Hepat Mon.2011;11(11):895-900. DOI: 10.5812/kowsar.1735143X.767 KOWSAR Journal home page: www.HepatMon.com Hepatitis C Virus Infection Trends in Italy, 1996–2006 Giuseppe La Torre 1*, Maria Rosaria Gualano 2, Leda Semyonov 1, Nicola Nicolotti 2, Walter Ricciardi 2, Antonio Boccia 1 1 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy 2 Institutes of Hygiene, Catholic University of the Sacred Heart, Rome, Italy A R T I C L E I N F O Article type: Original Article Article history: Received: 24 Apr 2011 Revised: 07 Jun 2011 Accepted: 18 Aug 2011 Keywords: Hepatitis C Infection Trend Italy A B S T R A C T Background: The World Health Organization (WHO) estimates that about 180 million peo- ple, 3% of the world population, are infected with the hepatitis C virus (HCV). In Italy, the prevalence in the general population is reported to be greater than 5% and 9% among households of HCV-positive patients. Objectives: The aim of this study was to estimate the trends of HCV infection in Italy in the period 1996–2006. Materials and Methods: The formula ln (rate) = b × years was applied for logarithmic trans- formation of the incidence rates to obtain time trends of HCV infection, using the join- point regression program software version 3.3.1. Linear graphs representing trends and the annual percentage change (APC) were considered for each joinpoint. Time changes are expressed as expected annual percentage change (EAPC) with the respective 95% con- ﬁdence intervals (CIs); signiﬁcance levels of time trends are also reported. The hy- pothesis was tested using a maximum of 3 changes in slope with an overall signiﬁcance level of 0.05 divided by the number of joinpoints in the ﬁnal model. Results: Considering all age groups, the incidence rate decreased from 2.02 to 0.55 per 100,000. The joinpoint analysis showed a statistically signiﬁcant decrease in the inci- dence rates of HCV infection. No joinpoints were found in any age groups. Our data show that the incidence rates of HCV infections have considerably decreased in each age group throughout the studied period (1996–2006). Conclusions: This decreasing trend in HCV infections is, in part, attributable to behavio- ral and social changes. Improved hygiene, use of precautions in medical settings, blood screening, and sexual educational campaigns seem to have contributed to reduce the transmission of infection during the last 10 years. c 2011, BRCGL, Published by Kowsar M.P.Co. All rights reserved. Implication for health policy/practice/research/medical education: Behavioral changes are a leading factor in the decrease of HCV infections. Every eﬀort should be made with the aim to maintain low levels of HCV infection. More attention, in particular, needs to be placed to improve socio-economic condition and to sanitation during medical procedures, even for those performed at home. Please cite this paper as: La Torre G, Gualano MR, Semyonov L, Nicolotti N, Ricciardi W, Boccia A. Hepatitis C Virus Infection Trends in Italy, 1996-2006. Hepat Mon. 2011; 11(11):895-900. DOI: 10.5812/kowsar.1735143X.767 * Corresponding author: Giuseppe La Torre, Department of Public Health and Infectious Diseases, Sapienza University of Rome, Regina Aldo Maro 5, 00185 Rome, Italy. Tel: +39-49970388; ext: 06, Fax: + 39-49972473; ext: 06, E-mail: giuseppe.latorre@uniroma1.it DOI: 10.5812/kowsar.1735143X.767 Copyright c 2011, BRCGL, Published by Kowsar M.P.Co. All rights reserved. 1. Background Hepatitis C virus (HCV) infection is a major public health problem and chronic liver disease secondary to HCV is a leading indication for liver transplantation (1). In fact, infection with HCV is generally asymptomatic and in less than half of the infection cases, hepatitis be- comes chronic, progressing to cirrhosis or liver cancer (2,