{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:18:38Z","timestamp":1773785918386,"version":"3.50.1"},"reference-count":22,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T00:00:00Z","timestamp":1643155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: In 1991, a mass immunization campaign against the hepatitis B virus (HBV) for children and teenagers was introduced in Italy. This study evaluated the impact of the immunization campaign on the incidence and modes of HBV transmission. Method: Acute HBV cases of viral hepatitis were reported to the National Surveillance System (SEIEVA). Hepatitis A cases reported to the same system were used as controls to calculate the adjusted odds ratios and the population attributable risk for potential risk factors. Results: The incidence of acute HBV declined from 5.0 in 1990 to 0.4 in 2019 per 100,000 population. The fall was almost total in people targeted by the campaign: in 2019, zero cases (100% reduction) in the age-group 0\u201314 years and 0.1 cases per 100,000 population (99.4% reduction) in the age-group 15\u201324 years were reported. In the decade 2010\u20132019, nearly one-fifth (19.3%) of cases occurred in foreigners. Intravenous drug use is no longer a risk factor (OR = 0.7; 95% CI = 0.5\u20131.02). Beauty treatments, risky sexual exposure, and household contact with an HBsAg carrier were found to be independent predictors of acute hepatitis B. Conclusions: The HB vaccination campaign proved effective in minimising acute HBV in Italy. Control of the infection is close to being reached for the first time in Europe.<\/jats:p>","DOI":"10.3390\/v14020245","type":"journal-article","created":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T03:33:32Z","timestamp":1643168012000},"page":"245","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Effectiveness of Hepatitis B Vaccination Campaign in Italy: Towards the Control of HBV Infection for the First Time in a European Country"],"prefix":"10.3390","volume":"14","author":[{"given":"Tommaso","family":"Stroffolini","sequence":"first","affiliation":[{"name":"Department of Tropical and Infectious Diseases, Policlinico Umberto I, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filomena","family":"Morisco","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigina","family":"Ferrigno","sequence":"additional","affiliation":[{"name":"National Center for Global Health, National Institute of Health (Istituto Superiore di Sanit\u00e0 ISS), 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina","family":"Pontillo","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina","family":"Iantosca","sequence":"additional","affiliation":[{"name":"National Center for Global Health, National Institute of Health (Istituto Superiore di Sanit\u00e0 ISS), 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Cossiga","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simonetta","family":"Crateri","sequence":"additional","affiliation":[{"name":"National Center for Global Health, National Institute of Health (Istituto Superiore di Sanit\u00e0 ISS), 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1392-9874","authenticated-orcid":false,"given":"Maria","family":"Tosti","sequence":"additional","affiliation":[{"name":"National Center for Global Health, National Institute of Health (Istituto Superiore di Sanit\u00e0 ISS), 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"the SEIEVA Collaborating Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2268","DOI":"10.1080\/21645515.2020.1852869","article-title":"Long-term immune protection against HBV: Associated factors and determinants","volume":"17","author":"Mastrodomenico","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.physbeh.2019.02.025","article-title":"Hindbrain astrocytes and glucose counter-regulation","volume":"204","author":"Rogers","year":"2019","journal-title":"Physiol. Behav."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/S0168-8278(00)80132-4","article-title":"The impact of the hepatitis B mass immunisation campaign on the incidence and risk factors of acute hepatitis B in Italy","volume":"33","author":"Stroffolini","year":"2000","journal-title":"J. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1086\/528687","article-title":"Acute Hepatitis B 14 Years after the Implementation of Universal Vaccination in Italy: Areas of Improvement and Emerging Challenges","volume":"46","author":"Mele","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.puhe.2015.02.015","article-title":"Assessment of timeliness, representativeness and quality of data reported to Italy's national integrated surveillance system for acute viral hepatitis (SEIEVA)","volume":"129","author":"Tosti","year":"2015","journal-title":"Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/ije\/7.2.175","article-title":"Calculation of Attributable Risks from Epidemiological Data","volume":"7","author":"Walter","year":"1978","journal-title":"Int. J. Epidemiol."},{"key":"ref_7","first-page":"397","article-title":"Chronic active hepatitis in Italy: A multicentric study","volume":"41","author":"Giusti","year":"1994","journal-title":"Hepatogastroenterology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1007\/s10096-020-04065-6","article-title":"Chronic hepatitis B virus infection in Italy during the twenty-first century: An updated survey in 2019","volume":"40","author":"Stroffolini","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e190","DOI":"10.1016\/j.ejim.2012.08.009","article-title":"The impact of a vaccination campaign against hepatitis B on the further decrease of hepatitis B virus infection in a southern Italian town over 14 years","volume":"23","author":"Stroffolini","year":"2012","journal-title":"Eur. J. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jinf.2010.11.014","article-title":"Evaluation of the compliance with the protocol for preventing perinatal hepatitis B infection in Italy","volume":"62","author":"Spada","year":"2011","journal-title":"J. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.jhep.2012.05.021","article-title":"Minimization of hepatitis B infection by a 25-year universal vaccination program","volume":"57","author":"Ni","year":"2012","journal-title":"J. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1093\/epirev\/mxj010","article-title":"Nationwide Hepatitis B Vaccination Program in Taiwan: Effectiveness in the 20 Years After It Was Launched","volume":"28","author":"Chien","year":"2006","journal-title":"Epidemiologic Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1002\/hep.24442","article-title":"Elimination of hepatocellular carcinoma and acute hepatitis B in children 25 years after a hepatitis B newborn and catch-up immunization program","volume":"54","author":"McMahon","year":"2011","journal-title":"Hepatology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1471-2334-14-7","article-title":"Efficacy and effectiveness of infant vaccination against chronic hepatitis B in the Gambia Hepatitis Intervention Study (1986\u201390) and in the nationwide immunisation program","volume":"14","author":"Peto","year":"2014","journal-title":"BMC Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1093\/cid\/civ332","article-title":"Epidemiology of acute hepatitis B in the United States from population-based sur-veillance, 2006\u20132011","volume":"61","author":"Iqbal","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1093\/infdis\/jiab224","article-title":"Trends in Prevalence and Characteristics of Resolved and Current Hepatitis B Among US-Born Persons: National Health and Nutrition Examination Survey, 2001\u20132018","volume":"224","author":"Ly","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e2022388","DOI":"10.1001\/jamanetworkopen.2020.22388","article-title":"Prevalence of Hepatitis B Vaccination Coverage and Serologic Evidence of Immunity Among US-Born Children and Adolescents From 1999 to 2016","volume":"3","author":"Le","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_18","first-page":"409","article-title":"Prevalence, incidence and residual risk of transfusion-transmitted hepatitis B virus in-fection in Italy from 2009 to 2018","volume":"17","author":"Velati","year":"2019","journal-title":"Blood Transfus."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1017\/S0950268805004942","article-title":"Hospital transmission of hepatitis B virus in the absence of exposure prone procedures","volume":"134","author":"Smellie","year":"2005","journal-title":"Epidemiology Infect."},{"key":"ref_20","first-page":"1700641","article-title":"Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017","volume":"33","author":"Ndumbi","year":"2018","journal-title":"Euro Surveill."},{"key":"ref_21","unstructured":"World Health Organization Regional Office for Europe (WHO-EURO) (2021, December 15). Health of Refugees and Migrants Regional Situation Analysis, Practices, Experiences, Lessons Learned and Ways Forward, WHO European Region (2018). Available online: https:\/\/www.euro.who.int\/en\/publications\/abstracts\/report-on-the-health-of-refugees-and-migrants-in-the-who-european-region-no-public-health-without-refugee-and-migrant-health-2018."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.healthpol.2020.12.010","article-title":"Health assessment for migrants and asylum seekers upon arrival and while hosted in reception centres: Italian guidelines","volume":"125","author":"Tosti","year":"2020","journal-title":"Health Policy"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/2\/245\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:07:50Z","timestamp":1760134070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/2\/245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,26]]},"references-count":22,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["v14020245"],"URL":"https:\/\/doi.org\/10.3390\/v14020245","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,26]]}}}