Late presentation of chronic HBV and HCV patients seeking first time specialist care in Spain: a 2-year registry review

Camila A. Picchio, Sabela Lens, Manuel Hernandez-Guerra, Juan Arenas, Raul J. Andrade, Javier Crespo, Javier Garcia-Samaniego, Manuel Romero-Gomez, Juan Turnes, Jose Luis Calleja, Miguel Angel Simon, Trenton M. White, Mar Riveiro-Barciela, Anna Pocurull, Dalia Morales-Arraez, Alexandra Gomez, Maria Buti, Jeffrey Lazarus

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12 Citations (Scopus)


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
Original languageEnglish
Article number24133
Pages (from-to)1-12
Number of pages12
Issue number1
Publication statusPublished - 17 Dec 2021

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