1,720,961 research outputs found
Acute hepatitis A in Italy: incidence, risk factors and preventive measures
No full textThe incidence of, and risk factors for, acute hepatitis A (AHA) were assessed by using data collected from the Italian surveillance system of acute viral hepatitis (SEIEVA). To this end, a case-control study within a population-based surveillance for acute viral hepatitis was performed. AHA incidence has been estimated since 1991; the association with considered risk factors was analysed from 2001 to 2006 employing cases of acute hepatitis B (AHB) as controls. The incidence of AHA declined from 4 / 100 000 in 1991 to 1.4/100 000 in 2006, with a peak during 1996-1998 due to an outbreak in southern Italy. The incidence of AHA was highest among persons aged 15-24 years. The case-fatality rate was 2.9 / 10 000. Contact with individuals with AHA [adjusted OR (OR(adj)) = 3.8, 95% CI 2.7-5.5; population-attributable risk (PAR) = 7.5%], travelling to endemic areas (OR(adj) = 3.1, 95% CI = 2.6-3.8; PAR = 19.5%), ingestion of raw shellfish (OR(adj) = 1.8, 95% CI = 1.6-2.1; PAR = 26.6%), and cohabitation with day care children (OR(adj) = 1.3, 95% CI = 1.01-1.7; PAR = 2.3%) were the main important risk factors. In 2003, an outbreak, with high case-fatality rate occurred among intravenous drug users, in a central Italian town. A weak association was found for male homosexuality when acute hepatitis C cases were employed as controls (OR(adj) = 1.4 CI, 95% CI = 1.1-1.9). Hepatitis A virus infections are currently occurring more frequently in adults, in whom the disease is most severe. In conclusion, looking at the attributable risks, at present most of the AHA infections are due to shellfish consumption, travel to endemic areas and contact with patients with AHA. Vaccination of individuals at increased risk of infection, as well as persons with underling liver disease and those at increased risk of complications, combined with surveillance of shellfish retail outlets are efficient control measures
Risk of parenterally transmitted hepatitis following exposure to invasive procedures in Italy: SEIEVA surveillance 2000-2021
No full textAcute Delta Hepatitis in Italy spanning three decades (1991-2019): Evidence for the effectiveness of the hepatitis B vaccination campaign
No full textUpdated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come
Acute hepatitis delta virus infection in Italy: incidence and risk factors after the introduction of the universal anti-hepatitis B vaccination campaign
No full textEffectiveness of Hepatitis B Vaccination Campaign in Italy: Towards the Control of HBV Infection for the First Time in a European Country
No full textBackground: In 1991, a mass immunization campaign against the hepatitis B virus (HBV) for children and teenagers was introduced in Italy. This study evaluated the impact of the immunization campaign on the incidence and modes of HBV transmission. Method: Acute HBV cases of viral hepatitis were reported to the National Surveillance System (SEIEVA). Hepatitis A cases reported to the same system were used as controls to calculate the adjusted odds ratios and the population attributable risk for potential risk factors. Results: The incidence of acute HBV declined from 5.0 in 1990 to 0.4 in 2019 per 100,000 population. The fall was almost total in people targeted by the campaign: in 2019, zero cases (100% reduction) in the age-group 0–14 years and 0.1 cases per 100,000 population (99.4% reduction) in the age-group 15–24 years were reported. In the decade 2010–2019, nearly one-fifth (19.3%) of cases occurred in foreigners. Intravenous drug use is no longer a risk factor (OR = 0.7; 95% CI = 0.5–1.02). Beauty treatments, risky sexual exposure, and household contact with an HBsAg carrier were found to be independent predictors of acute hepatitis B. Conclusions: The HB vaccination campaign proved effective in minimising acute HBV in Italy. Control of the infection is close to being reached for the first time in Europe
Acute hepatitis delta virus infection in Italy: incidence and risk factors after the introduction of the universal anti-hepatitis B vaccination campaign
No full textAcute hepatitis B 14 years after the implementation of universal vaccination in Italy: areas of improvement and emerging challenges
No full textBackground. 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 aged25 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
Acute hepatitis B 14 years after the implementation of universal vaccination in Italy: areas of improvement and emerging challenges
No full textBackground. 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 aged25 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
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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