Giusti G, Sagnelli E, Gallo C, Piccinino F, Galanti B, Gaeta G B
Clinic of Infectious Diseases, School of Medicine, Second University of Naples, Italy.
Hepatogastroenterology. 1994 Aug;41(4):397-400.
In a multicenter retrospective study, we reviewed the etiology of chronic hepatitis (CH) in Italy during the period 1980-1989, before the laboratory diagnosis of HCV hepatitis had become possible. Among the 5,461 patients investigated, 31.3% had HBV-CH, 5.5% HDV-CH, 3.0% serological markers of autoimmune hepatitis and 3.7% post-transfusion NANB CH. Alcohol abuse was considered responsible in 10.9% of the cases and a diagnosis of crytogenic CH was made in 42.5%. Considering that most cryptogenic cases were actually due to chronic HCV infection, we may assume that as many as two-thirds of our cases were due to a hepatitis virus infection. Some differences were observed between patients with chronic hepatitis of different etiologies. Drug abuse was frequently recorded only in HDV-CH; patients with HBV-CH and HCV-CH were younger than those in other etiological groups; a histological picture of chronic active hepatitis was more frequently recorded in HDV-CH and autoimmune CH. The only identifiable geographical differences observed were a higher prevalence of HDV-CH in the south and of alcoholic chronic liver diseases in the north. During the period under observation, we noted a clear reduction in the percentages of HBV chronic hepatitis cases after 1984 and, accordingly, the mean age of HBV-CH progressively increased from 1980 to 1989 by almost a year each year. This observation is in agreement with recent data suggesting a reduction in HBV endemicity in Italy in recent years.
在一项多中心回顾性研究中，我们回顾了1980年至1989年期间意大利慢性肝炎（CH）的病因，当时丙型肝炎病毒（HCV）肝炎的实验室诊断尚未成为可能。在5461名接受调查的患者中，31.3%患有乙型肝炎病毒慢性肝炎（HBV-CH），5.5%患有丁型肝炎病毒慢性肝炎（HDV-CH），3.0%有自身免疫性肝炎的血清学标志物，3.7%为输血后非甲非乙型慢性肝炎（NANB CH）。10.9%的病例被认为是由酒精滥用引起的，42.5%的病例被诊断为隐源性慢性肝炎（cryptogenic CH）。考虑到大多数隐源性病例实际上是由慢性HCV感染引起的，我们可以假设多达三分之二的病例是由肝炎病毒感染引起的。不同病因的慢性肝炎患者之间观察到了一些差异。药物滥用仅在HDV-CH患者中经常被记录；HBV-CH和HCV-CH患者比其他病因组的患者更年轻；HDV-CH和自身免疫性慢性肝炎中慢性活动性肝炎的组织学表现更常见。观察到的唯一可识别的地理差异是南部HDV-CH的患病率较高，北部酒精性慢性肝病的患病率较高。在观察期间，我们注意到1984年后HBV慢性肝炎病例的百分比明显下降，相应地，HBV-CH的平均年龄从1980年到1989年每年逐渐增加近一岁。这一观察结果与最近的数据一致，表明近年来意大利HBV的流行率有所下降。
