Chronic Viral Hepatitis
in Balkans

The XXIVth National Congress of Hepatology
The Fourth Romanian-French Hepatology Meeting
The Fifth Balkan Hepatology Course

October 2nd - 4th, 2014, Pullman Hotel, Bucharest, Romania

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Hepatitis viruses - a global public health problem

It has been estimated that around the world...

HBV infection
- 2 billion people have serologic evidence of past / present HBV infection
- 350 - 400 million people are chronically infected
- 4 million acute cases per year
- 1 million deaths per year

HDV infection
- more prevalent in Balkan and Italy
- co- or supra-infection of HBV infection
- responsible for acute hepatic failure due to supra-infection

HCV infection
- 170 million people (3%) of the world population are chronically infected
- 5 million people infected in Western Europe
- higher rates in eastern Europe
- first cause of liver transplant
- second cause worldwide and first cause in Europe of liver cancer

HEV infection
- more prevalent in South-East and Central Asia
- HEV has a global distribution now
- characteristics:
- transmission: faecal-oral route
- causes large waterborne epidemics of icteric hepatitis
- possible parental transmission
- there was no association with blood borne infection (HBV or HCV)
- anti HEV prevalence among chronic haemodialysis patients is controversial

10 leading causes of infectious disease death worldwide:
HBV on 7th and HCV on 10th place

Descriptive epidemiological studies showed that hepatitis viruses' prevalence rates vary greatly across the world.
The prevalence of hepatitis viruses has been changing all over the world, in Europe also, due to: moving people, new socio-economical conditions, new viruses, new mutants, and HBV vaccination.

Problems in Europe
In Europe three main geographical areas can be distinguished according to their incidence and classified as:
- High risk: Southern Europe, Greece, Italy, Romania,
- Intermediate risk: Central and Western Europe
- Low risk: Northern Europe

Southern Europe and The Balkans have always been the regions with the highest prevalence in Europe, demonstrated by the "North to South gradient".

Prevalence of HBV/HCV: Europe estimates

Prevalence of HBV/HCV: Balkans estimates