The present profile of chronic hepatitis B virus infection highlights future challenges: an analysis of the Multicenter Italian MASTER-B cohort

Background: Chronic hepatitis B virus (HBV) infection remains a primary cause of morbidity and mortalityworldwide.Aim: The study is aimed at updating the clinical and epidemiological profile of chronic HBV infection inItaly.Methods: A cross-sectional multicenter prospective study enrolled consecutive HBsAg positive patientsseen in 73 Italian centers in the period 2012–2015. Individual patient data were collected using anelectronic platform and analyzed using standard statistical methods.Results: Among 2877 HBsAg positive individuals (median age 49.8 years, 68% males), 27% were non-Italian natives (NINs); 20% had chronic infection, 58.5% chronic hepatitis and 21.5% cirrhosis. AmongNINs, age was younger, male gender was less prevalent and liver disease less advanced than in Italians (allp < 0.0001). HBeAg positive cases were 23.6% among NINs vs 8.2% in Italians (p < 0.0001); HDV coinfections11.1% vs 7.3% (p = 0.006) and HCV coinfections 2.3% vs 4.2% (p = 0.017), respectively. Anti-HDV or anti-HCVantibodies were detected more frequently in patients with cirrhosis. Fifty percent of NINs with cirrhosiswere aged below 45 years.Conclusion: The study offers an insight into the evolving burden of chronic hepatitis B virus infection inthe near future and highlights new territories for public health interventions.