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Hepatitis A incidence and hospital-based seroprevalence in Italy: a nation-wide study

  • Hepatitis
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Abstract

To define the pattern of HAV infection in Italy and to study the differences among geographic areas (northern, central and southern Italy) and age-classes, we performed HAV antibody testing on sera collected in 1996–1997 from a large sample of the Italian population and compared the results with those of other seroprevalence studies and with incidence data for the period 1985–2005, calculated by a surveillance system specific for acute viral hepatitis based on symptomatic cases. A total of 3,561 sera, collected by hospital-based reference laboratories in 18 out of 20 Italian Regions, were tested; 1,138 (32%, 95% CI: 30.5–33.5) were positive. The age-adjusted prevalence was 60.1% and the age-specific rates were among the highest rates reported in Europe in the 1990s. The age-adjusted seroprevalence showed a significant north–south gradient, increasing from 55% in northern Italy to 68% in southern Italy. Age and area of residence were found to be strong predictors of previous HAV infection: the marked increase in prevalence with increasing age represents a strong cohort effect. In northern Italy, a marked increase with age was observed beginning with the 20- to 29-year age-class, whereas in southern Italy, such an increase was observed beginning with the 12- to 19-year age-class, indicating that northern Italy preceded southern Italy by 10–20 years in terms of improvements in hygiene and sanitation. The incidence of HAV infection shows an evident peak in 1997, when an outbreak occurred in southern Italy, mainly affecting 15- to 24-year-old individuals. In the period from 1998 to 2005, the incidence drastically decreased (average of 3.2/100,000 inhabitants), reaching a minimum of 2/100,000 inhabitants in 2005.

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Abbreviations

Anti-HAV:

Antibodies to hepatitis A virus

HAV:

Hepatitis A virus

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Acknowledgements

The authors wish to thank Mark Kanieff for editorial assistance and Patrizia Caligiuri for technical assistance.

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Authors and Affiliations

  1. Department of Health Sciences, University of Genoa, Via Pastore 1, 16100, Genoa, Italy

    Filippo Ansaldi, Bianca Bruzzone, Paolo Durando, Roberto Gasparini & Giancarlo Icardi

  2. Istituto Superiore di Sanità, Roma, Italy

    Maria Cristina Rota, Antonino Bella & Marta Ciofi degli Atti

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  1. Filippo Ansaldi
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  2. Bianca Bruzzone
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  3. Maria Cristina Rota
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and the Serologic Study Group

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Correspondence to Filippo Ansaldi.

Additional information

Serologic Study Group: S. Barbuti, M.C. Berlinghieri, W. Caraccio, E. Ciotoli, L. Cosentino, E. Del Prete, A. Favero, A. Focà, M. Fringuelli, G. Gabutti, C. Germinario, A. Giammanco, A. Goglio, S. Grandesso, M. Greco, F. Leoncini, G. Maistri, D. Marchetti, P. Martelli, P. Montanera, A. Mundo, G. Obino, S. Oliva, S. Pegoretti, V. Perani, P. Quaranta, G. Riario Sforza, G. Santini, L. Simula, L. Titone, and M. Tronci.

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Ansaldi, F., Bruzzone, B., Rota, M.C. et al. Hepatitis A incidence and hospital-based seroprevalence in Italy: a nation-wide study. Eur J Epidemiol 23, 45–53 (2008). https://doi.org/10.1007/s10654-007-9198-y

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