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T Stroffolini

Publications and source records attributed to T Stroffolini.

162 records · Page 9Linked to original sources

Acute viral hepatitis in childhood: etiology and evolution.

A study of 164 consecutive patients (97 males, 67 females; aged 3-11 years) with acute hepatitis was done. Hepatitis A was the most frequent etiologic type. It occurred in 82.7% of the 3-5-year age group, and in 72.2% and 57.2% of the 6-8- and 9-11-year age groups, respectively. Non-A, non-B hepatitis was rather infrequent (4.3%). Hepatitis B occurred in 13.7% of the 3-5-year age group and reached 39.6% in the 9-11-year age group. While all hepatitis A and non-A, non-B cases recovered within a relatively short time, hepatitis B patients recovered more slowly; two cases recovered 1 year after the onset of symptoms. Chronicity was demonstrated in 23.8% of hepatitis B patients 2 years after the onset of the disease. HBsAg clearance was slower in children than in adults. At 4 months, only 59% of patients had serum converted, and a chronic carrier state occurred in 13 of 42 subjects followed for up to 2 years (three healthy carriers and 10 with chronic hepatitis of various types). Our data show that persistence of HBeAg positivity does not always lead to chronicity in children. Of the eight patients HBeAg-positive 1 year after the onset of symptoms, two recovered.

Acute Disease↗

Interaction between HDV and HBV infection in HBsAg-chronic carriers.

We studied the interaction between HBV and HDV infection in 149 consecutive subjects with HBsAg positive chronic hepatitis and in 22 chronic HBsAg healthy carriers. Liver HBcAg was detected in 52 (30.4%) of the 171 subjects. Of these 52, 35 were HBV-DNA and HBeAg positive, 11 HBV-DNA positive only; two HBeAg positive only and four were negative for both HBeAg and HBV-DNA. None of the 119 HBcAg-negative subjects had detectable HBV-DNA in serum. HD-Ag in hepatocytes was detected in 31 of the 171 subjects (18%); it was detectable in none of the 22 HBsAg healthy carriers, in four of the 56 patients with chronic persistent hepatitis (7.2%), in six of the 24 patients with chronic lobular hepatitis (25%), in 16 of the 40 patients with chronic active hepatitis (40%) and in five of the 29 with cirrhosis (17%). A presence of anti-HD in serum in the absence of liver HD-Ag was found in 54 of the 171 subjects (32%). This condition was observed not only in patients with a progressive disease (37.7% of chronic active hepatitis or cirrhosis and 33% of chronic lobular hepatitis), but also in healthy carriers (36%) and in chronic persistent hepatitis patients (21.4%). Liver HBcAg was detected in 6.4% of the 31 HD-Ag-positive patients, in 12.9% of the 54 HD-Ag-negative/anti-HD positive, but in 50% of the 86 with no marker of HDV infection. HDV appears to inhibit HBV genome and such inhibition may persist even when anti-HD is the only HDV marker detectable.

DNA Replication↗

Baseline seroepidemiology of hepatitis A virus infection among children and teenagers in Italy.

During the period from May 1987 through November 1989, the prevalence of antibodies to hepatitis A virus infection (anti-HAV) was assayed by the ELISA method in the serum samples of 5,507 (54% males, 46% females) apparently healthy subjects three to 19 years old in Italy. Subjects were selected by a systematic cluster sampling in five different geographical areas of Italy. The overall prevalence of anti-HAV was 9.5%; it increased from 2.3% among children three to five-years-old to 16.3% in teenagers 17 to 19 years old (p less than 0.001). A slight preponderance of females was observed (10% versus 9.1%), but the difference was not statistically significant. The prevalence was significantly higher in Southern Italy than in Northern Italy (27.4% versus 4.8%; p less than 0.01). The prevalence of anti-HAV was inversely related to the fathers' years of schooling (O.R. 3.3; 95% C.I. = 2.5-4.2) and positively related to the family size (O.R. 2.4; 95% C.I. = 1.9-3.1). These findings indicate that, today, exposure to HAV infection at a young age in Italy is very low. However, sociodemographic factors are still important determinants in the spread of this infection.

Adolescent↗

Prevalence of pertussis IgG antibodies in children in Palermo, Italy.

The prevalence of IgG antibodies to Bordetella pertussis in a sample of 615 1-12-year-old unvaccinated children in Palermo was estimated by ELISA. The overall prevalence was 56%; it increased from 24% in one to three-year-old children to 67% in 11-12-year-old children (p less than 0.01). IgG antibody prevalence was not associated with the father's years of schooling (OR 1), nor with the family size (OR 1.3; C.I. 95% = 0.8-2.2). For children aged one the three years, serological results showed that the history of pertussis reported by parents in questionnaires gave high specificity (93.2%) and negative predictive value (85.4%). Our seroepidemiological study evidences a great exposure of children to B. pertussis in Palermo, with a high proportion of infections occurring after three years of age.

Child↗

Prevalence of hyperimmunization against tetanus in Italians born after the introduction of mandatory vaccination of children with tetanus toxoid in 1968.

Systematic mandatory immunization of children against tetanus was started in Italy in 1968. Prevalence of tetanus hyperimmunization (> 5 IU/ml) was assessed among 214 immune subjects born after 1968 and found to be 17.3%. This figure is significantly higher (p < 0.01) than the 10.8% found in a previous study of subjects born before 1968. This increase is statistically significant in the Center (p < 0.01) and in the South (p < 0.05) of Italy, but not in the North. Hyperimmunization is not associated with family size (odds ratio 2.16; C. I. 95% = 0.5-7.6) or the father's years of education (odds ratio 1.83; C. I. 95% = 0.6-5.3). No difference was found between urban and rural areas of residence. Indiscriminate administration of booster doses of tetanus vaccine in hyperimmune subjects in some areas could result in unnecessary vaccinations, which can cause hypersensitivity reactions.

Adolescent↗

Low prevalence of anti-HCV antibody among Italian children.

The seroprevalence of anti-HCV antibody was studied among 2,749 children and teenagers (1,438 males and 1,311 females) living in Italy. Anti-HCV antibody testing was positive by both EIA and RIBA in ten (0.36%) subjects. The positivity rate increased with age, ranging from 0 among children less than 6 years of age to 0.8% among those aged 17-19 years chi 2 linear regression = 0.038). Anti-HCV prevalence ranged from 0.2% in northeastern regions and in Apulia to 0.6% in Sicily and Sardinia (p > 0.005), and no difference was seen between males (0.35%, C.I. 95%: 0.04-0.66) and females (0.38%, C.I. 95%: 0.04-0.66) (Fisher's exact test = 0.565). From these data it appears that in Italy HCV infection is an uncommon event during childhood.

Adolescent↗

Hepatitis C virus infection in households of anti-HCV chronic carriers in Italy: a multicentre case-control study.

To test the hypothesis that households of anti-HCV positive subjects might be at increased risk of HCV infection, a case-control study was carried out comparing 518 family members of 205 anti-HCV positive subjects (index carriers) with 281 family members of 100 anti-HCV negative subjects (index controls), consecutively observed in ten gastroenterology units in different Italian regions. The index carriers were age and sex matched to the index controls and their households were similar with respect to the main sociodemographic characteristics. Anti-HCV antibodies were found in 6.9% (36/518) of household members of index carriers and in 3.2% (9/281) of household members of index controls (p < 0.05). The results of multiple logistic regression analysis showed that being over 50 years of age was the sole independent predictor for a household contact of the likelihood of being anti-HCV positive (O.R. 3.6; C.I. 95% = 1.5-8.2). Being in the household of an anti-HCV index carrier was marginally associated to anti-HCV positivity (O.R. 2.0; C.I. 95% = 0.9-4.6). No association was found for sex, area of residence, family size, lowest level of schooling, or any type of family relationship. These findings are not in compliance with the statement that household contacts of HCV carriers are at increased risk of HCV infection. The 3.2% anti-HCV prevalence rate observed among household contacts of anti-HCV negative index controls may suggest that the true anti-HCV prevalence in the general population in Italy is nearly 2.5 times as high as the 1.3% found in Italian blood donors.

Adolescent↗

Incidence of hepatitis A virus infection among an Italian military population.

In 1990, a prospective serological survey to estimate the rate of clinical and inapparent infection with hepatitis A virus (HAV) was performed in a cohort of 1,268 soldiers, 18-24 years old, during an 8 month period in the Campania region in Italy. At the time of enrollment 318 (25%) of the 1,268 soldiers were positive for total antibodies to HAV (anti-HAV). None of them was positive for IgM anti-HAV. Among the 950 susceptible subjects who were followed up for 8 months, eight (0.8%) later seroconverted to anti-HAV positivity. This figure corresponds to an incidence of 1.3/100 person/years (eight seroconversions during 633.3 years of observation). There were two clinical (with presence of IgM-anti-HAV) and six inapparent infections. The clinical/subclinical HAV ratio was 1:3. These findings indicate that the risk of HAV infection among soldiers residing in this area is not negligible.

Adolescent↗

Incidence of Helicobacter pylori infection in a cohort of Italian military students.

Prevalence and incidence of Helicobacter pylori infection among 250 Italian military students were studied using specific IgG antibodies. Subjects susceptible at enrollment were evaluated during a 10-month follow-up period, when two serum samples were collected after 5 and 10 months, respectively. Samples were also analyzed for anti-CagA (a protein associated with virulent H. pylori strains) IgG antibodies. Finally, spectrotypic analysis by isoelectric focusing and reverse blotting (IEFRB) was performed in the majority of positive samples. Forty-three out of 250 (17.2%) were positive at the time of enrollment, a seroprevalence rate very similar to that observed in a larger Italian military population 5 years earlier. Among the 207 susceptible subjects, two seroconverted at 5 months after enrollment; they were still positive at the end of follow-up (incidence rate of 1.16 per 100 person/years of exposure). This data suggests a spread of H. pylori in the Italian military population that is not negligible. Nearly all anti-H. pylori-positive subjects were also CagA antibody positive (agreement percentage: 97.6%; K = 0.91), suggesting that the large majority of H. pylori strains were of the virulent type. Sixty-four percent of positive sera presented an oligoclonal spectrotype, which seems to be a hallmark of humoral immune response to H. pylori.

Adolescent↗

Seroepidemiology of pertussis in Italy.

During 1988 and 1989 the prevalence of serum IgG antibodies to pertussis toxin in a sample of 3,875 unvaccinated, apparently healthy persons between the ages of 1 year to 19 years was estimated by enzyme-linked immunosorbent assay. The participants were recruited by means of systematic cluster sampling from public and private schools in five geographic areas of Italy. The overall prevalence of IgG antibodies was 80.8%, with a steady increase from 33.5% among 1- to 3-year-old children to 95% among 17- to 19-year-old individuals. The prevalence of natural immunity was 50% and 75% at the ages of 4 and 6 years, respectively. No gender-related difference in immunity was observed. For children greater than 10 years of age, the seroprevalence of pertussis antibodies was significantly higher in northern regions than in southern regions until the age of 17-19 years, when the pattern reversed. There was no association of a child's immune status with the father's number of years of schooling or with family size. For children aged 1-3 years, serologic studies showed that the history of pertussis reported by parents in questionnaires was highly specific (97.6%) in predicting antibody status, with positive and negative predictive values of 90.5% and 79.2%, respectively. However, 20.8% of children had antibodies to pertussis toxin even though they had no history of whooping cough.

Adolescent↗

Changing epidemiology of hepatitis A virus (HAV) infection: a comparative seroepidemiological study (1979 vs 1989) in north-east Italy.

A comparative seroepidemiological study (1979 vs 1989) on HAV infection, was carried out in children and adolescents from North-East Italy. Anti-HAV was tested in 850 subjects 6 to 8 years of age and the results were compared to those observed in 1979, in 462 subjects of the same age range and from the same geographical area. Overall anti-HAV prevalence was 1.9% (ranging from 0.5 to 5.2) in 1989 vs 32.5% (ranging from 7.8 to 70.7) in 1979. This dramatic decline of HAV infection in children and adolescents reflects the improved sanitation standard of our country but, on the other hand, indicates that the number of non-immune adults is increasing, with a higher risk of symptomatic infection in the near future.

Adolescent↗

Changing pattern of hepatitis B infection in children: a comparative seroepidemiological study (1979 vs 1989) in north-east Italy.

Hepatitis B infection was endemic in Italy and household transmission has been considered to be the main mode of HBV spread. Prevalence of HBsAg positive subjects was therefore higher in children than in adults. Serum samples from 500 children (aged 6-15 year) without overt liver disease were tested for HBV serum markers in 1979. Serological evidence of HBV infection was present in 16% of the subjects. To verify a possible decline of HBV infection we designed a seroepidemiological study in school children from the same town. Three classes of age (6 yrs, 10 yrs, 14 yrs) were selected. Children were recruited from those attending primary and secondary schools using a systematic cluster sampling. After parents' informed consent sera were collected in May 1989. All were tested for anti-HBc: anti-HBc + ve sera were then tested for HBsAg and anti-HBs (EIA Abbott Lab., Chicago, Ill. USA). Of the 1635 children one was HBsAg positive and 21 were positive for any HBV marker. Both the prevalence of HBsAg and that of any HBV marker were significantly lower (p less than 0.001) in 1989 when compared to the corresponding age-class of 1979.

Adolescent↗

The descriptive epidemiology of primary liver cancer in Italy.

Using figures from the official death registry, we studied the descriptive epidemiology of primary liver cancer (PLC) in Italy from 1969 to 1985. The annual age-standardized mortality rate rose from 3.7/100,000 in 1969 to 4.7/100,000 in 1985, reaching the peak of 6.5/100,000 in 1983. The male/female ratio increased from 1.2:1 in 1969 to 2:1 in 1985. The age-specific mortality rate was very low in subjects under 55 years of age and peaked in subjects in their seventies and eighties. The rate was higher for men in all age-groups. The highest proportion of deaths (32%) was observed in the 65-74 year age group. The median age of death for patients with PLC was 10 years older than the median age for patients who died of alcoholic liver cirrhosis, but similar to that of patients who died of liver cirrhosis due to other causes. The highest regional age-standardized mortality rate was reported in Lombardia, Lazio and Veneto respectively, where hepatitis B virus (HBV) infection is less endemic than in the southern regions and the Islands. It should be kept in mind that these findings are not extremely accurate because they are based on mortality figures, where the contamination with metastatic cases is practically unavoidable; furthermore, their validity and comparability are not first-rate due to the wide variation in diagnostic accuracy and registration completeness.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Serum antibodies to capsular polysaccharide vaccine of group A and C Neisseria meningitidis in military recruits in Italy.

In this study we evaluated, by a standard bactericidal assay, the antibody response to the meningococcal group A and C polysaccharide vaccine used for the immunization programme of the Italian military recruits, compulsory by law since 1987. The percentage of responders, those who developed a four-fold increase in the bactericidal titre to polysaccharide A and C, was 96% and 98%, respectively. No significant side effects were observed after vaccination.

Antibodies, Bacterial↗

The changing epidemiology of hepatitis A in Italy.

In 1990, the prevalence of antibodies to hepatitis A virus infection (anti-HAV) was assayed by the ELISA method on a national sample of 1000 recruits aged 18-24 years. The overall prevalence was 29.4% (22.4% in the northern and central regions, 32.2% in the south and islands; p < 0.01). Compared with a similar study conducted in 1981, the results show a marked reduction in anti-HAV prevalence (from 66.3% to 29.4%; p < 0.01). These findings reflect the improved sanitation standards in Italy and indicate that the proportion of non-immune adults is increasing, with a higher risk of symptomatic infection in the near future.

Adolescent↗