Estimating the incidence, prevalence and clinical burden of hepatitis C over time in Italy

Abstract

Our objective was to estimate HCV clinical burden over time in Italy. A national age-specific HCV prevalence in 1995 was obtained from studies conducted in general population samples and intravenous drug users. Age profile of new HCV infections and trend of incidence since 1985 were derived from a database of reported acute HCV infections. These incidence and prevalence data were used to estimate HCV burden from 1950 to 2030 by mathematical modelling. Different rates of HCV related liver disease progression were tested to assess the robustness of estimates. It is estimated that HCV had a major spread in Italy in 1945-1969. HCV RNA-positive subjects peaked around 1970; their prevalence in 2005 was 3.2%, 58% of them being >65 y of age. The number of individuals with HCV related cirrhosis and that of HCV liver related deaths peaked in 1980-1985. In 2005, they were approximately 230,000 (range 150,000-240,000, according to lower or higher disease progression rates) and approximately 7,000 (range 2200-12,300), respectively: both will be halved by 2025. In conclusion, unlike other industrialized countries, the burden of clinically relevant HCV-positive cases in Italy is already on the decline and will further reduce in the future. This is due to differences in the age-specific prevalence, most of HCV-positive Italians currently being >65 y of age.

Global control of hepatitis C: where challenge meets opportunity

“…97 In France, HCV HCC related mortality is projected to increase through 2020 98 . With few exceptions 99 , most countries have yet to experience the peak burden of HCV infection. Fortunately, these projections do not account for improved efforts to control morbidity and mortality by prevention and treatment.…”

Update on epidemiology of HCV in Italy: focus on the Calabria Region

“…Intravenous drug use, beauty treatment, hospitalization, surgical intervention, dental therapy and having more than two sexual partners were in decreasing order the most frequently reported risk factors [15]. However, the epidemiology of HCV infection has undergone substantial changes over the past two decades, with a progressive decrease in incidence and a shift in risk factors [16]. In particular, the most recent decrease in incidence rates could be due to changes in injecting behavior among IVDUs and information campaigns on HIV/AIDS.…”

Update on Current Epidemiologic Trends in Hepatitis C

“…In Italy, mathematical modeling suggested that accelerated spread of HCV occurred from 1945 to 1969 (earlier than in the United States), with prevalence peaking in 1970, and HCV-related cirrhosis and deaths peaking from 1980 to 1985. When compared with 2005, cirrhosis and deaths in 2025 may be halved [13]. Lastly, in Australia, mathematical modeling estimated that HCV incidence peaked in 1999 and has fallen since then from 14,000 to 9700 infections by 2005, mostly from reduced injection drug use.…”