Sergio Rodríguez-Tajes, Adriana Palom, Álvaro Giráldez-Gallego, Antonio Moreno, Juan José Urquijo, Manuel Rodríguez, Marta Alvarez-Argüelles, Moisés Diago, María García-Eliz, Javier Fuentes, Ana María Martínez-Sapiña, Pilar Castillo, Marta Casado, Elena Pérez-Campos, Raquel Muñoz, Marta Hernández-Conde, Rosa María Morillas, Rafael Granados, Mireia Miquel, María Julia Morillas, Monserrat García-Retortillo, Jose Antonio Carrión, José María Moreno, Cristina Montón, Jesús Manuel González-Santiago, Sara Lorente, Joaquín Cabezas, Beatriz Mateos, Sergio Vázquez-Rodríguez, Fernando Díaz-Fontenla, José María Pinazo, Mercè Delgado, Domingo Pérez-Palacios, Diana Horta, Cristina Fernández-Marcos, Carmen López, José Luis Calleja, Inmaculada Fernández, Javier García-Samaniego, Xavier Forns, María Buti, Sabela Lens
{"title":"西班牙三角洲肝炎的特点及其管理差距。","authors":"Sergio Rodríguez-Tajes, Adriana Palom, Álvaro Giráldez-Gallego, Antonio Moreno, Juan José Urquijo, Manuel Rodríguez, Marta Alvarez-Argüelles, Moisés Diago, María García-Eliz, Javier Fuentes, Ana María Martínez-Sapiña, Pilar Castillo, Marta Casado, Elena Pérez-Campos, Raquel Muñoz, Marta Hernández-Conde, Rosa María Morillas, Rafael Granados, Mireia Miquel, María Julia Morillas, Monserrat García-Retortillo, Jose Antonio Carrión, José María Moreno, Cristina Montón, Jesús Manuel González-Santiago, Sara Lorente, Joaquín Cabezas, Beatriz Mateos, Sergio Vázquez-Rodríguez, Fernando Díaz-Fontenla, José María Pinazo, Mercè Delgado, Domingo Pérez-Palacios, Diana Horta, Cristina Fernández-Marcos, Carmen López, José Luis Calleja, Inmaculada Fernández, Javier García-Samaniego, Xavier Forns, María Buti, Sabela Lens","doi":"10.1016/j.gastrohep.2024.502222","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Chronic hepatitis D (CHD) is a severe form of chronic viral hepatitis. The estimated hepatitis delta prevalence in Spain is around 5% of patients with hepatitis B. Reimbursement of new antiviral therapies (Bulevirtide, BLV) was delayed in our country until February 2024. We aimed to characterize the clinical profile of patients with HDV/HBV infection in Spain and current barriers in their management at the time of BLV approval.</p><p><strong>Method: </strong>Multicenter registry including patients with positive anti-HDV serology actively monitored in 30 Spanish centers. Epidemiological, clinical and virological variables were recorded at the start of follow-up and at the last visit.</p><p><strong>Results: </strong>We identified 329 anti-HDV patients, 41% were female with median age 51 years. The most common geographical origin was Spain (53%) and East Europe (24%). Patients from Spain were older and had HCV and HIV coinfection probably associated to past drug injection (p<0.01). HDV-RNA was positive in 138 of 221 assessed (62%). Liver cirrhosis was present at diagnosis in 33% and it was more frequent among viremic patients (58% vs 25%, p<0.01). After a median follow-up of 6 (3-12) years, 44 (16%) resolved infection (18 spontaneously and 26 after Peg-INF). An additional 10% of patients developed cirrhosis (n=137) during follow-up (45% had portal hypertension and 14% liver decompensation). Liver disease progression was associated to persisting viremia.</p><p><strong>Conclusion: </strong>One-third of the patients with CHD already have cirrhosis at diagnosis. Persistence of positive viremia is associated to rapid liver disease progression. Importantly, barriers to locally determine/quantify HDV-RNA were present.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502222"},"PeriodicalIF":2.2000,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characterizing Hepatitis Delta in Spain and the gaps in its management.\",\"authors\":\"Sergio Rodríguez-Tajes, Adriana Palom, Álvaro Giráldez-Gallego, Antonio Moreno, Juan José Urquijo, Manuel Rodríguez, Marta Alvarez-Argüelles, Moisés Diago, María García-Eliz, Javier Fuentes, Ana María Martínez-Sapiña, Pilar Castillo, Marta Casado, Elena Pérez-Campos, Raquel Muñoz, Marta Hernández-Conde, Rosa María Morillas, Rafael Granados, Mireia Miquel, María Julia Morillas, Monserrat García-Retortillo, Jose Antonio Carrión, José María Moreno, Cristina Montón, Jesús Manuel González-Santiago, Sara Lorente, Joaquín Cabezas, Beatriz Mateos, Sergio Vázquez-Rodríguez, Fernando Díaz-Fontenla, José María Pinazo, Mercè Delgado, Domingo Pérez-Palacios, Diana Horta, Cristina Fernández-Marcos, Carmen López, José Luis Calleja, Inmaculada Fernández, Javier García-Samaniego, Xavier Forns, María Buti, Sabela Lens\",\"doi\":\"10.1016/j.gastrohep.2024.502222\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Chronic hepatitis D (CHD) is a severe form of chronic viral hepatitis. The estimated hepatitis delta prevalence in Spain is around 5% of patients with hepatitis B. Reimbursement of new antiviral therapies (Bulevirtide, BLV) was delayed in our country until February 2024. We aimed to characterize the clinical profile of patients with HDV/HBV infection in Spain and current barriers in their management at the time of BLV approval.</p><p><strong>Method: </strong>Multicenter registry including patients with positive anti-HDV serology actively monitored in 30 Spanish centers. Epidemiological, clinical and virological variables were recorded at the start of follow-up and at the last visit.</p><p><strong>Results: </strong>We identified 329 anti-HDV patients, 41% were female with median age 51 years. The most common geographical origin was Spain (53%) and East Europe (24%). Patients from Spain were older and had HCV and HIV coinfection probably associated to past drug injection (p<0.01). HDV-RNA was positive in 138 of 221 assessed (62%). Liver cirrhosis was present at diagnosis in 33% and it was more frequent among viremic patients (58% vs 25%, p<0.01). After a median follow-up of 6 (3-12) years, 44 (16%) resolved infection (18 spontaneously and 26 after Peg-INF). An additional 10% of patients developed cirrhosis (n=137) during follow-up (45% had portal hypertension and 14% liver decompensation). Liver disease progression was associated to persisting viremia.</p><p><strong>Conclusion: </strong>One-third of the patients with CHD already have cirrhosis at diagnosis. Persistence of positive viremia is associated to rapid liver disease progression. Importantly, barriers to locally determine/quantify HDV-RNA were present.</p>\",\"PeriodicalId\":12802,\"journal\":{\"name\":\"Gastroenterologia y hepatologia\",\"volume\":\" \",\"pages\":\"502222\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-06-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterologia y hepatologia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.gastrohep.2024.502222\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterologia y hepatologia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.gastrohep.2024.502222","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Characterizing Hepatitis Delta in Spain and the gaps in its management.
Background and aims: Chronic hepatitis D (CHD) is a severe form of chronic viral hepatitis. The estimated hepatitis delta prevalence in Spain is around 5% of patients with hepatitis B. Reimbursement of new antiviral therapies (Bulevirtide, BLV) was delayed in our country until February 2024. We aimed to characterize the clinical profile of patients with HDV/HBV infection in Spain and current barriers in their management at the time of BLV approval.
Method: Multicenter registry including patients with positive anti-HDV serology actively monitored in 30 Spanish centers. Epidemiological, clinical and virological variables were recorded at the start of follow-up and at the last visit.
Results: We identified 329 anti-HDV patients, 41% were female with median age 51 years. The most common geographical origin was Spain (53%) and East Europe (24%). Patients from Spain were older and had HCV and HIV coinfection probably associated to past drug injection (p<0.01). HDV-RNA was positive in 138 of 221 assessed (62%). Liver cirrhosis was present at diagnosis in 33% and it was more frequent among viremic patients (58% vs 25%, p<0.01). After a median follow-up of 6 (3-12) years, 44 (16%) resolved infection (18 spontaneously and 26 after Peg-INF). An additional 10% of patients developed cirrhosis (n=137) during follow-up (45% had portal hypertension and 14% liver decompensation). Liver disease progression was associated to persisting viremia.
Conclusion: One-third of the patients with CHD already have cirrhosis at diagnosis. Persistence of positive viremia is associated to rapid liver disease progression. Importantly, barriers to locally determine/quantify HDV-RNA were present.
期刊介绍:
Gastroenterology and Hepatology is the first journal to cover the latest advances in pathology of the gastrointestinal tract, liver, pancreas, and bile ducts, making it an indispensable tool for gastroenterologists, hepatologists, internists and general practitioners.