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  3. Characterizing Hepatitis Delta in Spain and the gaps in its management;

Characterizing Hepatitis Delta in Spain and the gaps in its management;

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Rodríguez-Tajes S.
  • Palom A.
  • Giráldez-Gallego Á.
  • Moreno A.
  • Urquijo J.J.
  • Rodríguez M.
  • Alvarez-Argüelles M.
  • Diago M.
  • Fuentes J.
  • Martínez-Sapiña A.M.
  • Castillo P.
  • Casado M.
  • Pérez-Campos E.
  • Muñoz R.
  • Hernández-Conde M.
  • Morillas R.M.
  • Granados R.
  • Miquel M.
  • Morillas M.J.
  • García-Retortillo M.
  • Carrión J.A.
  • Moreno J.M.
  • Montón C.
  • González-Santiago J.M.
  • Lorente S.
  • Cabezas J.
  • Mateos B.
  • Vázquez-Rodríguez S.
  • Díaz-Fontenla F.
  • Pinazo J.M.
  • Delgado M.
  • Pérez-Palacios D.
  • Horta D.
  • Fernández-Marcos C.
  • López C.
  • Calleja J.L.
  • Fernández I.
  • García-Samaniego J.
  • Forns X.
  • Buti M.
  • Lens S.

Grupos

Abstract

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. © 2024 Elsevier España, S.L.U.

Datos de la publicación

ISSN/ISSNe:
0210-5705, 0210-5705

Gastroenterologia y Hepatologia  ELSEVIER ESPANA SLU

Tipo:
Article
Páginas:
-
PubMed:
38908682
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,280 SCImago ℠
Cuartil:
Q3 SCImago ℠

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Keywords

  • Adult; Aged; Antiviral Agents; Coinfection; Female; Hepatitis B, Chronic; Hepatitis D, Chronic; Hepatitis Delta Virus; Humans; Liver Cirrhosis; Male; Middle Aged; Registries; Spain; bulevirtide; peginterferon; antivirus agent; adult; age distribution; aged; Article; chronic hepatitis D; cohort analysis; coinfection; decompensated liver cirrhosis; demography; disease association; disease course; drug approval; epidemiology; female; follow up; health care disparity; hepatitis B; human; Human immunodeficiency virus infection; injection drug user; major clinical study; male; portal hypertension; remission; retrospective study; serology; sex ratio; Spain; viremia; virology; chronic hepatitis B; chronic hepatitis D; clinical trial; drug therapy; Hepatitis delta virus; isolation and purification; liver cirrhosis; middle aged; multicenter study; register

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