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Risk profiles for acute hepatitis B and C from 2004 to 2024 in Italy: A cluster and disproportionality analysis from
Roberto Benoni1, Arianna Bellini2, Luigina Ferrigno3
1Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy.
Objectives:
Despite the decline in HBV and HCV incidence in Italy, identifying at-risk populations remains a priority. We aimed to identify risk profiles for acute HBV and HCV infections and possible signals of reporting disproportionality.
Methods:
The study used data from the Integrated Epidemiological System of Acute Viral Hepatitis from 2004 to 2024. K-medoids clustering was applied to identify acute hepatitis profiles, considering demographic characteristics and major risk factors (drug use, nosocomial risk, men who have sex with men - MSM, risky sexual behaviour, living with HBsAg+ person). Disproportionality signals were assessed using reporting odds ratio (ROR) and 95% confidence intervals (95%CI).
Results:
The 3339 HBV cases were divided into 9 profiles. The most common profiles included Italian males: without reported risk factors (n=940, 28.2%), with heterosexual (n=719, 21.5%), or MSM (n=315, 9.4%) risk sexual behaviour. Six signals for HBV were identified, the most recent for females living with HBsAg+ person (2023 ROR=2.8, 95%CI=1.4-5.6) or without reported risk factors (2021 ROR=2.4, 95%CI=1.5-8.1). The 975 HCV cases were divided into 8 profiles, the most frequent consisting of predominantly Italian females with no reported risk factors (n=181, 18.6%) and young Italian males with a history of drug use (n=135, 13.8%). There were 11 signals identified for HCV of which 5 related to the MSM profile with risky sexual behaviour (most recent in 2024: ROR=4.0, 95%CI=1.5-10.3).
Conclusions:
Acute HBV and HCV infections are frequently reported in individuals lacking commonly known risk factors. Awareness and screening campaigns aimed also at low-prevalence populations are needed to reach the elimination target of viral hepatitis as a public health problem.
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