title: The burden and recent epidemiological changes of the main chronic liver diseases in a Greek referral tertiary centre.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Second Department of Internal Medicine, Athens University Medical School, Hipppokration General Hospital, Athens 115 27, Greece.
authors.forename: Ioannis P
authors.initials: IP
authors.lastname: Giannousis
authors.forename: George V
authors.initials: GV
authors.lastname: Papatheodoridis
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Deutsch
authors.forename: Spilios G
authors.initials: SG
authors.lastname: Manolakopoulos
authors.forename: Emanuel K
authors.initials: EK
authors.lastname: Manesis
authors.forename: John S
authors.initials: JS
authors.lastname: Koskinas
authors.forename: Athanasios J
authors.initials: AJ
authors.lastname: Archimandritis
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001706:Biopsy; D017281:Cost of Illness; D004279:DNA, Viral / Q000097:blood; D055030:Drug Users / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005234:Fatty Liver / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006115:Greece / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D013997:Time Factors; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral