More than 15% of Greek blood donors exhibit elevated liver enzymes, most likely as a result of unrecognized nonalcoholic fatty liver disease. The prevalence of nonalcoholic fatty liver disease is mainly associated with male sex, obesity and waist circumference, but it may range significantly among different population groups.

I nterferon alfa (IFN), lamivudine, and adefovir dipivoxil are the only approved treatments for chronic hepatitis B. IFN treatment has a moderate efficacy and frequent side effects, and is associated with an inconvenient 3-timesweekly dosing regimen. Lamivudine and adefovir have significant antiviral activity, although viral rebound after cessation of therapy and development of resistance after long-term lamivudine therapy are major clinical limitations.The new pegylated forms of IFN (pegylated interferon alfa-2a or 2b) are currently being evaluated among chronic hepatitis B patients. The benefit of conjugation of IFN with polyethylene glycol is the improvement of delivery of IFN by significantly prolonging its plasma halflife and thereby providing protracted activity, which allows once-per-week dosing. Results from trials among hepatitis B e antigen (HBeAg) (ϩ) or HBeAg (Ϫ) chronic hepatitis B patients indicate that treatment with pegylated interferon alfa-2a is superior to conventional interferon alfa-2a or lamivudine monotherapy. 1-3 The combination of pegylated interferon alfa-2a or alfa-2b and lamivudine was not found to improve sustained response rates over pegylated interferon monotherapy in HBeAg (Ϫ) or HBeAg (ϩ) chronic hepatitis B patients, respectively. 3,4 Mathematical modeling of the dynamics of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection during antiviral therapy has provided useful insight into viral replication, host cell death rate, and treatment efficacy. [5][6][7] In the last years, similar studies have been Abbreviations: IFN, interferon alpha; HCV, hepatitis C virus; HBV, hepatitis B virus; ALT, alanine aminotransferase; LMV, lamivudine; QD, daily; QW, once weekly. From the

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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.

The aim was to demonstrate adherence to treatment has been suggested to enhance rates of sustained response in patients with hepatitis C. In this study, we evaluated the effect of drug dosage reduction or the duration of the expected therapy in patients treated with interferon (IFN)-alpha2b plus ribavirin. Virologic response rates were re-analysed according to compliance to therapy in (i) 301 naive and (ii) 142 nonresponders to previous IFN therapy treated with either IFN 5 MU TIW for 8 weeks followed by IFN 3 MU TIW for 40 weeks plus ribavirin or IFN 3 MU QD for 16 weeks followed by IFN 3 MU TIW for 24 weeks plus ribavirin. Patients were separated into those who adhered to > or =80% of their intended treatment schedule (dose of both drugs and duration) and those who did not. Compliance to treatment resulted in significantly higher response rates in both groups of patients: 43.93% compared with 6.90% of noncompliant naive patients and 30.77% compared with 10.53% of nonresponder patients. Compliance to treatment was found to have a similar effect when the results were analysed according to HCV genotype. Our findings suggest that compliance to treatment for > or =80% of the intended treatment schedule results in significantly higher sustained response rates in both naive and nonresponder patients. Consequently, every effort should be made to improve patient adherence to therapy.