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Background/Aims : This study assess prevalence, risk factors, and clinical and virological features of dual hepatitis B virus (HBV)/hepatitis C virus (HCV) infection. Methods : We evaluated 837 hepatitis B surface antigen positive patients, prospectively enrolled in 14 Italian units. Results : Anti-HCV was present in 59 cases (7%); age specific prevalences were 4.5% (0–30 years), 4.4% (>30–50) and 14% (>50). Independent predictors of dual infection were age >42 years, history of I.V. drug use (IDU), blood transfusion and residence in the South of the country. The strength of the association with IDU was high, but this exposure accounted for five coinfection cases only. Cirrhosis was present in 107 of the 709 patients with HBV alone (15.1%), in 30 of 69 with hepatitis D virus coinfection (43%) and in 17 of 59 with HCV coinfection (28.8%); a light alcohol use was marginally associated with cirrhosis. Of 36 B/C coinfected patients, 16 (44.4%) had only HBV-DNA in serum, (median age=47.5 years) five (13.9%) had both HBV-DNA and HCV-RNA (age=53), nine (25%) had HCV-RNA alone (age=59) and six (16.7%) tested negative for both. Conclusions : This study depicts the epidemiological and clinical burden of dual HBV/HCV infection in Italy.

Hepatitis delta virus (HDV) was responsible for a high proportion of cases of acute and chronic liver disease in Southern Europe during the 1970s. Some data suggest that by the 1990s HDV circulation had substantially declined. We have assessed the prevalence of HDV infection and its clinical impact in 834 Italian hepatitis B surface antigen (HBsAg) carriers in 1997. Anti-HDV antibodies were sought in all consecutive chronic HBsAg carriers observed in 14 referral liver units throughout Italy. Risk factors for anti-HDV positivity were evaluated. Anti-HDV antibodies were found in 69 of 834 (8.3%) HBsAg-positive patients. Cohabitation with an anti-HDV-positive subject, intravenous drug addiction, residence in the South of the country, and the presence of cirrhosis were independently associated with the presence of anti-HDV antibodies. The overall prevalence of anti-HDV antibodies was lower than those observed in 2 multicenter surveys performed in 1987 and 1992 (23% and 14%, respectively). By 1997, the percentage of anti-HDV-positive subjects had sharply decreased in the 30 to 50 years age group, whereas it was almost unchanged in subjects over 50 years of age. The highest prevalence of anti-HDV antibodies (11.7%) was found in patients with cirrhosis. This prevalence was as high as 40% in the 1987 study. The circulation of HDV sharply decreased in Italy, by 1.5% per year, from 1987 to 1997. This decrease resulted mainly from the reduction in chronic HDV infections in the young, for whom high morbidity and mortality rates were recorded in the past. The results anticipate the almost complete control of HDV infection in the near future.

Chronic hepatitis B infection with the hepatitis B e antigen (HBeAg)-negative variant is associated with a severe clinical course and a low response rate to interferon (IFN). In an attempt to improve the chances of sustained response to interferon we designed a pilot study, using titres of IgM antibodies to hepatitis B core antigen (HBcAb IgM) to guide treatment initiation. Eighteen adults who were HBeAg-negative with biopsy-proven chronic active hepatitis (seven with cirrhosis) entered the study. They were followed-up bimonthly with routine liver function tests, and HBcAb IgM titres were also determined. Treatment (lymphoblastoid IFN 5 million units (MU) m(-2) three times weekly for 6 months) was started when the HBcAb IgM titre was increasing. Fifteen (83.3%) patients had normal alanine aminotransferase (ALT) levels and undetectable HBV DNA at the end of treatment. HBcAb IgM decreased in all responders. We observed a relapse in four patients (three with cirrhosis), in the first year after treatment, with an increase in ALT, HBV DNA and titre of HBcAb IgM. Eleven patients (61.1%) had a sustained response and eight of these 11 patients were followed-up for more than 18 months; two responders cleared hepatitis B surface antigen (HBsAg). Hence, the rate of sustained response to IFN in HBeAb-positive patients with chronic hepatitis is improved if treatment is started when HBcAb IgM levels are increasing.

Background and Aims. In Italy, per-capita consumption is low (6.9 lt in 2009), with an increase in binge drinking, but there are not results on treatment outcomes. This study aims to evaluate the efficacy of treatment of AUDs and alcohol abuse/dependence based on integrated social-health approach to individual needs. Material …

O6.1 SEXUAL ORIENTATION AND DRUG OF CHOICE {#article-title-2} There has been some previous report on an association between sexual orientation and substance use, most studies reporting on elevated rates of illegal drug use among LGBs. Despite numerous assertions on supposed drugs of choice among gay/bisexual men (poppers, metamphetamines etc.), the hypothesis has, to our knowledge, not been specifically tested in a population study. Methods. Data from a representative sample of Swiss men (n = 5,387) approximately 20 years old were collected between August 2010 and November 2011. 167(2.8) reported to be gay/bisexual. Results. While no differences could be found regarding lifetime consumption of alcohol, tobacco and cannabis, gay/bisexual men had, compared to heterosexual participants, more often tried other illegal substances (heroin, cocaine, stimulants, hallucinogens etc.). No differences were found regarding the 12-month prevalence among the ever users, with the exception of poppers, which consumption gay/bisexual men had continued more often. Conclusion. Gay/bisexual men do not differ from heterosexual men regarding the trying out of drugs, but differed with regard to the maintenance of poppers consumption. # O6.2 SUSCEPTIBILITY OF AGE AND GENDER TO INTERMITTENT ALCOHOL ABUSE {#article-title-3} Intermittent alcohol abuse (binge drinking) may induce brain damage as well as cognitive impairment in adolescents. However it is unknown whether such alcohol abuse will also have such a devastating effect in adults as well as pre-adolescents engaged in under age drinking. In these present studies, an intermittent ethanol regimen (2or3g/kg, 3x/day for 2 days, followed by 5 days of abstinence for a total of three weeks) was administered to male and female pre-adolescent, adolescent and adult rats. Microdialysis studies identified significant changes in glutamate and arginine basal levels in the nucleus accumbens, NAc, of a) pre-adolescent male and females (glutamate increased; arginine decreased), b) adolescent male (glutamate decreased; arginine increased) and female (glutamate increased; arginine increased or decreased respectively for low and high ethanol dose) and, c) adult male (glutamate decreased; arginine increased) and female (glutamate increased; arginine decreased) rats after 3 weeks of the ethanol dosing regimen. In addition the concentrations of these two amino acids varied between the different groups. A further challenge with ethanol induced variable effects in the release of glutamate and arginine in each of these groups. Significant losses of hippocampal neuronal cells were evident in each of the groups, with the female adolescent rats showing the highest cell loss. These studies indicate that female adolescent rats are more susceptible to the toxic effects of binge drinking, while the male pre-adolescent, adolescent and adult rats appeared to be more resilient. # O6.3 HIGH EDUCATIONAL LEVELS AS PROTECTIVE FACTOR AGAINST DRUG AND ALCOHOL CONSUMPTION {#article-title-4} Background & Aims. Alcohol consumption is linked to social-cultural aspects in Northeast Italy. Precedently alcohol was consumed daily by all members of the family in Northern Italy (steady drinking). This study aimed to determine the prevalence of alcohol and drug consumption in drivers on weekend nights. Methods. As part of the government sponsored “Safe Roads” Program (November 2008 to September 2012) 3150 drivers were stopped in Padova (Italy) by law enforcement officials between midnight and 6. All underwent a preliminary alcohol test and if positive also a urine test for drugs. T test and multivariate analysis were used. Results. 1068 (909M-85% and 159F-15%; mean age 30.5 yr) drivers underwent the Breathalyzer test. 714 of 3150 (22.6%) were found positive (mean alcohol 0.77g/l; range 0-2.67). 242 of 1068 (22.6%) were also positive for drugs. Drug use was more frequent in those resulting positive to alcohol (23,6% vs 15,4%; p = 0.006209). The highest mean alcohol value (0.88g/l) was found between 4 and 5 am (p = 0.006509). Positivity rate for drugs and mean blood alcohol content resulted higher in subjects with lower educational levels (30,8%vs18,0%, p < 0,001 and 0,689g/l vs 1,027, p = 0,00782). At the multivariate analysis drug use is correlated with age, sex, scholar level and alcohol, instead positive test for alcohol is correlated only with scholar level and use of drugs. Conclusions. The prevalence of drugs and alcohol consumption on weekends is high. High educational levels may be protective against the use of drugs and binge drinking. # O6.4 AGE OF ONSET, PHYSICAL AND MENTAL HEALTH AND SOCIAL FUNCTIONING IN OLDER ALCOHOL-DEPENDENT INPATIENTS {#article-title-5} Background. Alcohol dependence is a severe and often chronic condition with a strong impact on physical and mental health and social functioning, especially in older patients. This study aims to determine whether older alcohol-dependent inpatients with early (age

O4.1 BRIEF MOTIVATIONAL INTERVENTION TO REDUCE ALCOHOL CONSUMPTION IN YOUNG PATIENTS IN A FRENCH EMERGENCY DEPARTMENT {#article-title-2} Background. Alcoholic intoxication (AI) in young people is an important problem in emergency departments (EDs). Aim - To establish the effectiveness of a Brief Motivational Intervention (BMI) in reducing alcohol consumption among young patients admitted in a French ED for AI. Methods. Two-group simple blind randomised controlled trial. From September 2011 to July 2012, patients aged 16 to 24 who tested positive for blood alcohol content of 0.5g/l or above were randomised, with stratification according to patient's age (16-17 or 18-24), between intervention (BMI performed by a psychologist in the ED setting followed by a phone booster session at one and two months) and controls (delivery only of an information leaflet and a list of addresses of services for alcohol misuse). The principal criteria used to assess the reduction of alcohol use at 3 months follow-up was the number of alcoholic drinks in the last week. Results. A total of 263 patients (controls 131, intervention group 132, mean age 20, men 72%) were randomized. Attrition accounted for 38% in controls and 43% in intervention group. Data analysis was conducted for a Poisson frequency distribution and showed no significant difference in effectiveness between the two conditions (OR 0.93 [0.64; 1.36]). All secondary outcomes were also not influenced by the intervention (including the number of AIs in the last month). Conclusions. This study did not detect a significant effect of Brief Motivational Intervention in reducing alcohol consumption after hospitalization for alcoholic intoxication in emergency department in young people. # O4.2 HARMFUL ALCOHOL CONSUMPTION IN HEALTH-WORKERS: RESULTS OF A SCREENING STUDY {#article-title-3} Background. In Italy national alcoholism risk prevention programs to assess number for year of accidents in health workplaces is actually in progress leaded by Health Minister and Regional administration. Particularly, prevention program acts consist in comprehensive informations for health workers and their co- workers, about prevention and identification of alcoholism related risks. Aims. To assess the rate of harmful alcohol consumption in a population of health workers in Padua. Materials and methods. Modified CAGE questionnaire was sent to 5590 health-workers in Padua. Anonymous questionnaires were collected in dedicated boxes. Results. 654/5590 (11.7%) subjects performed the test (M: 150, F: 504, mean age 42.9 yrs, range 28-65). The professional role was nurse in 300/654 (45,9%), physician 83 (12,7%), administrator 80 (12,2%), other 191 (29,2%). 57/654 (8.7%) had positive questionnaire for alcohol abuse or dependence: 33/57 (57,9%) had suspicion, 15 (26.3%) high probability and 9 (15.8%) were certainly alcohol abusers. 37/504 females (7,3%) and 20/150 males (13,3%) showed positive CAGE test. The professional role indicated positive test in 26/300 (8,7%) nurses, 9/83 (10,8%) physicians, 1180 (1,2%) administrator and 21/191 (11%) other professional roles. Conclusions. The number of tests performed is unsatisfactory, particularly among males and physicians. Our data suggest that harmful alcohol consumption is present in health-workers, more frequently in male sex. Physicians demonstrate an high prevalence of positive test. These data also suggests that the awarness of alcohol related problems doesn't reduce the probability of harmful consumption. A screening study can be useful to identify harmful alcohol users among the selective population of health-workers. # O4.3 BRIEF INTERVENTION IN PRIMARY HEALTH CARE FOR ALCOHOL USERS: AN EXPERIENCE IN PORTUGAL {#article-title-4} Introduction. The professionals of primary health care have a crucial role in screening individuals with risk consumption and harmful alcohol. The effectiveness of brief interventions in reducing alcohol consumption however, in Portugal its use is not yet widespread in particularly in primary care. Objective. to evaluate the effect of Brief Interventions in reducing excessive alcohol consumption on users accessing health center services, Coimbra, Portugal. Methods. A pre-trial, with a single group, and the assessment before the intervention (5 months). The sample included 45 patients (19 females, Mean= 48 age, SD = 15.199), enrolled in the Health Center Ansiao. We used a structured interview, using a questionnaire that included the AUDIT (Alcohol Use Disorders Identification Test), to evaluate the level of risk in relation to alcohol consumption. Interventions were made by previous protocol based on the level of risk identified, for data analysis resorting to the Wilcoxon test. Results. At baseline: 86.7% were at risk level I, 11.1% in the risk level II and 0% in the risk level III. In folow-up five months after the brief interventions, 95.6% were at risk level I, 2.2% in the risk level II and 0% in the risk level III. There was a positive effect on the progress of participants in respect to the levels of risk, with statistical significance (p = 0.046). Conclusions. Brief Interventions took effect in lowering and stabilizing the risk levels of alcohol consumption, reinforcing the importance of integration of Brief Interventions in Primary Health Care. # O4.4 UNIVERSAL SCHOOL-BASED PREVENTION INTERVENTION AND ALCOHOL USE {#article-title-5} Background. The Unplugged, a prevention intervention based on the Comprehensive Social Influence model, was implemented to reduce the risk of alcohol use in Czech adolescents. We investigated the effect of the Unplugged on the reduction of drunkenness. Methods. A randomized controlled prevention trial was conducted over 33 months. 1,874 6th-graders (mean age 11.82 years) completed the baseline testing. We compared self-reported drunkenness in control and intervention groups. Using logistic regression we study relationship between drunkenness and other variables such as gender, peer and parents effect, leisure time, ideas of hurting oneself, safe sex and school grades. Results. We find a significant effect of the Unplugged on the reduction of drunkenness. Male adolescents with unstructured leisure time activities and lower parents control report higher frequency of drunkenness. Idea of hurting oneself and unsafe sex is also associated with higher risk of getting drunk. Conclusion. We present evidence on the composition of risk profiles in adolescents who are engaged in high-risk alcohol consumption. Besides the intervention a screening tool should be used to identify adolescents who are eligible for complementary selective and/or indicated prevention interventions.

Background/Aims : Transmission of hepatitis B virus (HBV) in countries of intermediate endemicity, such as Italy, is thought to be primarily horizontal and, to a lesser extent, vertical. Most chronic carriers therefore become infected in infancy or at a very young age. The index cases in such events have been assumed to come from within the family unit or from sources outside the immediate family, with whom the affected person is in close contact. Methods : We studied a number of Italian families with multiple members chronically infected with HBV. The precore/core region of the virus was amplified from serum derived HBV-DNA, and the sequences subjected to phylogenetic tree analysis. In addition, the extent of amino-acid variation within the core region was correlated to HLA type, determined by allele-specific PCR. Results : The phylogenetic tree analysis provided strong evidence of intra-familial transmission of the virus. Analysis of amino-acid substitutions in the core region in relation to HLA class II alleles from members of the same family showed that these substitutions were restricted in siblings with concordant, and more diverse in those with discordant HLA haplotypes. Conclusions : This is consistent with major histocompatibility complex class II mediated selection pressure on the virus.

Preliminary results of a two-center trial with colchicine for the treatment of chronic Hepatitis B

Results: We evaluated 118 subjects (55 M, 63 F), 71 (60.1%) 25–45 years old, 28 (23.7%) >45 years old, 16 (13.5%) 15–24 years old and 3 (82.5%) 20,000 in 4 (33.3%). Conclusions: The data of this pilot phase suggest a high prevalence of HBV infection in the immigrant population. The prevalence appears similar to that of country of birth. HBV-DNA quantification indicate that 50% of carriers have to be evaluated for treatment. On the basis of these data we confirm the utility of a screening programme for HBV in the immigrants.

A S L D A b st ra ct s levels were significantly decreased in UDCA group compared to control group. Microarray analysis revealed that gene expression of glutathione S-transferase (GST) ismarkedly increased in UDCA group compared to control group. Since Nrf2-activated genes such as glutamatecysteine ligase, catalytic subunit (Gclc), heme oxygenase 1 (HO-1) exert antioxidant effects, we next investigated mRNA expression levels of these genes by quantitative real-time PCR. Quantitative real-time PCR revealed the elevated expression of both Gclc and HO-1 in UDCA group. Conclusion : UDCA administration blocks progression of liver inflammation in NASH by inducing Nrf2-regulated antioxidant gene expression and reducing serum ROS levels.