Epidemiology, course and disease burden of chronic hepatitis B virus infection. HEPNET study for chronic hepatitis B: a multicentre Greek study.

SUMMARY: Hepatitis B virus infection (HBV) has been recognized as a major health problem worldwide. Greece belongs to the intermediate endemicity countries with a trend of decreasing prevalence of HBV infection during the last decade. However, the recent massive immigration to our country may have led to alterations of HBV epidemiology. In this study, we evaluated the epidemiological features of HBV infection in a sample of 3480 patients followed up during the years 1997-2006. Immigrants mainly from Albania represented the 18.6% of the total study population and 56.6% of children. The majority of the patients had no family history of HBV infection (67.3%) or of acute hepatitis (95.4%), no known source of infection (64.6%), with intrafamilial spread accounting for 16.9% of the HBV transmission in adults and 33.9% in children. HBeAg(-) hepatitis B was the predominant form of hepatitis (92.1%) among the Greek patients in contrast to the immigrants where 16.6% were HBeAg(+). Liver cirrhosis was diagnosed in 8.8% of the total population and 0.9% had hepatocellular carcinoma. A high proportion of children were HBeAg(+) (62%), 55% from immigrant families, 25.2% were infected in the perinatal period and had no evidence of disease complications. In conclusion our results showed (a) a changing pattern in the epidemiology of HBV infection in Greece due to the significant number of HBeAg(+) patients, especially among children and (b) a considerable number of patients although aware of their infection, present with advanced disease.

Factors influencing influenza vaccination rates among healthcare workers in Greek hospitals.

Influenza vaccination rates are generally low among healthcare workers (HCWs) worldwide. In September 2005, the Hellenic Center for Disease Control and Prevention conducted a nationwide campaign to promote influenza vaccination in hospital HCWs. During the 2005-2006 influenza season, the overall vaccination rate among HCWs was 16.36% (range: 0-85.96%). The self-reported vaccination rate during the previous season was 1.72%, indicating a 9.5-fold increase. Compared with physicians, significantly fewer technical personnel were vaccinated, whereas administrative personnel were more likely to receive the vaccine. Among clinicians, rates for internal medicine departments exceeded those of surgical departments by a factor of 2.71 and laboratory medicine departments by a factor of 2.36. Multivariate analysis showed lower vaccination rates in large hospitals (>200 beds) than in smaller hospitals and lower rates in hospitals with specialist services (intensive care unit, psychiatry or dermatology) than in general hospitals. Factors associated with higher rates included working in northern Greece, in a paediatric or an oncology hospital, or in a prefecture with avian influenza H5N1 activity. In conclusion, in Greece influenza vaccination rates among HCWs remain low, but the implementation of a nationwide campaign had a considerable impact. Efforts should focus on hospital- and HCW-associated factors to increase vaccination uptake.