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Epidemiological trend of hepatitis C-related liver events in Spain (2000–2015): A nationwide population-based study

  • Author Footnotes
    1 Both authors contributed equally to this study.
    Irene Mate-Cano
    Footnotes
    1 Both authors contributed equally to this study.
    Affiliations
    Primary Health Center “Ensanche de Vallecas”, Madrid, Spain

    Laboratory of Reference and Research in Viral Hepatitis, National Centre for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
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  • Author Footnotes
    1 Both authors contributed equally to this study.
    Alejandro Alvaro-Meca
    Footnotes
    1 Both authors contributed equally to this study.
    Affiliations
    Department of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
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  • Pablo Ryan
    Affiliations
    Servicio de Medicina Interna, Hospital Universitario Infanta Leonor, Madrid, Spain

    Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
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  • Author Footnotes
    2 Both authors contributed equally to this study.
    Salvador Resino
    Correspondence
    Corresponding authors at: National Centre for Microbiology, Institute of Health Carlos III; Carretera Majadahonda- Pozuelo, Km 2.2; 28220 Majadahonda (Madrid).
    Footnotes
    2 Both authors contributed equally to this study.
    Affiliations
    Laboratory of Reference and Research in Viral Hepatitis, National Centre for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
    Search for articles by this author
  • Author Footnotes
    2 Both authors contributed equally to this study.
    Verónica Briz
    Correspondence
    Corresponding authors at: National Centre for Microbiology, Institute of Health Carlos III; Carretera Majadahonda- Pozuelo, Km 2.2; 28220 Majadahonda (Madrid).
    Footnotes
    2 Both authors contributed equally to this study.
    Affiliations
    Laboratory of Reference and Research in Viral Hepatitis, National Centre for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
    Search for articles by this author
  • Author Footnotes
    1 Both authors contributed equally to this study.
    2 Both authors contributed equally to this study.
Published:March 03, 2020DOI:https://doi.org/10.1016/j.ejim.2020.02.002

      Highlights

      • The real disease burden of Chronic hepatitis C (CHC) infection is underestimated.
      • Epidemiological trends of CHC infection and its clinical stages.
      • Provides a framework to evaluate future healthcare policies.

      Abstract

      Objective

      Analysis the epidemiological trends of hospital admissions, intra-hospital deaths, and costs related to chronic hepatitis C (CHC) taking into account four major clinical stages [compensated cirrhosis (CC), end-stage liver disease (ESLD), hepatocellular carcinoma (HCC), and liver transplantation (LT)] in Spain.

      Methods

      Retrospective study in patients with chronic hepatitis C and a hospital admission in the Spanish Minimum Basic Data Set from 2000 to 2015. Outcome variables were admission, death, length of hospital stay and costs.

      Results

      A total of 868,523 hospital admissions with CHC (25.5% CC, 25.3% ESLD, 8.6% HCC, and 2.5% LT) were identified. Overall rates of admission and mortality increased from 2000–2003 to 2004–2007, but after 2008, these rates stabilized and/or decreased. An upward trend was found for hospitalization percentage in CC (from 22.3% to 30%; p < 0.001), ESLD (from 23.9% to 27.1%; p < 0.001), HCC (from 7.4% to 11%; p < 0.001), and LT (from 0.07% to 0.10%; p = 0.003). An upward trend was also found for case fatality rate, except in ESLD (p = 0.944). Gender and age influenced the evolution of hospitalization rates and mortality differently. The length of hospital stay showed a significant downward trend in all strata analyzed (p < 0.001). Cost per patient had a significant upward trend (p < 0.001), except in LT, and a decrease from 2008–2011 to 2012–2015 in CC (p = 0.025), HCC (p < 0.001), and LT (p = 0.050) was found.

      Conclusion

      The initial upward trend of the disease burden in CHC has changed from 2000 to 2015 in Spain, improving in many parameters after 2004–2007, particularly in the 2012–2015 calendar period.

      Keywords

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