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Prevalence and clinical course of hepatitis delta infection in Greece: A 13-year prospective study
dc.creator | Manesis, E. K. | en |
dc.creator | Vourli, G. | en |
dc.creator | Dalekos, G. | en |
dc.creator | Vasiliadis, T. | en |
dc.creator | Manolaki, N. | en |
dc.creator | Hounta, A. | en |
dc.creator | Koutsounas, S. | en |
dc.creator | Vafiadis, I. | en |
dc.creator | Nikolopoulou, G. | en |
dc.creator | Giannoulis, G. | en |
dc.creator | Germanidis, G. | en |
dc.creator | Papatheodoridis, G. | en |
dc.creator | Touloumi, G. | en |
dc.date.accessioned | 2015-11-23T10:38:39Z | |
dc.date.available | 2015-11-23T10:38:39Z | |
dc.date.issued | 2013 | |
dc.identifier.issn | 0168-8278 | |
dc.identifier.uri | http://hdl.handle.net/11615/30612 | |
dc.description.abstract | Background & Aims: Hepatitis D virus (HDV) has decreased in Europe, but recent reports indicate a rising trend. We report the epidemiological changes, clinical progress, and effect of treatment on the natural course of HDV infection in Greece during the last 13 years. Methods: Prospective data were extracted from the Hep-Net. Greece Cohort-Study. Results: Since 1997, 4673 chronic HBV (CHB) cases (4527 adults, 146 children) have been followed prospectively. Two thousand one hundred thirty-seven patients were tested for anti-HDV [101 (4.7%) positive]. Anti-HDV testing in Greece decreased significantly (57.0% before 2003, 35.3% thereafter; p < 0.001). Anti-HDV prevalence among HBsAg-positives was 4.2%; lower in native Greeks (2.8%) than in immigrants (7.5%) or in children (15.3%; p < 0.001). Within 2.3 years of follow-up, HDV occurred in 11/2047 HBsAg-positive patients (2.2 new delta-infected adults and 8.7 children per 1000 HBsAg-positive annually). HDV-positive compared to CHB adults were younger (p = 0.035) and had more active and advanced disease at baseline, as indicated by laboratory indices and the higher prevalence of cirrhosis at younger age. During a 4.2-year median observation, significantly more anti-HDV-positive than CHB adults developed a liver-related first event (20.0% vs. 8.5%, p(Log-rank) = 0.014). Treatment was received by 46/90 (51.1%) patients, 40 of them interferon-based. In multivariable analysis, interferon significantly decreased disease progression in HDV-positive patients [HR = 0.14 (95% CI: 0.02-0.86; p = 0.033)]. Conclusions: In Greece, HDV serology is currently tested in only one-third of HBsAg-positive patients. HDV prevalence is lower in native Greeks compared to immigrants, who may contribute >50% of the HDV infection burden in Greece. Data show that HDV infection is a rapidly progressive disease, but interferon-based treatment may alter its course. (C) 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. | en |
dc.source.uri | <Go to ISI>://WOS:000325754200008 | |
dc.subject | Chronic HDV infection | en |
dc.subject | HDV-epidemiology | en |
dc.subject | HDV-clinical course | en |
dc.subject | Treatment | en |
dc.subject | of HDV | en |
dc.subject | Greece | en |
dc.subject | Anti-HDV testing in HBsAg-positive patients | en |
dc.subject | B-VIRUS INFECTION | en |
dc.subject | VANISHING DISEASE | en |
dc.subject | CIRRHOSIS | en |
dc.subject | MULTICENTER | en |
dc.subject | ENDEMICITY | en |
dc.subject | REFUGEES | en |
dc.subject | MARKERS | en |
dc.subject | Gastroenterology & Hepatology | en |
dc.title | Prevalence and clinical course of hepatitis delta infection in Greece: A 13-year prospective study | en |
dc.type | journalArticle | en |
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