Prevalence of Hepatitis C Virus Among Hospitalized Patients in a Tertiary Hospital in Italy: The Basis for a National Screening Assessment Model?
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Statistical Analysis
3. Results
4. Discussion and Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
Abbreviations
HCV Ab | HCV antibody |
HCOs | healthcare organizations |
EMRs | electronic medical records |
PTs | patients |
AST | aspartate aminotransferase |
ALT | alanine aminotransferase |
GGT | gamma glutamyl transpeptidase |
PLTs | platelets |
ALP | alkaline phosphatase |
SD | standard deviation |
References
- Polaris Observatory HCV Collaborators. Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: A modelling study. Lancet Gastroenterol. Hepatol. 2022, 7, 396–415. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Combating Hepatitis B and C to Reach Elimination by 2030; WHO: Geneva, Switzerland, 2016. [Google Scholar]
- Kondili, L.A.; Andreoni, M.; Alberti, A.; Lobello, S.; Babudieri, S.; De Michina, A.; Merolla, R.; Marrocco, W.; Craxì, A. A mathematical model by route of transmission and fibrosis progression to estimate undiagnosed individuals with HCV in different Italian regions. BMC Infect. Dis. 2022, 22, 58. [Google Scholar] [CrossRef] [PubMed]
- WHO. Global Health Sector Strategy on Viral Hepatitis 2016–2021; WHO: Geneva, Switzerland, 2016; Available online: https://www.who.int/publications/i/item/WHO-HIV-2016.06 (accessed on 20 May 2024).
- Kondili, L.A.; Gamkrelidze, I.; Blach, S.; Marcellusi, A.; Galli, M.; Petta, S.; Puoti, M.; Vella, S.; Razavi, H.; Craxi, A.; et al. Optimization of hepatitis C virus screening strategies by birth cohort in Italy. Liver Int. 2020, 40, 1545–1555. [Google Scholar] [CrossRef] [PubMed]
- Kondili, L.A.; Aghemo, A.; Andreoni, M.; Galli, M.; Rossi, A.; Babudieri, S.; Nava, F.; Leonardi, C.; Mennini, F.S.; Gardini, I.; et al. Milestones to reach Hepatitis C Virus (HCV) elimination in Italy: From free-of-charge screening to regional roadmaps for an HCV-free nation. Dig. Liver Dis. 2022, 54, 237–242. [Google Scholar] [CrossRef] [PubMed]
- Palchuk, M.B.; London, J.W.; Perez-Rey, D.; Drebert, Z.J.; Winer-Jones, J.P.; Thompson, C.N.; Esposito, J.; Claerhout, B. A global federated real-world data and analytics platform for research. JAMIA Open 2023, 6, ooad035. [Google Scholar] [CrossRef]
- Vandenbroucke, J.P.; von Elm, E.; Altman, D.G.; Gøtzsche, P.C.; Mulrow, C.D.; Pocock, S.J.; Poole, C.; Schlesselman, J.J.; Egger, M.; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration. PLoS Med. 2007, 4, e297. [Google Scholar] [CrossRef]
- Rassen, J.A.; Bartels, D.B.; Schneeweiss, S.; Patrick, A.R.; Murk, W. Measuring prevalence and incidence of chronic conditions in claims and electronic health record databases. Clin. Epidemiol. 2018, 11, 1–15. [Google Scholar] [CrossRef]
- Stroffolini, T.; Menchinelli, M.; Taliani, G.; Dambruoso, V.; Poliandri, G.; Bozza, A.; Lecce, R.; Clementi, C.; Ippolito, F.M.; Compagnoni, A. High prevalence of hepatitis C virus infection in a small central Italian town: Lack of evidence of parenteral exposure. Ital. J. Gastroenterol. 1995, 27, 235–238. [Google Scholar]
- Di Stefano, R.; Stroffolini, T.; Ferraro, D.; Usticano, A.; Valenza, L.M.; Montalbano, L.; Pomara, G.; Craxì, A. Endemic hepatitis C virus infection in a Sicilian town: Further evidence for iatrogenic transmission. J. Med. Virol. 2002, 67, 339–344. [Google Scholar] [CrossRef]
- Rosato, V.; Kondili, L.A.; Nevola, R.; Perillo, P.; Mastrocinque, D.; Aghemo, A.; Claar, E. Elimination of hepatitis C in Southern Italy: A model of HCV screening and linkage to care among hospitalized patients at different hospital divisions. Viruses 2022, 14, 1096. [Google Scholar] [CrossRef]
- Kondili, L.A.; Andreoni, M.; Alberti, A.; Lobello, S.; Babudieri, S.; Roscini, A.S.; Merolla, R.; Marrocco, W.; Craxì, A. Estimated prevalence of undiagnosed HCV infected individuals in Italy: A mathematical model by route of transmission and fibrosis progression. Epidemics 2021, 34, 100442. [Google Scholar] [CrossRef]
- Kondili, L. L’infezione cronica da virus dell’epatite C (HCV) in Lombardia. Infez. Med. 2021, S2, 7–10. [Google Scholar]
- Roshanshad, R.; Roshanshad, A.; Fereidooni, R.; Hosseini-Bensenjan, M. COVID-19 and liver injury: Pathophysiology, risk factors, outcome and management in special populations. World J. Hepatol. 2023, 15, 441–459. [Google Scholar] [CrossRef] [PubMed]
- Nawghare, P.; Jain, S.; Chandnani, S.; Bansal, S.; Patel, S.; Debnath, P.; Rane, S.; Deshmukh, R.; Rathi, P.; Contractor, Q. Predictors of severity and mortality in chronic liver disease patients with COVID-19 during the second wave of the pandemic in India. Cureus 2022, 14, e20891. [Google Scholar] [CrossRef] [PubMed]
- Ruggeri, M.; Coretti, S.; Prete, S.; Romano, F.; Orlando, V.; Codella, P.; Di Brino, E. Economic evaluation of screening programs for hepatitis C virus infection: Evidence from literature. Risk Manag. Healthc. Policy 2015, 8, 45–54. [Google Scholar] [CrossRef] [PubMed]
- Ruggeri, M.; Coretti, S.; Gasbarrini, A.; Cicchetti, A. Economic assessment of an anti-HCV screening program in Italy. Value Health 2013, 16, 965–972. [Google Scholar] [CrossRef] [PubMed]
- Coppola, C.; Kondili, L.A.; Staiano, L.; Cammarota, S.; Citarella, A.; Aloisio, M.P.; Annunziata, A.; Bernardi, F.F.; D’Avino, A.; D’Orazio, M.; et al. Hepatitis C virus micro-elimination plan in Southern Italy: The “HCV ICEberg” project. Pathogens 2023, 12, 195. [Google Scholar] [CrossRef]
- Morisco, F.; Loperto, I.; Stroffolini, T.; Lombardo, F.L.; Cossiga, V.; Guarino, M.; De Feo, A.; Caporaso, N. Prevalence and risk factors of HCV infection in a metropolitan area in southern Italy: Tail of a cohort infected in past decades. J. Med. Virol. 2017, 89, 291–297. [Google Scholar] [CrossRef]
- D’Ambrosio, R.; Rizzardini, G.; Puoti, M.; Fagiuoli, S.; Anolli, M.; Gabiati, C.; D’Amico, F.; Pasulo, L.; Restelli, U.; Colombo, M.; et al. Implementation of HCV screening in the 1969–1989 birth-cohort undergoing COVID-19 vaccination. Liver Int. 2022, 42, 1012–1016. [Google Scholar] [CrossRef]
- Piazzolla, A.V.; Paroni, G.; Bazzocchi, F.; Cassese, M.; Cisternino, A.; Ciuffreda, L.; Gorgoglione, F.; Gorgoglione, L.; Palazzo, V.; Sciannamè, N.; et al. High rates of hidden HCV infections among hospitalized patients aged 55–85. Pathogens 2021, 10, 695. [Google Scholar] [CrossRef]
- Messina, V.; Pisaturo, M.; Alessio, L.; Russo, A.; Tripaldelli, E.; Petruzziello, A.; Annecchiarico, A.; Romano, M.R.; Maggi, P.; Coppola, N. Hepatitis C virus (HCV) micro-elimination in the hospital setting: The results of the HCV Caserta hospital project. J. Infect. Public Health 2022, 15, 562–565. [Google Scholar] [CrossRef]
Overall Patients | Birth Year Cohort | |||||
---|---|---|---|---|---|---|
Characteristics | Before 1947 | 1947–1968 | 1969–1989 | 1990–2000 | 2001–2022 | |
Number | 42,805 | 10,322 | 18,238 | 11,155 | 2479 | 611 |
Age, years | 57.8 (±18) | 78.9 (±4.7) | 62.5 (±6.46) | 40.1 (±6.29) | 25.6 (±3.45) | 12.1 (±6.62) |
Males | 22,141 (52) | 6179 (60) | 11,103 (61) | 3856 (35) | 712 (29) | 291 (48) |
AST levels, IU/L | 50.1 (±373) | 50 (±324) | 52.9 (±422) | 43.4 (±219) | 39.6 (±201) | 56.4 (±228) |
ALT levels, IU/L | 44.3 ± 197 | 38.1 (±158) | 42.3 (±167) | 49.2 (±230) | 42.2 (±166) | 59.7 (±163) |
GGT levels, IU/L | 61.6 (±149) | 58.8 (±124) | 65.9 (±157) | 55.5 (±123) | 36.9 (±65.7) | 32.9 (±64.1) |
PLTs count, ×109/L | 232 (±84.8) | 218 (±85.8) | 233 (±85.3) | 242 (±80.3) | 239 (±78.6) | 268 (±119) |
Total bilirubin, mg/dL | 0.88 (±1.69) | 0.912 (±1.76) | 0.975 (±2.02) | 0.754 (±1.35) | 0.638 (±0.601) | 0.573 (±0.702) |
ALP levels, IU/L | 91.4 (±97.4) | 92.9 (±102) | 95.4 (±108) | 78.4 (±74.3) | 68 (±47.1) | 176 (±109) |
Years | ||||||
---|---|---|---|---|---|---|
2017 | 2018 | 2019 | 2020 | 2021 | 2022 | |
Patients at risk, total number | 16,468 | 18,843 | 19,440 | 17,278 | 15,443 | 9046 |
Incident case, number | 338 | 282 | 264 | 192 | 186 | 35 |
Incidence proportion, (%) | 2.05 | 1.50 | 1.36 | 1.11 | 1.20 | 0.39 |
Males, number | 8325 | 9343 | 9671 | 8533 | 7557 | 4414 |
Incident cases, number | 186 | 161 | 153 | 116 | 112 | 21 |
Incidence proportion (%) | 2.23 | 1.72 | 1.58 | 1.36 | 1.48 | 0.48 |
Females, number | 8143 | 9500 | 9769 | 8745 | 7886 | 4632 |
Incident cases, number | 152 | 121 | 111 | 76 | 74 | 14 |
Incidence proportion (%) | 1.87 | 1.27 | 1.14 | 0.87 | 0.94 | 0.30 |
Characteristics | Years of Birth | |||
---|---|---|---|---|
Overall | Before 1947 | 1947–1968 | 1969–1989 | |
Number | 1284 | 553 | 563 | 168 |
Age, mean (standard deviation), years | 66.7 (±14.5) | 79.7 (±4.9) | 62.1 (±6.74) | 42.7 (±6.09) |
Males (number) | 749 (57.6) | 282 (51) | 356 (63.2) | 103 (61.3) |
AST levels, IU/L | 75.7 (±602) | 80.9 (±826) | 77 (±400) | 57.5 (±117) |
ALT levels, IU/L | 52.3 (±193) | 45.2 (±239) | 54 (±149) | 71.6 (±157) |
GGT levels, IU/L | 70.3 (±123) | 55.4 (±95.5) | 83 (±138) | 86.5 (±153) |
PLTs count, 109/L | 196 (±91.3) | 186 (±87.1) | 195 (±89.5) | 225 (±101) |
Total bilirubin, mg/dL | 1.08 (±2.19) | 0.994 (±2.25) | 1.13 (±1.94) | 1.26 (±2.8) |
ALP levels, IU/L | 94.7 (±87.8) | 89.6 (±57.6) | 97.6 (±97.7) | 103 (±134) |
Age Group by Years of Birth | HCV RNA Tested (Number) | HCV RNA Positive (Number) | HCV RNA Positive (%) |
---|---|---|---|
Before 1947 | 57 | 24 | 42.11 |
1947–1968 | 92 | 30 | 32.61 |
1969–1989 | 45 | 20 | 44.44 |
1990–2000 | 4 | 3 | 75 |
2001–2022 | 0 | 0 | - |
Total | 198 | 77 |
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Morsica, G.; Locatelli, M.; Hernandez-Ibarburu, G.; Rusconi, F.; Segovia-Hilara, A.; Di Napoli, D.; Moro, M.; Mazzitelli, S.; Hasson, H.; Esposti, F.; et al. Prevalence of Hepatitis C Virus Among Hospitalized Patients in a Tertiary Hospital in Italy: The Basis for a National Screening Assessment Model? Microorganisms 2025, 13, 129. https://doi.org/10.3390/microorganisms13010129
Morsica G, Locatelli M, Hernandez-Ibarburu G, Rusconi F, Segovia-Hilara A, Di Napoli D, Moro M, Mazzitelli S, Hasson H, Esposti F, et al. Prevalence of Hepatitis C Virus Among Hospitalized Patients in a Tertiary Hospital in Italy: The Basis for a National Screening Assessment Model? Microorganisms. 2025; 13(1):129. https://doi.org/10.3390/microorganisms13010129
Chicago/Turabian StyleMorsica, Giulia, Massimo Locatelli, Gema Hernandez-Ibarburu, Francesca Rusconi, Alba Segovia-Hilara, Davide Di Napoli, Matteo Moro, Salvatore Mazzitelli, Hamid Hasson, Federico Esposti, and et al. 2025. "Prevalence of Hepatitis C Virus Among Hospitalized Patients in a Tertiary Hospital in Italy: The Basis for a National Screening Assessment Model?" Microorganisms 13, no. 1: 129. https://doi.org/10.3390/microorganisms13010129
APA StyleMorsica, G., Locatelli, M., Hernandez-Ibarburu, G., Rusconi, F., Segovia-Hilara, A., Di Napoli, D., Moro, M., Mazzitelli, S., Hasson, H., Esposti, F., Mazzuconi, R., & Castagna, A. (2025). Prevalence of Hepatitis C Virus Among Hospitalized Patients in a Tertiary Hospital in Italy: The Basis for a National Screening Assessment Model? Microorganisms, 13(1), 129. https://doi.org/10.3390/microorganisms13010129