BACKGROUND Hepatitis delta virus(HDV)infection is the most severe form of chronic viral hepatitis,yet sex-based clinical differences remain poorly defined.Understanding these differences may inform disease management ...BACKGROUND Hepatitis delta virus(HDV)infection is the most severe form of chronic viral hepatitis,yet sex-based clinical differences remain poorly defined.Understanding these differences may inform disease management and guide research.AIM To investigate sex-related differences in demographic and clinical characteristics of patients with chronic HDV infection in a nationwide,real-world Italian setting.METHODS We analyzed demographic,clinical,and virological data from 513 hepatitis B surface antigen/anti-HDV-positive patients,consecutively enrolled between 2019 and 2024,across 58 liver clinics in the Italian PITER HDV cohort.A propensity score-weighted logistic regression model evaluated the association between sex and cirrhosis and/or hepatocellular carcinoma.RESULTS Among 513 patients(61.6%male),median age(56.0 years)and age distribution were similar by sex(P=0.41).Cirrhosis was frequent:73.4%vs 66.0%(anti-HDV-positive)and 77.8%vs 74.2%(HDV RNA-positive)in males and females,respectively.HDV RNA levels were comparable(P=0.93).The highest proportion of females with cirrhosis(33.8%)was in the 56-60-year group,similar to males(34.9%).Among patients with cirrhosis aged≤40 years,females,(80.9%of whom of non-Italian origin),were more represented than males(16.1%vs 6.5%respectively,P<0.05).Male sex was associated with cirrhosis(odds ratio=1.85;95%confidence interval:1.004-3.40).Among HDV RNA-positive patients,males more often had hepatocellular carcinoma,elevated gammaglutamyl transpeptidase,alcohol use,diabetes,hypertension,steatotic liver disease,and hepatitis C virus/human immunodeficiency virus coinfection.Interferon eligibility was similar.CONCLUSION HDV-infected females develop cirrhosis earlier,without liver disease cofactors,while males show advanced liver disease with multiple cofactors.Tailored care for young migrant women and cofactor-guided management for men may improve HDV outcomes,promoting equity.展开更多
AIM: To evaluate the impact of the diagnosis of hepatitis C infection on lifestyle habits such as smoking, drinking, sports activity and diet.METHODS: A self-administered, anonymous question-naire was offered to out-p...AIM: To evaluate the impact of the diagnosis of hepatitis C infection on lifestyle habits such as smoking, drinking, sports activity and diet.METHODS: A self-administered, anonymous question-naire was offered to out-patients with HCV infection consecutively attending three clinical centres in Italy.RESULTS: Of the 275 respondents, 62.2% (171) were male. Mean age was 51 (range 20-80) years. Overall, after the diagnosis of hepatitis C, 74.5% of drinkers had modified (giving up or reducing) alcohol consumption, 21.3% of smokers had modifi ed their habits and 32.3% of subjects who reported sports activity had either stopped or reduced frequency of activity or chose a less fatiguing sport. Sixty-four percent of the respondents reported having modified their diet, most of them on physician's advice. CONCLUSION: After the diagnosis of hepatitis C many patients correctly modif ied their alcohol consumption and a minority their smoking habits. The reason for reported changes in diet and physical activity needs further investigations.展开更多
About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infec...About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infection also exposes patients to a higher risk of progression to AIDS, a faster evolution towards cirrhosis, more frequent drug toxicity, and lower tolerance for antiretroviral therapy. Moreover, HCV infection can play a part in increasing immune system depression;neurological, cognitive and renal damage;and bone fragility. Hence an optimal antiretroviral regimen needs to be chosen for co-administration with anti-HCV therapy and timed appropriately to improve the prognosis of co-infected HIV/HCV patients. Unfortunately, however, data on the safety and efficacy of antiretroviral drugs in these patients is scarce, as are studies of pharmacokinetics in patients with advanced liver impairment. Furthermore, restoring adequate immune constitution seems not to slow the progression of liver disease, and the metabolic and hepatic toxicity of some antiretroviral drugs can even contribute to inflammatory and fibrogenic processes. It is therefore essential that HIV/HCV co-infected patients receive only medications capable of ensuring the best immune recovery but possessing the lowest potential to trigger immune reconstitution syndrome or hepatic and metabolic damage.展开更多
基金Supported by the Investigator Sponsored Research Grant from Gilead Sciences,No.IN-IT-980-6816the Fondazione Italiana per la Ricerca sul Cancro(AIRC),No.IG 2020 ID 24858.
文摘BACKGROUND Hepatitis delta virus(HDV)infection is the most severe form of chronic viral hepatitis,yet sex-based clinical differences remain poorly defined.Understanding these differences may inform disease management and guide research.AIM To investigate sex-related differences in demographic and clinical characteristics of patients with chronic HDV infection in a nationwide,real-world Italian setting.METHODS We analyzed demographic,clinical,and virological data from 513 hepatitis B surface antigen/anti-HDV-positive patients,consecutively enrolled between 2019 and 2024,across 58 liver clinics in the Italian PITER HDV cohort.A propensity score-weighted logistic regression model evaluated the association between sex and cirrhosis and/or hepatocellular carcinoma.RESULTS Among 513 patients(61.6%male),median age(56.0 years)and age distribution were similar by sex(P=0.41).Cirrhosis was frequent:73.4%vs 66.0%(anti-HDV-positive)and 77.8%vs 74.2%(HDV RNA-positive)in males and females,respectively.HDV RNA levels were comparable(P=0.93).The highest proportion of females with cirrhosis(33.8%)was in the 56-60-year group,similar to males(34.9%).Among patients with cirrhosis aged≤40 years,females,(80.9%of whom of non-Italian origin),were more represented than males(16.1%vs 6.5%respectively,P<0.05).Male sex was associated with cirrhosis(odds ratio=1.85;95%confidence interval:1.004-3.40).Among HDV RNA-positive patients,males more often had hepatocellular carcinoma,elevated gammaglutamyl transpeptidase,alcohol use,diabetes,hypertension,steatotic liver disease,and hepatitis C virus/human immunodeficiency virus coinfection.Interferon eligibility was similar.CONCLUSION HDV-infected females develop cirrhosis earlier,without liver disease cofactors,while males show advanced liver disease with multiple cofactors.Tailored care for young migrant women and cofactor-guided management for men may improve HDV outcomes,promoting equity.
基金Supported by a grant from Minister of Health (Ricerca Corrente 2001), Linea 1
文摘AIM: To evaluate the impact of the diagnosis of hepatitis C infection on lifestyle habits such as smoking, drinking, sports activity and diet.METHODS: A self-administered, anonymous question-naire was offered to out-patients with HCV infection consecutively attending three clinical centres in Italy.RESULTS: Of the 275 respondents, 62.2% (171) were male. Mean age was 51 (range 20-80) years. Overall, after the diagnosis of hepatitis C, 74.5% of drinkers had modified (giving up or reducing) alcohol consumption, 21.3% of smokers had modifi ed their habits and 32.3% of subjects who reported sports activity had either stopped or reduced frequency of activity or chose a less fatiguing sport. Sixty-four percent of the respondents reported having modified their diet, most of them on physician's advice. CONCLUSION: After the diagnosis of hepatitis C many patients correctly modif ied their alcohol consumption and a minority their smoking habits. The reason for reported changes in diet and physical activity needs further investigations.
文摘About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infection also exposes patients to a higher risk of progression to AIDS, a faster evolution towards cirrhosis, more frequent drug toxicity, and lower tolerance for antiretroviral therapy. Moreover, HCV infection can play a part in increasing immune system depression;neurological, cognitive and renal damage;and bone fragility. Hence an optimal antiretroviral regimen needs to be chosen for co-administration with anti-HCV therapy and timed appropriately to improve the prognosis of co-infected HIV/HCV patients. Unfortunately, however, data on the safety and efficacy of antiretroviral drugs in these patients is scarce, as are studies of pharmacokinetics in patients with advanced liver impairment. Furthermore, restoring adequate immune constitution seems not to slow the progression of liver disease, and the metabolic and hepatic toxicity of some antiretroviral drugs can even contribute to inflammatory and fibrogenic processes. It is therefore essential that HIV/HCV co-infected patients receive only medications capable of ensuring the best immune recovery but possessing the lowest potential to trigger immune reconstitution syndrome or hepatic and metabolic damage.
