Madrid, Spain
Madrid, Spain

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Introduction: An estimated 6.8-8.9 million people are infected with hepatitis C virus in Latin America, of which less than 1% receives antiviral treatment. Studies so far in Colombia have attempted to determine the prevalence of the disease in some risk groups, thus preventing the identification of other factors potentially involved in the spread of the infection. Objectives: To identify traditional and non-traditional risk factors for chronic hepatitis C in the Colombian Caribbean coast. Materials and methods: This was a case-control study (1:3) matched by health care provider and age (± 10 years) conducted at the primary care level of gastroenterology and hepatology outpatient services. All patients with a positive ELISA underwent a confirmatory viral load test. A multivariate logistic regression analysis identified the independent predictors of infection. Results: Blood transfusion (OR=159.2; 95% CI: 35.4-715; p < 0.001) and history of hospitalization before 1994 (OR=4.7; 95% CI: 1.3-17.1; p=0.018) were identified as the only two independent predictors of infection. Conclusion: It is necessary to check the reproducibility of these results and to conduct cost-effectiveness studies before recommending their use in the design of new screening strategies.


Rodriguez de Lope C.,Hospital Universitario Marques Of Valdecilla | Reig M.,University of Barcelona | Matilla A.,Hospital General Universitario Gregorio Maranon | Ferrer M.T.,University of Seville | And 23 more authors.
Medicina Clinica | Year: 2017

Background and objective: In 2010 we published that 53% of cases of hepatocellular carcinoma (HCC) detected in Spain were diagnosed outside the context of standard screening programs, which consequently leads to lower survival rates. The aim of this study was to analyze the current situation and the causes of diagnosis out of screening programs. Material and methods: Prospective registry of 73 second- and third-level Spanish healthcare centers carried out between October 1, 2014 and January 31, 2015. The baseline characteristics of the disease and the first treatment administered for the incidental primary liver tumors during such period were recorded. Results: A total of 720 patients were included in the study: HCC (n = 686), intrahepatic cholangiocarcinoma (n = 29), hepatic cholangiocarcinoma (n = 2), other (n = 3). HCC characteristics: male 82%; mean age 67 years; cirrhosis 87%; main etiologies: alcohol 35%, HCV 30%, alcohol and HCV 15%, non-alcoholic fatty liver disease 6%; tumor stage: BCLC-0 11%, A 43%, B 19%, C 16% and D 11%; first treatment: transarterial chemoembolization (23%), percutaneous ablation (22%), symptomatic treatment (20%), resection (11%), sorafenib (11%). Three hundred and fifty-six patients (53%) were diagnosed outside of screening programs, mainly owing to the fact that they suffered from an undiagnosed liver disease (76%) and to the poor adherence to the screening program (18%). These patients were mainly male (P <. .001), with an alcoholic etiology (P <. .001) and active alcohol consumption (P <. .001). Moreover, the disease was predominantly diagnosed at more advanced stages (P <. .001) and was addressed with less radical treatments (P <. .001). Conclusions: In Spain, the main cause of diagnosis of a HCC outside the context of a screening program is the absence of a prior diagnosis of a liver disease, particularly in alcohol-consuming men. Detecting a liver disease in asymptomatic populations and improving adherence to screening programs are the main areas that must be subject to improvement in order to improve the early detection of HCC. © 2017 Elsevier España, S.L.U.


Matilla Pena A.,Institute Investigacion Sanitaria Gregorio Maranon | Matilla Pena A.,CIBER ISCIII | Chiva M.T.,Seccion de Hepatologia | Chiva M.T.,Hospital General Universitario Gregorio Maranon | And 2 more authors.
Medicine (Spain) | Year: 2012

Hepatocellular carcinoma is the most frequent malignant primary liver tumor that is generally found on the cirrhotic liver. There are different risk populations that determine the need to carry out screening strategies for early diagnosis. In cirrhotic patients, it is recommended to perform an ultrasound graph every six months. Diagnoses of the hepatocarcinoma is made using dynamic imaging tests. Detection on the four-dimension phase computed tomography or magnetic angioresonance of a hypervascular node in arterial phase and with early washout in the phase is diagnostic of hepatocarcinoma is performed. The BCLC staging system allows classification of the patients based on the tumor characteristics and those of the hepatic disease, and facilitates assigning therapeutic attitudes. Surgery, percutaneous ablation and liver transplant are alternatives with applicable curative intention in patients in early stages. Sorafenib is a multikinase inhibitor that improves survival in patients with advanced tumors.

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