Contributors: Picchio,CA; White,TM; Lazarus,JV Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain. Lens,S; Pocurull,A Liver Unit, Hospital Clinic, Universidad de Barcelona, Barcelona, Spain. Lens,S; Pocurull,A IDIBAPS, University of Barcelona, Barcelona, Spain. Lens,S; Andrade,RJ; García‑Samaniego,J; Calleja,JL; Pocurull,A; Buti,M CIBER Hepatic and Digestive Diseases (CIBERehd), Instituto Carlos III, Madrid, Spain. Hernandez-Guerra,M; Morales-Arraez,D Department of Gastroenterology, University Hospital of the Canary Islands, San Cristóbal de La Laguna, Spain. Arenas,J; Gomez,A Biodonostia, Liver Diseases Research Group, Osakidetza Basque Health Service, Donostia University Hospital, San Sebastián, Spain. Andrade,RJ Unidad de Gestión Clínica de Enfermedades Digestivas, Instituto de Investigación Biomédica de Málaga‑IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain. Crespo,J Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain. García-Samaniego,J Liver Unit, Department of Gastroenterology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain. Romero-Gómez,M UCM Digestive Diseases, Hospital Universitario Virgen del Rocío, Institute of Biomedicine of Seville, Universidad de Sevilla, Seville, Spain. Turnes,J Complejo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Pontevedra, Spain. Calleja,JL Gastroenterology and Hepatology Department, Hospital Universitario Puerta del Hierro de, Universidad Autónoma de Madrid, Madrid, Spain. Simón,MA Department of Digestive Diseases, Hospital Clínico de Zaragoza, Zaragoza, Spain. Simón,MA Instituto de Investigación Sanitario Aragón (IIS Aragón), Zaragoza, Spain. Riveiro-Barciela,M; Buti,M Liver Unit, Hospital Universitario Vall d’Hebron, Barcelona, Spain.
نبذة مختصرة : 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. ; CAP, TMW, JVL acknowledge support to ISGlobal from the Spanish Ministry of Science, Innovation and Universities through the “Centro de Excelencia Severo Ochoa 2019–2023” Programme (CEX2018-000806-S), and support from the Government of Catalonia through the CERCA Programme. CAP acknowledges support from the Secretaria d’Universitats i Recerca de la Generalitat de Catalunya and the European Social Fund as an AGAUR-funded PhD fellow. The authors would like to thank those who contributed to data collection: From the Basque Country: Leire Samaniego, Maria Vaamonde, and Edurne Almandoz. From Madrid; Dr Yza Frias, and Ana Robles. From Málaga; Enrique del Campo Herrera. From Sevilla; Bianca ...
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