Τίτλος:
Prevalence and clinical course of hepatitis delta infection in Greece: A
13-year prospective study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Manesis, Emanuel K.
Vourli, Georgia
Dalekos, George and
Vasiliadis, Themistoclis
Manolaki, Nina
Hounta, Athina and
Koutsounas, Sotirios
Vafiadis, Irini
Nikolopoulou, Georgia and
Giannoulis, Gregory
Germanidis, George
Papatheodoridis, George
and Touloumi, Giota
Περιοδικό:
WORLD JOURNAL OF HEPATOLOGY
Λέξεις-κλειδιά:
Chronic HDV infection; HDV-epidemiology; HDV-clinical course; Treatment
of HDV; Greece; Anti-HDV testing in HBsAg-positive patients
DOI:
10.1016/j.jhep.2013.07.005
