THE ETIOLOGY OF CHRONIC HEPATITIS IN ITALY - A MULTICENTER STUDY

In a multicenter retrospective study, we reviewed the etiology of chro nic hepatitis (CH) in Italy during the period 1980-1989, before the la boratory diagnosis of HCV hepatitis had become possible. Among the 5,4 61 patients investigated, 31.3 % had HBV-CH, 5.5 % KDV-CH, 3.0 % serol ogical markers of autoimmune hepatitis and 3.7 % post-transfusion NANB CH. Alcohol abuse was considered responsible in 10.9 % of the cases a nd a diagnosis of crytogenic CH was made in 42.5 %. Considering that m ost cryptogenic cases were actually due to chronic HCV infection, we m ay assume that as many as two-thirds of our cases were due to a hepati tis virus infection. Some differences were observed between patients w ith chronic hepatitis of different etiologies. Drug abuse was frequent ly recorded only in HDV-CH; patients with HBV-CH and HCV-CH were young er than those in other etiological groups; a histological picture of c hronic active hepatitis was more frequently recorded in HDV-CH and aut oimmune CH. The only identifiable geographical differences observed we re 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 ca ses after 1984 and, accordingly, the mean age of HBV-CH progressively increased from 1980 to 1989 by almost a year each year. This observati on is in agreement with recent data suggesting a reduction in HBV ende micity in Italy in recent years.