• acute hepatitis;
  • epidemiology;
  • HCV;
  • Italy


Surveillance systems for acute hepatitis C allow monitoring of disease incidence trends and transmission patterns. This study aimed to describe the epidemiological profile of reported cases of symptomatic acute hepatitis C in Italy after the achievement of blood supply safety. The incidence of symptomatic acute hepatitis C since 1991 was estimated. Risk factors for acute hepatitis C were analyzed for the period 2003–2010 through a case–control study within a population-based surveillance for acute viral hepatitis. From 1991 to 2010, the incidence decreased from 2 to 0.2 per 100,000, with a more evident decrease among persons aged 15–24 years. During 2003–2010, 1,053 cases were reported. Intravenous drug use (adjusted odds ratio [adjOR], 30.5; 95% confidence interval [CI], 18.9–49.1), cohabitation or sexual partnership with an hepatitis C virus (HCV) carrier (adjOR, 11.2; 95% CI, 6.6–19.2), nosocomial exposure (adjOR, 6.6; 95% CI, 4.6–9.4); unsafe sexual practices (adjOR, 3.1; 95% CI, 1.9–5.2), and cosmetic treatments with percutaneous exposure (adjOR, 1.7; 95% CI, 1.2–2.4) were independently associated with acute hepatitis C. Population attributable risk estimates indicated nosocomial exposure (39.6%) and intravenous drug use (30.5%) as responsible for most cases. In conclusion, the incidence of symptomatic acute hepatitis C is declining in Italy. Currently, the most important risk factors are: having an HCV-positive household or sexual partner, unsafe sexual practices, cosmetic percutaneous treatments, intravenous drug use, and nosocomial exposure; the latter two factors are responsible for most cases. Effective prevention programs for intravenous drug users and strict adherence to universal precautions in healthcare settings are needed. J. Med. Virol. 85:433–440, 2013. © 2012 Wiley Periodicals, Inc.