Epidemiology of viral hepatitis B in Italy

Hepatitis B has been one of the major public health problems in Italy in the last 30 years. This is shown by the number of carriers of hepatitis B virus (HBV) among the population (approximately 1.5 million) and the large number of deaths (approximately 9000) in Italy each year ascribable to liver disease as a result of previous HBV infection (chronic hepatitis, cirrhosis, primary liver cancer). In the last 20 years the incidence of hepatitis B has gradually decreased due to demographic and socioeconomic changes which have occurred in Italy and to the preventive measures adopted. The major result so far obtained is the marked reduction in new infections and therefore in the prevalence of HBsAg carriers in infancy and childhood (aged < 14 years). In older age groups, both the prevalence of HBsAg carriers and the annual rate of new cases of acute hepatitis B are still above the average for northern Europe. In particular, the highest incidence of new hepatitis B cases (approximately 10 in 100,000) currently occurs in subjects between 15 and 24 years of age. For these reasons, the health authorities decided to combine general measures aimed at preventing the transmission of HBV infection with a programme of universal, compulsory, vaccination of adolescents at 12 years of age and of newborns. The aim of the present strategy, which started in the second half of 1991, is to drastically reduce the rate of HBV infections within the next 12 years.