HEPATITIS-C VIRUS-INFECTION IN GREECE AND ITS ROLE IN CHRONIC LIVER-DISEASE AND HEPATOCELLULAR-CARCINOMA

The aim of this study was to evaluate the prevalence of hepatitis C vi rus infection (HCV) in Greece, to estimate its frequency in chronic li ver disease and to explore the role of HCV infection in the aetiology of hepatocellular carcinoma. A series of 1034 patients with chronic li ver disease of various aetiologies and 299 patients with hepatocellula r carcinoma allocated to two case-control studies was tested for anti- HCV. Twelve recent reports on HCV infection in Greece were reviewed an d analyzed. The results of the present study indicate the existence of a large pool of HCV infection in Greece and an impressive spread of t he virus in high-risk groups. Chronic HCV infection was found to accou nt for 83.6% of patients with chronic non-A, non-B hepatitis parentera lly transmitted, 56.5% of cases of sporadic community-acquired disease and for almost 1/4 of all patients with chronic liver disease. The re lative risks for development of hepatocellular carcinoma of patients w ith chronic HCV infection was 6.3 in the first and 13.7 in the second case-control study, increasing to 20.0 and 18.7, respectively, when he patitis B surface antigen (HBsAg) was positive. Serum HBV-DNA was posi tive and/or anti-HBc IgM levels were high in 12 of 15 (80%) patients w ith hepatocellular carcinoma positive only for HBsAg, and in 7 of 15 ( 47%) positive both for HBsAg and antibodies to HCV. The present data s upport the view that hepatitis B and C virus have an interacting role in the origin of hepatocellular carcinoma.