology ; Hepatitis D, Chronic - surgery ; Human viral diseases ; Humans ; Infectious diseases ; Italy ; Liver Cirrhosis - complications ; Liver Transplantation ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Prognosis ; Survival Analysis ; Viral diseases ; Viral hepatitis</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 1999-07, Vol.117 (1), p.161-166</ispartof><rights>1999 American Gastroenterological Association</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-4ea2ab8d374d283f68112e82ea8f80b8e42115944edefcfce9a6bab7ca4d52f93</citedby><cites>FETCH-LOGICAL-c437t-4ea2ab8d374d283f68112e82ea8f80b8e42115944edefcfce9a6bab7ca4d52f93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0016-5085(99)70563-9$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1895766$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10381923$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rosina, Floriano</creatorcontrib><creatorcontrib>Conoscitore ‡, Pasquale</creatorcontrib><creatorcontrib>Cuppone §, Renato</creatorcontrib><creatorcontrib>Rocca, Giuseppe</creatorcontrib><creatorcontrib>Giuliani ‡, Arcangela</creatorcontrib><creatorcontrib>Cozzolongo §, Raffaele</creatorcontrib><creatorcontrib>Niro ‡, Grazia</creatorcontrib><creatorcontrib>Smedile, Antonina</creatorcontrib><creatorcontrib>Saracco, Giorgio</creatorcontrib><creatorcontrib>Andriulli ‡, Angelo</creatorcontrib><creatorcontrib>Manghisi §, Onofrio Giuseppe</creatorcontrib><creatorcontrib>Rizzetto, Mario</creatorcontrib><title>Changing pattern of chronic hepatitis D in Southern Europe</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>Background & Aims: The aim of this study was to assess changes in the clinical pattern of hepatitis D virus (HDV) infection in Italy, brought about by improved control of hepatitis B and D viruses, and to establish the natural history of chronic hepatitis D.
Methods: Histological diagnosis and clinical features of 122 patients with HDV recruited from 1987 to 1996 in three Italian tertiary referral centers (Torino, northern Italy; San Giovanni Rotondo and Castellana Grotte, southern Italy) were compared with those of 162 patients collected in the same centers in the previous decade. Patients from both groups with at least 6 months of follow-up were included in a new subgroup to assess the natural history of the disease.
Results: Among 162 patients referred from 1977 to 1986, 9 (6%) had mild hepatitis at histology vs. 9 (8%) of 122 patients referred in the second decade; 105 (65%) vs. 21 (17%) had severe hepatitis; 46 (28%) vs. 38 (31%) had histological asymptomatic cirrhosis; and 2 (1%) vs. 54 (44%) had clinically overt cirrhosis. For 159 patients (121 men and 38 women; mean age, 34 ± 11), a follow-up of more than 6 months was documented, and they were included in the natural history subgroup. After 78 ± 59 months of follow-up, 112 (70%) survived free of liver transplantation: 9 underwent transplantation, 32 died of liver failure, and 6 of acquired immunodeficiency syndrome. Estimated 5- and 10-year probability of survival free of orthotopic liver transplantation was 100% and 100% for patients with mild hepatitis, 90% and 90% for severe hepatitis, 81% and 58% for histological asymptomatic cirrhosis, and 49% and 40% for clinical cirrhosis (
P < 0.01), respectively.
Conclusions: Occurrence of fresh and severe forms of hepatitis D has diminished greatly in Italy. Contemporary patients represent cohorts infected years ago who survived the immediate medical impact of hepatitis D. The disease has been asymptomatic and nonprogressive in a minority; in the majority, it rapidly advanced to cirrhosis but thereafter subsided with stable clinical conditions for more than a decade.
GASTROENTEROLOGY 1999;117:161-166</description><subject>Adult</subject><subject>AIDS/HIV</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hepatitis D, Chronic - complications</subject><subject>Hepatitis D, Chronic - metabolism</subject><subject>Hepatitis D, Chronic - pathology</subject><subject>Hepatitis D, Chronic - physiopathology</subject><subject>Hepatitis D, Chronic - surgery</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Italy</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Prognosis</subject><subject>Survival Analysis</subject><subject>Viral diseases</subject><subject>Viral hepatitis</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtLxDAQgIMouq7-BKUHET1Uk7RpEy8i6_qABQ-r55Cmk22k29akFfz3tttFvXmZgZlvHnwInRB8RTBJrpe4jyHDnF0IcZlilkSh2EETwigP-x7dRZMf5AAdev-OMRYRJ_vogOA-CxpN0M2sUNXKVqugUW0LrgpqE-jC1ZXVQQF90bbWB_eBrYJl3bXFgMw7VzdwhPaMKj0cb_MUvT3MX2dP4eLl8Xl2twh1HKVtGIOiKuN5lMY55ZFJOCEUOAXFDccZh5gSwkQcQw5GGw1CJZnKUq3inFEjoik6H_c2rv7owLdybb2GslQV1J2XieCxEIT2IBtB7WrvHRjZOLtW7ksSLAdpciNNDkakEHIjTQ4HTrcHumwN-Z-p0VIPnG0B5bUqjVOVtv6X44KlSdJjtyMGvY1PC056baHSkFsHupV5bf_55BvfjYh7</recordid><startdate>19990701</startdate><enddate>19990701</enddate><creator>Rosina, Floriano</creator><creator>Conoscitore ‡, Pasquale</creator><creator>Cuppone §, Renato</creator><creator>Rocca, Giuseppe</creator><creator>Giuliani ‡, Arcangela</creator><creator>Cozzolongo §, Raffaele</creator><creator>Niro ‡, Grazia</creator><creator>Smedile, Antonina</creator><creator>Saracco, Giorgio</creator><creator>Andriulli ‡, Angelo</creator><creator>Manghisi §, Onofrio Giuseppe</creator><creator>Rizzetto, Mario</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990701</creationdate><title>Changing pattern of chronic hepatitis D in Southern Europe</title><author>Rosina, Floriano ; 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Methods: Histological diagnosis and clinical features of 122 patients with HDV recruited from 1987 to 1996 in three Italian tertiary referral centers (Torino, northern Italy; San Giovanni Rotondo and Castellana Grotte, southern Italy) were compared with those of 162 patients collected in the same centers in the previous decade. Patients from both groups with at least 6 months of follow-up were included in a new subgroup to assess the natural history of the disease.
Results: Among 162 patients referred from 1977 to 1986, 9 (6%) had mild hepatitis at histology vs. 9 (8%) of 122 patients referred in the second decade; 105 (65%) vs. 21 (17%) had severe hepatitis; 46 (28%) vs. 38 (31%) had histological asymptomatic cirrhosis; and 2 (1%) vs. 54 (44%) had clinically overt cirrhosis. For 159 patients (121 men and 38 women; mean age, 34 ± 11), a follow-up of more than 6 months was documented, and they were included in the natural history subgroup. After 78 ± 59 months of follow-up, 112 (70%) survived free of liver transplantation: 9 underwent transplantation, 32 died of liver failure, and 6 of acquired immunodeficiency syndrome. Estimated 5- and 10-year probability of survival free of orthotopic liver transplantation was 100% and 100% for patients with mild hepatitis, 90% and 90% for severe hepatitis, 81% and 58% for histological asymptomatic cirrhosis, and 49% and 40% for clinical cirrhosis (
P < 0.01), respectively.
Conclusions: Occurrence of fresh and severe forms of hepatitis D has diminished greatly in Italy. Contemporary patients represent cohorts infected years ago who survived the immediate medical impact of hepatitis D. The disease has been asymptomatic and nonprogressive in a minority; in the majority, it rapidly advanced to cirrhosis but thereafter subsided with stable clinical conditions for more than a decade.
GASTROENTEROLOGY 1999;117:161-166</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10381923</pmid><doi>10.1016/S0016-5085(99)70563-9</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult AIDS/HIV Biological and medical sciences Cohort Studies Female Follow-Up Studies Hepatitis D, Chronic - complications Hepatitis D, Chronic - metabolism Hepatitis D, Chronic - pathology Hepatitis D, Chronic - physiopathology Hepatitis D, Chronic - surgery Human viral diseases Humans Infectious diseases Italy Liver Cirrhosis - complications Liver Transplantation Male Medical sciences Middle Aged Multivariate Analysis Prognosis Survival Analysis Viral diseases Viral hepatitis |
| title | Changing pattern of chronic hepatitis D in Southern Europe |
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