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. 2021;34(3):431-437.
doi: 10.20524/aog.2021.0614. Epub 2021 Feb 26.

The changing epidemiology of hepatitis B in Greece

Eirini I Rigopoulou  1 , Nikolaos K Gatselis  1 , Konstantinos Galanis  1 , Vasiliki Lygoura  1 , Stella Gabeta  1 , Kalliopi Zachou  1 , George N Dalekos  1
Affiliations

The changing epidemiology of hepatitis B in Greece

Eirini I Rigopoulou et al. Ann Gastroenterol. 2021.

Abstract

Background: The epidemiology of hepatitis B virus (HBV) infection has changed in recent years as a result of various factors. Our aim was to assess the epidemiological characteristics and the evolution of the HBV infection in a well-defined area of Greece.

Method: Prospectively collected data from 1910 consecutive patients (60.8% male, age: 50.1 years) with chronic hepatitis B (CHB) followed from 1999-2016 were analyzed.

Results: Of the patients evaluated, 90.6% were of Greek and 8% of Albanian origin. Vertical/intrafamilial transmission during early childhood (56.8%) and traditional practices (17.2%) were the most common infection sources. Several areas with higher rates of CHB were identified. At first evaluation, 68.8% had chronic infection, 21.7% chronic hepatitis, 6.1% cirrhosis and 3.4% hepatocellular carcinoma (HCC). Comparison between 2 periods (1999-2010 and 2011-2016) revealed older age and longer disease duration at first presentation (P<0.001 for both) to be more common during 2011-2016, while patients of foreign nationality doubled during this period. There was a trend towards more advanced disease stage at first assessment during 2011-2016. Patients after 2011 had lower rates of virological and biochemical breakthrough (P<0.001 for both) during treatment with new antivirals. In addition, fewer patients progressed to cirrhosis (P=0.02) and HCC (P=0.04).

Conclusions: CHB continues to be a major health problem in Central Greece, as highlighted by the preservation of high prevalence areas and a tendency towards an increase of chronic liver disease burden longitudinally. Our data highlight the need for scaling-up prevention and treatment strategies, especially in at-risk populations.

Keywords: Hepatitis B; cirrhosis; epidemiology; hepatocellular carcinoma; natural history.

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Conflict of interest statement

Conflict of Interest: None

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