title: [Hepatitis C virus infection in a first level rural hospital: descriptive study in the decade 1991-1999].
abstract: BACKGROUND
  To assess epidemiology, clinical manifestations and prognostic factors in subjects diagnosed with hepatitis C virus (HCV) infection in a first level rural hospital.
  
  
  METHODS
  This retrospective study includes 142 patients diagnosed with HCV infection at the Hospital de Llerena, from August 1991 to December 1999. Epidemiological and clinical parameters were collected at a mean of 2.7 years after diagnosis and prognostic factors were analyzed.
  
  
  RESULTS
  HCV infection predominated in males (69%) and the mean age of patients was 48.3 6 19.3 years. Mechanisms of transmission included unknown (46.5%), intravenous drug use (39.4%), and transfusions (14.1%). Human immunodeficiency virus coinfection was present in 23% of patients and hepatitis B virus (HBV) coinfection in 5.6%. At the time of diagnosis, 111 patients (78.2%) were asymptomatic; 26 (18.3%) presented with complications of portal hypertension and 5 (3.5%) with extrahepatic symptoms. Ultrasonographic signs of portal hypertension were observed in 32.4% of cases. Hepatocarcinoma was detected in 17 patients (12.0%) and extrahepatic neoplasms in 14 (9.9%). Twenty-eight patients died (19.7%). Independent risk factors for mortality included HBV coinfection (OR 26.9; 95% CI 2.19-331.47), ultrasonographic signs of portal hypertension (OR 11.0; 95% CI 3.38-32.61) and diagnosis of hepatocarcinoma (OR 182.7; 95% CI 14.85-2248.21).
  
  
  CONCLUSIONS
  Between 1990 and 1999 in our hospital HCV infection was frequently diagnosed in advanced stages and was associated with high mortality, particularly when ultrasonographic signs of portal hypertension or HBV coinfection were present.
authors.affiliation: Servicios de Medicina Interna. Hospital Comarcal de Llerena-Zafra. Badajoz. España. franciscof.rodirguez@hlla.ses.juntaex.es
authors.forename: Francisco Félix
authors.initials: FF
authors.lastname: Rodríguez-Vidigal
authors.forename: María José
authors.initials: MJ
authors.lastname: Baz
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Fernández
authors.forename: Francisco
authors.initials: F
authors.lastname: Najarro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006780:Hospitals, Rural; D006801:Humans; D006975:Hypertension, Portal / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012424:Rural Population; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D016019:Survival Analysis