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The burden and recent epidemiological changes of the main chronic liver diseases in a Greek referral tertiary centre
Ioannis P Giannousis1, George V Papatheodoridis, Melanie J Deutsch
1Second Department of Internal Medicine, Athens University Medical School, Hipppokration General Hospital, Athens 115 27, Greece.
Insights
Chronic viral hepatitis remains the leading cause of liver disease in Greece, but its patterns are shifting. An increase in immigrant populations and intravenous drug users is influencing these epidemiological changes.
Area of Science:
- Hepatology
- Epidemiology
- Public Health
Background:
- Chronic liver diseases represent a significant health burden globally.
- Understanding epidemiological shifts is crucial for effective public health strategies.
- Hepatitis B (HBV), Hepatitis C (HCV), Alcoholic Liver Disease (ALD), and Nonalcoholic Fatty Liver Disease (NAFLD) are key chronic liver conditions.
Purpose of the Study:
- To investigate the prevalence and recent epidemiological changes of major chronic liver diseases.
- To analyze trends in HBV, HCV, ALD, and NAFLD at a Greek tertiary referral center.
Main Methods:
- A retrospective analysis of 1080 adult patients with chronic liver disease.
- Patients were seen at an outpatient liver clinic between 2002 and 2007.
- The study population was divided into two periods: 2002-2004 (Period A) and 2005-2007 (Period B).
Main Results:
- Chronic viral hepatitis (HBV/HCV) accounted for 86.1% of cases, with HCV alone at 44.9%.
- A decrease in HBV cases was observed (44.0% to 37.8%), with immigrants comprising a growing proportion.
- Hepatitis B e antigen-positive cases and HCV cases linked to intravenous drug use showed an increasing trend.
Conclusions:
- Chronic viral hepatitis continues to dominate chronic liver disease in Greek tertiary centers.
- Epidemiological patterns are evolving, influenced by immigration and intravenous drug use.
- Targeted interventions may be needed to address these changing demographics.
Objective:
To investigate the burden and recent epidemiological changes of the main chronic liver diseases in a Greek referral tertiary centre.
Methods:
We evaluated the main epidemiological characteristics of 1080 consecutive adult patients, seen at our outpatient liver clinic between 2002 and 2007, with chronic hepatitis B (HBV) and/or C (HCV) virus infection, alcoholic liver disease (ALD) or nonalcoholic fatty liver disease (NAFLD). Our patient population was divided into two groups in relation to the time of the first visit (period A: 2002-2004, period B: 2005-2007).
Results:
Among our patient population, 86.1% had chronic HBV and/or HCV infection (chronic HCV alone: 44.9%), 9.2% NAFLD and 4.8% ALD. From period A to B, there was a decrease in chronic HBV cases (44.0 vs. 37.8%, P = 0.045) with immigrants being responsible for 35.5% of them and being more frequent in period B than A (39.7 vs. 30.5%, P = 0.046). In chronic hepatitis B, hepatitis B e antigen-positive patients, who were more frequent immigrants compared with hepatitis B e antigen-negative patients (65.5 vs. 29.5%, P = 0.001), increased from period A to B (8.0 vs. 17.6%, P = 0.045). Intravenous drug use was reported by 41.2% of HCV patients with its proportion increasing from period A to B (32.5 vs. 47.4%, P = 0.002). Decompensated cirrhosis was present in 67, 10, 11 and 3% of patients with ALD, HBV, HCV and NAFLD, respectively.
Conclusion:
At Greek tertiary centres, chronic viral hepatitis remains responsible for most chronic liver disease cases, but its epidemiology is changing owing to immigrants and intravenous drug users.
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