Naslov
Trends of late presentation to care in patients with HCV during a 10-year period in Croatia

Autori
Papić, Neven ; Radmanić, Leona ; Židovec lepej, Snježana ; Dušek, Davorka ; Vince, Adriana

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
ECCMID 2019 / - , 2019

Skup
ECCMID 2019

Mjesto i datum
Amsterdam, Nizozemska, 13.04.2019. - 16.04.2019

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Care, patients, HCV, Croatia

Sažetak
Background: Chronic hepatitis C continues to bea major public health problem and leading cause of liver cirrhosis and hepatocellular carcinoma.WHO has seta goal to reduce new viral hepatitis infections by 90% and deaths dueto viral hepatitis by 65% until 2030, which is now achievable by using highly effective direct-acting antivirals. However, linkageto careis the main obstacleto receiving treatmentand follow-up for liver disease. Consequently, a significant proportion of chronically-infected patients enter care only after developing significant fibrosis/cirrhosis.Theaim of this study was to investigatethe prevalenceand trends of late presenters (LP) at first consultations in our clinical center during a 10-year period. Materials/methods: A retrospectivecohort study included all adult patients atentranceto careat the University Hospital for Infectious Diseases, Zagreb between January 2009 and May 2018.Late presenters for care were defined as a reliableLSM ≥9.5 kPa, APRI >1.5, FIB-4 >3.25 or biopsy METAVIR F3. Results: A total of 805 patients wereincluded in thestudy (n=502, 62.3% male, median age 41 years (IQR 34-53), mainly PWID (293, 40.4%). Median age of patients atentranceto careincreased from 37 years (IQR 30-52) in 2009 to 52 years (IQR 44-54) in 2018. Changes in the HCV genotype distribution werealso observed: replacement of subtype 1b with 1a in 2009 vs 2017 (1b 32% to 24% ; 1a 21% to 37%) and increasein subtype 3a/b from 34% to 43%. A total of 293 patients (36.4%) werelate presenters and they were older (47.6, IQR 40.5-67.6), and more frequently infected with HCV 1b (100, 34.2%) and g3 (124, 42.4%).The prevalence of LP significantly increased from 31.9% in 2009 to 45.7% in 2017 and 61.9% in early 2018. Overall, 589 patients received treatment (73.2%), 44 (5.2%) were neglected to treatment, 51 (6.3%) are waiting for treatmentand 121 werelost to follow up (15.3%). Conclusions: Late presentation of CHC is increasing in Croatia and is associated with increasing age suggesting an important gap of CHC diagnosing strategies in patients over 50 years.

Izvorni jezik
Engleski

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