Current practice of chronic hepatitis B treatment in Southern Italy

Background: Treatment choice for chronic HBV infection is a continuously evolving issue, with a wide range ofoptions. We aimed to evaluate the current practice of HBV therapies in the real world in Southern Italy.Methods: A prospective study enrolling over a six month period (February–July 2010) all consecutive HBsAgpositive subjects, never previously treated, referred to 16 liver units in two Southern Italy regions (Calabriaand Sicily).Results: Out of 247 subjects evaluated, 116 (46.9%) had HBV-DNA undetectable or lower than 2000 UI/ml.There were 108 (43.7%) inactive carriers, 103 (41.7%) chronic hepatitis, and 36 (14.6%) liver cirrhosis. Antiviraltreatment was planned in 94 (38.0%) patients (26 cases with Interferon or Pegylated Interferon and68 with nucleos(t)ides analogues). As many as 49.5% of subjects with chronic hepatitis did not receiveantiviral treatment.Discussion: The majority of chronic HBsAg carrier referring centres for evaluation were not consideredsuitable for antiviral treatment. Nucleos(t)ides analogues are the preferred first choice for therapy. A longlastingperiod of observation may be needed to make appropriate therapeutic decisions in several cases.