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T Stroffolini

Publications and source records attributed to T Stroffolini.

At least 91 records · Page 5Linked to original sources

Prevalence of hepatitis E in a central Italian town at high endemicity for hepatitis C virus.

In the spring of 1994, the occurrence of Hepatitis E virus antibodies was evaluated in 653 subjects representing all age-groups in the general population of a Central Italian town, where a high hepatitis C virus prevalence had been reported. The overall anti-HEV prevalence was 2.6% ranging from 1.4% in the 30-49 age-group to 5.7% (p < 0.01) in the 60-70 age-group; none of the subjects under 30 years of age were positive. Sociodemographic variables, such as family size and years of schooling were not associated with HEV exposure. Anti-HEV positivity was found in 1.8% (1/56) of the subjects who were positive for anti-HCV and in 2.7% (16/597) of those who were anti-HCV negative (O.R 1.5; C.I.: 95% = 0.2-11.7). Thus no association was found between HEV and HCV infections. These data suggest a past spread of HEV in this area and underline the occurrence of long-lasting antibodies in infected subjects.

Adult↗

Hospitalization rate and mean days of hospitalization of notified viral hepatitis cases in Italy. The Seieva Collaborating Group.

The hospitalization rate and the mean days of hospitalization of notified viral hepatitis cases in Italy were estimated by a specific surveillance system for acute viral hepatitis over the period 1987-1992. The hospitalization rate was very high, ranging from 88.8% for hepatitis A to 90.9% for non-A, non-B hepatitis. No changes were observed over time. For each type of hepatitis the highest figure was observed in the 15-24 year age group. The mean days of hospitalization of hepatitis B (24.2) and non-A, non-B (20.5) hepatitis was significantly higher (p < 0.05) than that of hepatitis A (16.5). The highest mean days of hospitalization of hepatitis A and B occurred in the 0-14 year age group, while for non-A, non-B hepatitis it was observed in subjects over 24 years of age. These findings indicate a nearly similar rate of hospitalization of all types of hepatitis. Hepatitis B and non-A, non-B hepatitis show a more prolonged course than hepatitis A.

Adolescent↗

Retrospective survey on the epidemiology of H. influenzae type B meningitis in Italy (1987-91).

A retrospective survey on the epidemiology of H. Influenzae type b (Hib) meningitis was carried out in seven Italian hospitals. During the period 1987-1991, 95 (16.3%) Hib meningitis cases out of 581 bacterial meningitis cases were observed. The proportion of Hib meningitis was lowest in 1987 (11.3%); elevated in 1988 (17.9%); thereafter it did not change. A male preponderance was observed (Sex ratio 1.6). The age distribution showed that 93.7% of cases occurred in subjects < 5 years, 53.7% of cases in those < 1 year. Although Hib meningitis accounts for a small proportion of all bacterial meningitis, it is also a major problem in Italy in early childhood, because nearly all cases occur in children < 5 years.

Child, Preschool↗

Low prevalence of anti-HCV antibodies among Italian Air Force recruits.

In 1990, the prevalence of antibodies to hepatitis C virus (anti-HCV) was assessed among 4,978 Air Force recruits aged 18-26 years coming from all regions of Italy. Positivity to anti-HCV was found by both IIIrd generation EIA and RIBA in 24 (0.48%) study participants. The prevalence was twice as high in Southern Italy and the islands as in Northern and Central Italy (0.76% vs. 0.35%), a difference which was not statistically significant. The results of multiple logistic regression showed that no sociodemographic variable (region of birth, father's years of education, number of siblings) was associated with anti-HCV positivity. No anti-HCV-positive individual was positive for HBsAg. Anti-HCV positivity was found in 0.8% (2/236) of the participants who were positive for anti-HBc and in 0.5% (22/4742) of those who were anti-HBc negative, also a difference which was not statistically significant. Thus no association was found between HCV and HBV infections. These findings indicate that in Italy, HCV infection is an uncommon event among young adult males.

Adolescent↗

High prevalence of hepatitis C virus infection in a small central Italian town: lack of evidence of parenteral exposure.

In the spring of 1994, anti-HCV prevalence and associated risk factors were evaluated in 681 subjects representing all age-groups in the general population of a small central Italian town. The overall anti-HCV prevalence was 8.4%, ranging from 3.7% in the 30-39 age-group to 18.2% (p < 0.01) in the 60-70 age-group; no subject below 30 years of age was positive. Multiple logistic regression analysis showed that the only variables independently associated with anti-HCV positivity were awareness of unspecified liver disease (O.R. 3.58), age > 45 years (O.R. 2.72), and lowest number of years of schooling (O.R. 11.0) while no association was found with any parenteral exposure such as blood transfusion, intravenous drug use, major or minor surgical intervention, use of glass syringes or dental therapy. The HBsAg prevalence in this population was 1.3%, which corresponds to the rate reported in central Italy. These findings show a high level of HCV endemicity, with no evidence of parenteral exposure.

Adolescent↗

Incidence of hepatitis B virus infection among an Italian military population: evidence of low infection spread.

In 1990, a prospective serological survey to estimate the rate of clinical and inapparent infection with hepatitis B virus was performed in a cohort of 1324 soldiers, 18-24 years old, during an eight-month period in Italy. At the time of enrollment the prevalence of hepatitis B markers was 4.6% (0.7% subjects positive for hepatitis B surface antigen [HBsAg], 3.0% positive for antibody to hepatitis B surface antigen [anti-HBs], and 0.9% positive for antibody to hepatitis B core antigen [anti-HBc] alone. Among the 1263 susceptible subjects who were followed-up, only 2 (0.24/100 person-years of exposure) had seroconversion for HBV markers, none of which was associated with clinical illness. Among the 9 subjects HBsAg-positive at the time of enrollment, 1 (11.2%) had lost HBsAg at the end of follow-up. These data show a low spread of HBV infection among Italian young generations.

Adolescent↗

Decline in anti-HAV prevalence in the Milan area between 1958 and 1992.

We have compared the prevalence of antibody to HAV in sera collected from healthy individuals of Milan in 1958, 1977 and 1992 respectively. The results show a dramatic reduction of HAV circulation likely due to the considerable improvement of socioeconomic and hygienic living conditions which have occurred in Italy during the last decades.

Adolescent↗

Pathogenic factors in cirrhosis with and without hepatocellular carcinoma: a multicenter Italian study.

We designed a multicenter cross-sectional study to evaluate the role of alcohol abuse, the hepatitis viruses and other pathogenic factors in cirrhosis and hepatocellular carcinoma. A total of 1,829 consecutive cirrhosis patients, with or without HCC, was enrolled over 6 mo in 21 centers throughout Italy. The etiological categories and diagnostic criteria were preestablished. The median age of the patients was 59 yr (range, 13 to 85 yr); 63.6% of the patients were graded as Child class A, 23.4% as Child class B and 13% as Child class C. Hepatitis C virus antibodies were found in 72.1% of cases (47.7% alone, 21.2% with alcohol abuse, 3.2% with hepatitis B virus); HBsAg was present in 13.8% (4.2% alone, 3.2% with hepatitis D virus, 3.2% with hepatitis C virus, 3% with alcohol abuse), alcohol abuse with no concomitant viral infection was recorded in 8.7%, primary biliary cirrhosis was found in 1.8%, other causes were found in 1.4% and cryptogenic cirrhosis was only present in 5.3%. Hepatocellular carcinoma was detected in 11.9% of patients (217 cases). The presence of hepatocellular carcinoma was more frequent in males than females (14.7% vs. 7.3%; p < 0.001) and increased with worsening Child class (8.3% in Child class A, 16.9% in Child class B, 19.9% in Child class C, p < 0.001). The highest prevalences of hepatocellular carcinoma were observed in hepatitis B virus infection, with or without alcohol abuse (20% and 16%, respectively) and in hepatitis C virus cirrhosis, with or without alcohol abuse (16% and 10.3%, p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Serological survey of hepatitis B infection in Tanzania.

In 1992, the prevalence of hepatitis B virus (HBV) markers was evaluated in 1004 subjects aged one to 76 years living in urban and rural areas in Tanzania. The overall prevalence rates of hepatitis B surface antigen (HBsAg) and of any HBV marker were 4.4% and 37.0%, respectively. No statistically significant difference by sex was found. The HBsAg prevalence among pregnant women was 4.3% (20/463). The proportion of HBeAg positive among HBsAg positive pregnant women was 10% (2/20). The HBsAg age-specific prevalence was 2.1% in the 1-5 year age-group; peak prevalence (12.1%) occurred in the 6-15 year age-group. Markers of HBV infection were 4.1% by age five years; they increased with advancing age (P < 0.01). Subjects residing in urban areas had statistically significant higher HBV exposure than those residing in rural areas (43.9% vs 27.4%, P < 0.01). Subjects belonging to the largest family size (seven or more members) showed increasing risk (OR 2.9; 95% CI = 1.96-4.28) of HBV exposure. Because maternal HBV transmission early in life appears to be of minor impact and children are mostly infected later in infancy, HBV vaccination at birth is not indicated, while vaccination of all infants at 2-3 months of age with other paediatric vaccinations is the first priority.

Adolescent↗

Hepatitis B in health workers in Italy.

In Italy, a vaccination campaign against hepatitis B was launched in 1985. It was strongly recommended for health care workers. Over the period 1986-91 the incidence rate of acute B hepatitis in the general population declined from 12/100,000 in 1986 to 5/100,000 in 1991. The corresponding figures among hospital workers were 42.5/100,000 (RR 3.5; 95% CI 2.55-4.92) in 1986 and 14.5/100,000 (RR 2.9; 95% CI 2.03-4.14) in 1991, respectively. The proportion of HBV cases with jaundice was about the same in the general population (77.6%) and in the health care staff (74.2%). Nearly 6% of hospital workers cases had completed the schedule of HBV vaccine. Despite the fact that vaccination against HBV has been strongly recommended for hospital workers, the incidence of infection in this job category has continued to be higher than that in the general population, probably as a consequence of poor vaccine coverage. These findings reiterate the need for aggressive vaccination programmes in hospital workers.

Health Personnel↗

Incidence and risk factors of acute Delta hepatitis in Italy: results from a national surveillance system. SEIEVA Collaborating Group.

The incidence of hepatitis Delta virus in the general Italian population was estimated by a specific surveillance system for acute viral hepatitis over the period 1987-1992. The hepatitis Delta virus incidence rate declined from 3.1/1,000,000 inhabitants in 1987 to 1.2/1,000,000 in 1992. Males predominated (83.8% of cases); the sex ratio was 5.2. Only 2.5% of cases occurred in subjects younger than 15 years. There were 119 (49.4%) coinfections of Delta and B hepatitis and 122 (50.6%) Delta superinfections in chronic HBsAg carriers. Jaundice was present in 83.6% of cases. The hospitalization rate was 97.5%; median stay in hospital was 25 days (range 1-98 days). The results of multivariate analysis showed that a history of intravenous drug abuse (odds ratio 34.9; confidence interval 95% = 16.8-72.5), household contact with an HBsAg+ carrier (odds ratio 10.7; confidence interval 95% = 4.36-23.30) and a history of two or more sexual partners within the previous 6 months (odds ratio 2.44; confidence interval 95% = 1.34-4.43) were independent risk factors associated with Delta hepatitis. No association was found with the other risk factors considered, such as blood transfusion, surgical intervention, hospitalization, other percutaneous exposures, dental therapy, contact with an icteric case, and household contact with an i.v. drug abuser. These findings indicate that, in Italy, Delta hepatitis currently has a minor impact. In addition to intravenous drug abuse and household contact with an HBsAg+ carrier, heterosexual activity appears to be an efficient route of HDV transmission.

Acute Disease↗

Substantial decline of notified hepatitis B in major parts of Europe after 1985.

A decline in the incidence of notified hepatitis B cases has been observed in major parts of Europe since the mid-1980s. Sweden may be taken as an example of a low prevalence area in the north where notifications of acute hepatitis B declined from 6 cases/100,000 inhabitants in 1985 to only 3/100,000 annually in 1988-91. Choosing W. Germany as an example from central Europe, the notification rate of acute hepatitis B declined from 11 cases/100,000 inhabitants in 1984 to 6-8/100,000 in 1988-91. In Italy, a dramatic decline in hepatitis B infections has occurred since 1985, according to the national hepatitis surveillance system (SEIEVA), from 12 cases/100,000 inhabitants in 1985 to 5/100,000 in 1988-91. A similar trend has also been observed in the USA which seems to be unrelated to vaccination, since only limited vaccination programs have been initiated in high-risk groups. Also in Europe, changed sexual and needle-usage practices in risk groups such as drug addicts and male homosexuals have probably contributed to the observed decline. In southern Europe, rapidly improving socio-economic conditions and improved medical precautions against hepatitis B have probably also been important factors.

Europe↗

Intrafamily spread of hepatitis C virus infection.

Using the second generation ELISA test, we studied the prevalence of antibodies against hepatitis C virus (anti-HCV) among 159 household contacts of 86 anti-HCV positive subjects (index cases). Fourteen (8.8%) relatives were found anti-HCV positive, a rate higher than the corresponding figure reported among the general population in the same area. The prevalence of anti-HCV was significantly higher among sexual partners than among household contacts without sexual relations with the index case (18% vs. 3.1%; P < 0.01). These findings indicate that sexual transmission may be the main route for intrafamily HCV spread.

Adolescent↗

Dramatic reduction of meningococcal meningitis among military recruits in Italy after introduction of specific vaccination.

Meningococcal meningitis is still a serious infectious disease with a mortality rate that can be as high as 10% even in developed countries. Military recruits are generally a high-risk group for meningococcal disease, with a reported incidence of four to ten times greater than that of the general population. In Italy the results of the National Meningitis Surveillance Programme showed a high attack rate of the disease among recruits in 1985 as well as in 1986, with 92 and 95% of the cases, respectively, caused by serogroup C and thus preventable. These findings led to the authorities' decision to make vaccination against meningococcal disease mandatory for recruits starting from January 1987. After almost 5 years from the introduction of meningococcal vaccination, we here sum up the epidemiological and immunological effects of the vaccination. From the epidemiological point of view we have observed a dramatic reduction of the prevalence of the disease. In 1987, the year in which we had 150,000 unvaccinated and 150,000 vaccinated recruits, the protective efficacy was 91.2%. From the immunological point of view, vaccination is highly effective, as seroconversion against polysaccharide (PS) A and C is 84 and 91%, respectively. The spectrotypic analysis of the sera before and after vaccination shows that the type of response is mainly oligoclonal, like the majority of the responses to PSs, and the antibodies induced by a sole PS are not qualitatively different from the antibodies induced by natural immunization. In addition, the efficacy is not modified by environmental factors like hypoxia, as demonstrated during permanence at 16,174 feet for 20 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗