对意大利 PITER-B 和 Delta 队列中登记的慢性丁型肝炎病毒 (HDV) 感染患者的整体评估。
A holistic evaluation of patients with chronic Hepatitis D virus (HDV) infection enrolled in the Italian PITER-B and Delta cohort.
发表日期：2024 May 25
作者：
Loreta A Kondili, Giuseppina Brancaccio, Maria Elena Tosti, Barbara Coco, Maria Giovanna Quaranta, Vincenzo Messina, Alessia Ciancio, Filomena Morisco, Valentina Cossiga, Ernesto Claar, Valerio Rosato, Marianna Ciarallo, Irene Cacciola, Francesca Romana Ponziani, Lucia Cerrito, Roberta Coppola, Francesco Longobardi, Elisa Biliotti, Alessia Rianda, Francesco Barbaro, Nicola Coppola, Maria Stanzione, Francesco Barchiesi, Stefano Fagiuoli, Mauro Viganò, Marco Massari, Francesco Paolo Russo, Alberto Ferrarese, Diletta Laccabue, Vito Di Marco, Pierluigi Blanc, Aldo Marrone, Giulia Morsica, Alessandro Federico, Donatella Ieluzzi, Alba Rocco, Francesco Giuseppe Foschi, Alessandro Soria, Ivana Maida, Luchino Chessa, Michele Milella, Elena Rosselli Del Turco, Salvatore Madonia, Liliana Chemello, Ivan Gentile, Pierluigi Toniutto, Matteo Bassetti, Lorenzo Surace, Leonardo Baiocchi, Adriano Pellicelli, Adriano De Santis, Massimo Puoti, Elisabetta Degasperi, Grazia Anna Niro, Anna Linda Zignego, Antonio Craxi, Giovanni Raimondo, Teresa Antonia Santantonio, Maurizia Rossana Brunetto, Giovanni Battista Gaeta, On Behalf Of Piter Collaborating Investigators
来源：
TROPICAL MEDICINE & INTERNATIONAL HEALTH
摘要：
我们旨在描述意大利临床实践中跟踪的慢性丁型肝炎 (CHD) 患者的流行病学和合并症概况，并探讨他们的干扰素 (IFN) 资格。这是一项 PITER 队列的横断面研究，由连续 HBsAg 阳性组成2019-2023 年期间来自 59 个中心的患者。采用logistic回归模型进行多变量分析。在5,492例HBsAg阳性入组患者中，4,152例（75.6%）进行了HDV筛查，422例（10.2%）抗HDV阳性。与HBsAg单一感染者相比，抗HDV阳性患者通常更年轻、非意大利人、有吸毒史、丙氨酸转氨酶（ALT）升高、肝硬化或肝细胞癌（HCC）。与意大利人相比，抗 HDV 阳性的非意大利人更年轻（42.2% 年龄≤40 岁 vs. 2.1%；p<0.001），女性较多（男性 43.0% vs. 68.6%；p<0.001），肝硬化发生率较低和肝癌。 63.2% 的抗 HDV 阳性患者中检测到 HDV-RNA，这些患者更有可能患有 ALT 升高、肝硬化和 HCC。 47.4% 的抗 HDV 阳性患者存在肝外合并症，并且可能影响至少 53.0% 的接受治疗的患者接受含干扰素治疗的资格。CHD 影响年轻、外国出生的患者和老年意大利人，其中三分之二患有肝硬化或肝癌。意大利人和非意大利人都经常患有合并症，并影响了 IFN 的使用资格。版权所有 © 2024。由 Elsevier Ltd 出版。
We aimed to characterize the epidemiologic and comorbidities profiles of patients with chronic Hepatitis D (CHD) followed in clinical practice in Italy and explored their interferon (IFN) eligibility.This was a cross-sectional study of the PITER cohort consisting of consecutive HBsAg-positive patients from 59 centers over the period 2019-2023. Multivariable analysis was performed by logistic regression model.Of 5,492 HBsAg-positive enrolled patients, 4,152 (75.6%) were screened for HDV, 422 (10.2%) were anti-HDV positive. Compared with HBsAg mono-infected, anti-HDV positive patients were more often younger, non-Italians, with a history of drug use, had elevated alanine transaminase (ALT), cirrhosis, or hepatocellular carcinoma (HCC). Compared with Italians, anti-HDV positive non-Italians were younger (42.2% age≤40 years vs. 2.1%; p<0.001), more often females (males 43.0% vs. 68.6%; p<0.001) with less frequent cirrhosis and HCC. HDV-RNA was detected in 63.2% of anti-HDV-positive patients, who were more likely to have elevated ALT, cirrhosis, and HCC. Extrahepatic comorbidities were present in 47.4% of anti-HDV positive patients and could affect the eligibility of IFN-containing therapies in at least 53.0% of patients in care.CHD affects young, foreign-born patients and older Italians, of whom two-thirds had cirrhosis or HCC. Comorbidities were frequent in both Italians and non-Italians and impacted eligibility for IFN.Copyright © 2024. Published by Elsevier Ltd.