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Background: Vallecamonica-Sebino is a community in Northern Italy (99,776 inhabitants) with one of the highest mortality rates for primary liver cancer and cirrhosis in Italy, and voluntary screening for HCV and HBV is widespread. The aim of this study was to estimate the prevalence of chronic liver diseases and their aetiology in the area., Methods: We used the following sources of data, linked at an individual level: (1) hospital discharge data; (2) local Viral Hepatitis Services; (3) tests for anti-HCV antibodies and HBsAg from local laboratories; (4) Local Health Authority registry of chronic liver disease patients; (5) drug prescriptions for HBV and HCV treatment; (6) archives of Alcohol Units., Results: 3.5% of the residents had chronic liver disease, mainly chronic hepatitis (61.6%), followed by cirrhosis (14.0%) and alcoholic liver disease (11.2%). HCV was the main cause of chronic liver disease in females (46.3%) and males (29.8%), followed by alcohol abuse in males (22.9%) and HBV (10.9% males and 9.2% females). Prevalence of anti-HCV positivity was 3.2%, and increased with age to 8.8% in subjects aged 65 years and over., Conclusion: This study shows that an epidemiologic pattern of the prevalence of chronic liver diseases and their aetiology can be obtained using routinely collected data., (Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Background/aims: Hepatitis C virus (HCV) easily undergoes genomic changes, thus accounting for the presence of different genotypes, with different geographic distributions and different outcomes of chronic hepatitis. Type 1b is frequently found in advanced diseases; however, since this genotype is the most prevalent in older patients, the association with advanced age and severity of the disease is confounding. The aim of this study was to assess changes in the prevalence of HCV genotypes by surveying a large population of chronic hepatitis C patients in Northern Italy, and to assess if the high prevalence of genotype 1b in older patients with advanced diseases simply reflects the duration of HCV infection, rather than intrinsic biological properties of HCV., Methods: We studied 1368 HCV-RNA positive patients, with histologically proven chronic hepatitis. Drug addiction, blood transfusions and sporadically acquired infections represented the risk factors., Results: Genotype 1b, the most prevalent isolate, and genotype 2a were associated with older age, cirrhosis, sporadically-acquired infections and blood transfusion, while types 1a, 3a, and 4 were associated with younger age, chronic persistent hepatitis and drug addiction. Patients with a history of transfusions were divided into four groups depending on the period of transfusion. The prevalence of genotype 1b decreased with time. Type 3a appeared only after 1979., Conclusion: The severity of chronic hepatitis C could be related more to the duration of the infection rather than to the intrinsic pathogenicity of HCV genotypes.

This is the first epidemiological study of Hepatocellular Carcinoma (HCC) in the province of Bergamo, an area well-known to have a high incidence of HBsAg (9.1%) and chronic alcoholic liver disease. 72 cases of HCC (60 male, 12 female) al from the province of Bergamo and encountered in 1980-84 were subjected to an epidemiological case-control study. Analysis of the results confirmed the role of certain known Risk Factors (RF) with a prevalence of male sex (83.3%), age (mean age 63), association with live cirrhosis (79.2%) and HBsAg+ (31.9%). Such findings are in line with the Italian average found in previous studies. No difference between the sexes was found in these RF except for alcoholic abuse which was significantly higher in the males (53.3%, p less than 0.05). The case-control correlation analysis revealed no difference in the prevalence of alcohol addiction and previous HBV infection (HBV-Ab+) between the HCC (with or without cirrhosis) and the various control groups (Group A: patients with no liver pathology. Group B: patients with cirrhosis of the liver). HBsAg+ was significantly higher among HCC patients without cirrhosis (46.6%, p less than 0.001), but there was no significant difference between HCC + cirrhosis and cirrhosis alone (88%). The difference between "expected" and "observed" HCC-HBsAg+ was highly significant (p less than 0.001). The overall Relative Risk (RR) of HCC for the RF-HBsAg+ was 4.6. When divided into subgroups this gave: RR = 1 for patients with cirrhosis of the liver. RR = 11.5 for patients with no liver pathology. These data confirm the importance of current HBV infection (HBsAg+), in the province, though the presence or absence of cirrhosis probably influences its significance. The approximate incidence of HCC is 9.7%/100,000/year. Considering the limitations of data on a small monocentric study in a limited area (USSL no. 30) the figure is probably underestimated and the real incidence probably higher.