All Journals > Clinical Infectious Diseases > 15 March 2008 > Acute Hepatitis B Epidemiology in Italy

Article Tools

Search for Related Articles

  • By Author
  • Search In

Announcements

CID LISTED AMONG
“MOST INFLUENTIAL”

Clinical Infectious Diseases has been named as one of the "100 Most Influential Journals in Biology and Medicine" of the past 100 years by the Special Libraries Association. The list was compiled by the 680-plus members of SLA’s Biomedical and Life Sciences Division.

See the full list here.

Source: The DBIO 100, the 100 Most Influential Journals in Biology & Medicine over the last 100 Years

In the News

Featured in MSNBC
"Germs and flu are up; infection control is down" June 9, 2009
Trends in the Incidence of Methicillin‐Resistant Staphylococcus aureus Infection in Children’s Hospitals in the United States
Jeffrey S. Gerber, Susan E. Coffin, Sarah A. Smathers, and Theoklis E. Zaoutis
Just this week, researchers reported that the incidence of MRSA infections among children admitted to pediatric hospitals in the United States more than tripled between 2002 and 2007. Researchers at the Children’s Hospital of Philadelphia and the University of Pennsylvania found cases of MRSA jumped from 6.7 per 1,000 admissions in 2002 to 21.1 cases per 1,000 admissions in 2007, according to a study released online Monday in the journal Clinical Infectious Diseases.

Featured in Toronto Star
"Pigs, viruses and politics" May 2, 2009
Are Swine Workers in the United States at Increased Risk of Infection with Zoonotic Influenza Virus?
Kendall P. Myers, Christopher W. Olsen, Sharon F. Setterquist, Ana W. Capuano, Kelley J. Donham, Eileen L. Thacker, James A. Merchant, and Gregory C. Gray
Another study, this one published in the U.S. journal Clinical Infectious Diseases in 2006, found that workers in meat-processing plants have a greater likelihood of being infected by some version of the H1N1 flu virus than the general population (the odds of pig farmers getting the disease are significantly greater again).

Featured in Philadelphia Inquirer
"A shot in the arm for vaccines" April 19, 2009
Vaccines: Pneumococcal Vaccination of Elderly Adults: New Paradigms for Protection
Lisa A. Jackson and Edward N. Janoff
Every year, an estimated 915,000 people 65 and older get pneumonia, and 40 percent of them end up in hospitals, according to a 2004 paper in the journal Clinical Infectious Diseases. Pneumonia often kills older people, said Richard Stefanacci, a geriatrician at the University of the Sciences in Philadelphia.

15 March 2008

Volume 46, Number 6
Clinical Infectious Diseases 2008;46:868–875
© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4606-0013$15.00
DOI: 10.1086/528687
MAJOR ARTICLE

Acute Hepatitis B 14 Years after the Implementation of Universal Vaccination in Italy: Areas of Improvement and Emerging Challenges

Alfonso Mele,1

Maria Elena Tosti,1

Andrea Mariano,2

Renato Pizzuti,4

Antonio Ferro,5

Bianca Borrini,6

Carla Zotti,7

Pierluigi Lopalco,8

Filippo Curtale,3

Emanuela Balocchini,9 and

Enea Spada,1 for the

National Surveillance System for Acute Viral Hepatitis (SEIEVA) Collaborating Groupa

1National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 2Clinical Research Department, National Institute for Infectious Diseases Lazzaro Spallanzani, and 3Public Health Agency of the Lazio Region, Rome, 4Regional Health Authority, Regione Campania, Naples, 5Service of Public Health and Screening, Regione Veneto, Venezia, 6Regional Health Authority, Regione Emilia Romagna, Bologna, 7Department of Public Health and Microbiology, University of Turin, Turin, 8Institute of Hygiene, University of Bari, Bari, and 9Regional Health Authority, Toscana Region, Florence, Italy

Background.Italy had intermediate‐level endemicity for hepatitis B virus (HBV) infection in the 1970s and 1980s. In 1991, vaccination of infants and adolescents became mandatory. We report the impact of universal vaccination 14 years after its beginning.

Methods.We performed a case–control study within a population‐based surveillance for acute viral hepatitis. The incidence of acute hepatitis B (AHB) was estimated for the time since 1991, and the association between AHB and the considered risk factors was analyzed for the period 2001–2005.

Results.The incidence of AHB progressively decreased from 1991 to 2005, mainly for persons in the age groups targeted by the universal vaccination campaign: there was a 24‐fold and 50‐fold decrease in the 15–24‐year and 0–14‐year age groups, respectively; for the 25‐year age group, the incidence halved. Owing to the persons' ages, 3% of total AHB cases should have been the target of vaccination campaign. In 2004–2005, foreigners accounted for 14% of total cases and for 57% of persons who should have been targets for vaccination. Missed opportunities for immunization were documented for 50% of patients with AHB who reported cohabitation with HBV carriers and for 70% of those who reported injection drug use. The strongest associations with AHB were found for blood transfusion (adjusted odds ratio [ORadj], 8.4; 95% confidence interval [CI], 2.7–26), cohabitation with HBV carriers (ORadj, 5.3; 95% CI, 3.6–7.7), injection drug use (ORadj, 3.8; 95% CI, 2.5–5.8), and unsafe sexual practices (ORadj, 2.8; 95% CI, 1.9–4.2).

Conclusion.Universal vaccination has contributed to a decreasing AHB incidence in Italy, especially by reducing the risk of infection among persons aged 15–24 years. Most infections occur in persons aged 25 years in association with injection drug use, unsafe sexual activity, percutaneous treatment, and iatrogenic exposure. Improvement of vaccine coverage in high‐risk groups and adherence to infection control measures during surgery and percutaneous treatment are needed. The high risk still associated with blood transfusion needs to be further investigated, with consideration of occult HBV infection in blood donors. The potential spread of HBV infection from the immigrant population deserves adequate health policy prevention programs.

Received 25 July 2007; accepted 1 November 2007; electronically published 12 February 2008.

Reprints or correspondence: Dr. Enea Spada, Istituto Superiore di Sanità, National Center of Epidemiology, Surveillance and Health Promotion, Clinical Epidemiology Unit, Via Giano Della Bella, 34‐00162 Rome, Italy ().

Cited by

P. Iudicone, M. Miceli, M. Palange, A. Agresti, A. Gallo, G. Isacchi, E. Girolami, L. Pierelli, E. Mannella. (2009) Hepatitis B virus blood screening: impact of nucleic amplification technology testing implementation on identifying hepatitis B surface antigen non-reactive window period and chronic infections. Vox Sanguinis 96:4, 292-297
Online publication date: 1-Jun-2009.
CrossRef
Anne Gervais, Pascale Longuet, and Catherine Leport. (2008) Editorial Commentary: A Success Story: Universal Vaccination in Italy—What Has to Be Done to Eradicate Residual Acute Hepatitis B?. Clinical Infectious Diseases 46:6, 876-877
Online publication date: 15-Mar-2008.
Citation-Full Text-PDF Version (164 kB)
Back to Top
Close Popup