Late presentation of chronic HBV and HCV patients seeking first time specialist care in Spain : a 2-year registry review
Picchio, Camila A. (Hospital Clínic i Provincial de Barcelona)
Lens, Sabela (Hospital Clínic i Provincial de Barcelona)
Hernandez-Guerra, Manuel (Hospital Universitario de Canarias (La Laguna))
Arenas, Juan (Hospital de Donostia (Sant Sebastià, País Basc))
Andrade, Raúl J. (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
Crespo García, Javier (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
García-Samaniego, Javier (Instituto de Investigación Sanitaria del Hospital Universitario La Paz)
Romero-Gómez, Manuel (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Turnes, Juan (Complejo Hospitalario Universitario de Pontevedra)
Calleja, Jose Luis (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Simón, Miguel Ángel (Instituto de Investigación Sanitario Aragón)
White, Trenton M. (Hospital Clínic i Provincial de Barcelona)
Riveiro Barciela, Mar (Hospital Universitari Vall d'Hebron)
Pocurull, Anna (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Morales-Arraez, Dalia (Hospital Universitario de Canarias (La Laguna))
Gómez, Alexandra (Biodonostia Osasun Ikerketako Institutura (País Basc))
Buti, Maria (Hospital Universitari Vall d'Hebron)
Lazarus, Jeffrey V. (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	Chronic viral hepatitis infection affects an estimated 325 million people globally. People who initiate treatment after significant disease progression face increased risk of severe liver complications and death. Data are scarce on the characteristics and risk factors of people who present late to care in Spain and globally. Data were collected from January 2018 to December 2019 to report late presentation (LP) to specialist care at 11 large university hospitals in Spain to assess related risk factors using a multivariable logistic regression model. 2290 (CHB = 505, CHC = 1785) patients were analysed, with 581 (25. 2%) presenting late. Hepatitis C patients more frequently reported LP compared to hepatitis B patients (28. 1% vs 15. 0%; p < 0. 001). Older age (p < 0. 001), being male (p < 0. 001), being Spanish-born (p < 0. 001), and having an unknown origin of referral (p = 0. 08) were associated with a higher likelihood of LP. Advanced liver disease was identified in 533 (23%) patients and late-stage liver disease in 124 (5. 4%). LP, including with irreversible liver damage, to viral hepatitis specialist care is frequent in Spain, despite being a country with unrestricted treatment access. Initiatives to reduce LP should specifically target men, older individuals, foreign-born populations for CHB, and Spanish nationals for CHC.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Health services ; Hepatitis B ; Hepatitis C ; Hepatology
Published in:	Scientific reports, Vol. 11 (december 2021) , ISSN 2045-2322

DOI: 10.1038/s41598-021-01885-0
PMID: 34921156

12 p, 1.2 MB

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