title: Profiles and clinical management of hepatitis C patients in Spain: disHCovery study.
abstract: BACKGROUND
  To assess the clinical profile and management of patients with hepatitis C (HCV) infection in an observational study in Spanish hospitals.
  
  
  METHODS
  The study included an initial cross-sectional phase (study phase I), in which investigators at 48 hospitals from 14 Spanish regions collected data from approximately 20 consecutive patients each (a total of 1,000 patients) to assess the general features of HCV-infected patients of any genotype. During the second phase (study phase II), data from 878 patients that were infected exclusively with genotype 1 HCV were assessed retrospectively. Eight pre-defined clinical profiles were established, in order to assess clinical and previous treatments characteristics.
  
  
  RESULTS
  Among the HCV-infected individuals that were analysed during the first part, HCV genotype 1 was found to be predominant (with a prevalence of 76.6%), prevailing the subtype 1b (69.8%), with other significant groups infected by genotype 3 (12.3%) and 4 (7.4%). In the second part of the study, 44% of the HCV genotype 1-infected patients were at a F3/F4 fibrosis stage. 15.9% had never been treated, and previously unsuccessfully treated patients that were no longer receiving anti-HCV treatment accounted for 50.8% of cases. Individuals with a sustained virologic response (SVR) to previous dual therapies (based on Interferon and Ribavirin) were only 14.5% and patients under treatment during the study accounted for the remaining 18.8%. A total of 713 patients (81.2%) in the second phase were not receiving any type of therapy over the period analysed, mainly due to the anticipation of new anti-HCV drugs (41.8%), SVR achievement (17.8%) and unresponsiveness to therapies available at the time of the study (9.5%).
  
  
  CONCLUSIONS
  HCV genotype 1, predominately 1b, is the most prevalent type in Spain. Advanced fibrosis or cirrhosis is frequent in this group, mainly patients not yet cured.
authors.affiliation: Maria Buti, Internal Medicine and Hepatology, Hospital Vall d´Hebron and Ciberehd del Institut Carlos III, Passeig de la Vall d´Hebron 119, Barcelona, 08035 Spain. mbuti@vhebron.net.
authors.forename: Maria
authors.initials: M
authors.lastname: Buti
authors.forename: Alejandro
authors.initials: A
authors.lastname: Franco
authors.forename: Isabel
authors.initials: I
authors.lastname: Carmona
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Sánchez-Ruano
authors.forename: Andreu
authors.initials: A
authors.lastname: Sansó
authors.forename: Marina
authors.initials: M
authors.lastname: Berenguer
authors.forename: Luisa
authors.initials: L
authors.lastname: García-Buey
authors.forename: Manuel
authors.initials: M
authors.lastname: Hernández-Guerra
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Morillas
authors.forename: Francisco
authors.initials: F
authors.lastname: Ledesma
authors.forename: Rafael
authors.initials: R
authors.lastname: Esteban
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D019468:Disease Management; D004359:Drug Therapy, Combination; D015507:Drugs, Investigational; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015507:Drugs, Investigational