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Article: Prevalence and detection of undiagnosed active hepatitis C virus infections in Navarre, Spain, 2017-2019.

Burgui, Cristina / Martín, Carmen / Aguinaga, Aitziber / Pérez-García, Alejandra / Ezpeleta, Carmen / Castilla, Jesús

Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

2020 Volume 113, Issue 1, Page(s) 28–34

Abstract: Background: undiagnosed active hepatitis C virus (HCV) infection remains an obstacle towards its eradication. This study aimed to estimate the prevalence of HCV infection and to describe the diagnostic advances in Navarre, Spain.: Methods: HCV- ... ...

Abstract	Background: undiagnosed active hepatitis C virus (HCV) infection remains an obstacle towards its eradication. This study aimed to estimate the prevalence of HCV infection and to describe the diagnostic advances in Navarre, Spain. Methods: HCV-infection diagnostic performance was analyzed in Navarre's primary and specialized health care between 2017 and 2019. The prevalence of undiagnosed infections was estimated for patients with programmed surgeries unrelated to HCV infection, who underwent a routine HCV antibody (anti-HCV) determination. HCV-RNA (viral load) was quantified in anti-HCV positive cases. The prevalence was standardized according to the sex and age distribution in the general population. Results: from the 63,405 subjects examined for anti-HCV, 84 (five per 100,000 person-years) were diagnosed with an active infection. In Primary Health Care, 20,363 patients were analyzed and 47 active infections were detected, i.e. one case for every 433 people tested, implying 56 % of all identified active infections. On the other hand, 9,399 surgical patients were analyzed and 120 anti-HCV positive cases were detected (adjusted prevalence: 1.47 %; 95 % CI: 1.24-1.52). A positive viral load had been determined at any time in 66 cases (0.61 %), of which five were undiagnosed active infections (adjusted prevalence: 0.04 %; 95 % CI: 0.01-0.11). Preoperative screening allowed the detection of one undiagnosed infection per 795 people analyzed aged between 45 and 64 years. Conclusions: Primary Health Care efficiently contributes to the detection of undiagnosed HCV active infections. This may be speeded up by performing population screening, targeting subjects between 45 and 64 years of age.
MeSH term(s)	Hepacivirus ; Hepatitis C/diagnosis ; Hepatitis C/epidemiology ; Hepatitis C Antibodies ; Humans ; Middle Aged ; Prevalence ; Spain/epidemiology
Chemical Substances	Hepatitis C Antibodies
Language	English
Publishing date	2020-11-18
Publishing country	Spain
Document type	Journal Article
ZDB-ID	1070381-0
ISSN	1130-0108 ; 0212-7512
ISSN	1130-0108 ; 0212-7512
DOI	10.17235/reed.2020.7000/2020
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Article ; Online: Autochthonous Weil's disease: A case report.

Pérez-García, Alejandra / Tihista, Juan Ángel / Navascués, Ana / Aguinaga, Aitziber

Enfermedades infecciosas y microbiologia clinica (English ed.)

2018 Volume 37, Issue 5, Page(s) 349–350

Title translation	Enfermedad de Weil autóctona: a propósito de un caso.
MeSH term(s)	Adult ; Disease Transmission, Infectious ; Humans ; Male ; Spain ; Weil Disease/diagnosis ; Weil Disease/transmission
Language	Spanish
Publishing date	2018-06-08
Document type	Case Reports ; Letter
ISSN	2529-993X
ISSN (online)	2529-993X
DOI	10.1016/j.eimc.2018.05.013
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Article ; Online: Hepatitis C core antigen: Diagnosis and monitoring of patients infected with hepatitis C virus.

Pérez-García, Alejandra / Aguinaga, Aitziber / Navascués, Ana / Castilla, Jesús / Ezpeleta, Carmen

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2019 Volume 89, Page(s) 131–136

Abstract: Introduction: New efficient strategies are needed for the assessment of active hepatitis C virus (HCV) infection. The aim of this study was to evaluate the ability of HCV core antigen (HCV-cAg) as a marker of active HCV infection in newly diagnosed ... ...

Abstract	Introduction: New efficient strategies are needed for the assessment of active hepatitis C virus (HCV) infection. The aim of this study was to evaluate the ability of HCV core antigen (HCV-cAg) as a marker of active HCV infection in newly diagnosed patients, for treatment monitoring, and for the detection of therapeutic failure. Materials and methods: A prospective study was conducted at a regional reference hospital in Spain. HCV-cAg and viral load (RNA-HCV) were tested in plasma or serum samples from three patient groups: new diagnosis, treatment monitoring, and treatment failure. The treatment monitoring group was tested at the beginning of treatment, at 4 weeks post-initiation, at the end of treatment, and at 12 weeks post-treatment completion. The Architect HCV core antigen assay was performed for HCV-cAg testing, and viral load was quantified with the Cobas 6800 system. Results: A total of 303 samples from 124 patients were analyzed. Excellent correlation was seen between HCV-cAg and HCV-RNA (R Conclusions: HCV-cAg demonstrated good sensitivity and specificity as a marker for active HCV infection, new diagnosis, detection of antiviral therapeutic failure, and treatment monitoring.
MeSH term(s)	Adult ; Antiviral Agents/therapeutic use ; Female ; Hepacivirus/classification ; Hepacivirus/genetics ; Hepacivirus/isolation & purification ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Hepatitis C/virology ; Hepatitis C Antigens/genetics ; Hepatitis C Antigens/metabolism ; Humans ; Male ; Middle Aged ; Prospective Studies ; RNA, Viral/genetics ; ROC Curve ; Sensitivity and Specificity ; Spain/epidemiology ; Viral Load
Chemical Substances	Antiviral Agents ; Hepatitis C Antigens ; RNA, Viral
Language	English
Publishing date	2019-09-30
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2019.09.022
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Article ; Online: Detection of Respiratory Viruses in Deceased Persons, Spain, 2017.

Navascués, Ana / Casado, Itziar / Pérez-García, Alejandra / Aguinaga, Aitziber / Martínez-Baz, Iván / Floristán, Yugo / Ezpeleta, Carmen / Castilla, Jesús

Emerging infectious diseases

2018 Volume 24, Issue 7, Page(s) 1331–1334

Abstract: During the 2016-17 influenza season in Spain, we tested specimens from 57 elderly deceased persons for respiratory viruses. Influenza viruses were detected in 18% of the specimens and any respiratory virus in 47%. Only 7% of participants had received a ... ...

Abstract	During the 2016-17 influenza season in Spain, we tested specimens from 57 elderly deceased persons for respiratory viruses. Influenza viruses were detected in 18% of the specimens and any respiratory virus in 47%. Only 7% of participants had received a diagnosis of infection with the detected virus before death.
MeSH term(s)	Aged ; Aged, 80 and over ; Autopsy ; Female ; History, 21st Century ; Humans ; Male ; Population Surveillance ; Respiratory Tract Infections/epidemiology ; Respiratory Tract Infections/history ; Respiratory Tract Infections/mortality ; Respiratory Tract Infections/virology ; Spain/epidemiology ; Virus Diseases/epidemiology ; Virus Diseases/history ; Virus Diseases/mortality ; Virus Diseases/virology
Keywords	covid19
Language	English
Publishing date	2018-07-23
Publishing country	United States
Document type	Historical Article ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2407.180162
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Article ; Online: Interim effectiveness of trivalent influenza vaccine in a season dominated by lineage mismatched influenza B, northern Spain, 2017/18.

Castilla, Jesús / Navascués, Ana / Casado, Itziar / Pérez-García, Alejandra / Aguinaga, Aitziber / Ezpeleta, Guillermo / Pozo, Francisco / Ezpeleta, Carmen / Martínez-Baz, Iván

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

2018 Volume 23, Issue 7

Abstract: The 2017/18 interim estimate of trivalent influenza vaccine effectiveness (VE) was 39% (95% confidence interval: 20-54) in Navarre. Compared with individuals unvaccinated in the current and five previous seasons, VE against influenza B was 41% for ... ...

Abstract	The 2017/18 interim estimate of trivalent influenza vaccine effectiveness (VE) was 39% (95% confidence interval: 20-54) in Navarre. Compared with individuals unvaccinated in the current and five previous seasons, VE against influenza B was 41% for current and any prior doses, 67% for current vaccination only, and 22% for any prior doses, and 43%, 51% and 54%, respectively against influenza A(H3N2). This suggests moderate VE despite predominance of lineage mismatched influenza B.
MeSH term(s)	Adolescent ; Adult ; Aged ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Influenza A Virus, H3N2 Subtype/immunology ; Influenza A Virus, H3N2 Subtype/isolation & purification ; Influenza B virus/immunology ; Influenza B virus/isolation & purification ; Influenza Vaccines/administration & dosage ; Influenza Vaccines/immunology ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Male ; Middle Aged ; Seasons ; Sentinel Surveillance ; Spain/epidemiology ; Vaccination/statistics & numerical data ; Young Adult
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2018-02-14
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	1338803-4
ISSN	1560-7917 ; 1025-496X
ISSN (online)	1560-7917
ISSN	1025-496X
DOI	10.2807/1560-7917.ES.2018.23.7.18-00057
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Article ; Online: Progress in the elimination of hepatitis C virus infection: A population-based cohort study in Spain.

Juanbeltz, Regina / Pérez-García, Alejandra / Aguinaga, Aitziber / Martínez-Baz, Iván / Casado, Itziar / Burgui, Cristina / Goñi-Esarte, Silvia / Repáraz, Jesús / Zozaya, José Manuel / San Miguel, Ramón / Ezpeleta, Carmen / Castilla, Jesús

PloS one

2018 Volume 13, Issue 12, Page(s) e0208554

Abstract: Background: The World Health Organization set targets to eliminate hepatitis C virus (HCV) infection through detection and treatment of all cases by 2030. This study aimed to describe the progress and difficulties in the elimination of HCV infection in ... ...

Abstract	Background: The World Health Organization set targets to eliminate hepatitis C virus (HCV) infection through detection and treatment of all cases by 2030. This study aimed to describe the progress and difficulties in the elimination of HCV infection in Navarra, Spain. Methods: Using electronic healthcare databases, we performed a population-based prospective cohort study to describe changes in the prevalence of diagnosed active HCV infection at the beginning of 2015 and the end of 2017, the rate of new diagnoses and the rate of post-treatment viral clearance (PTVC) during this period. Results: At the beginning of 2015 there were 1503 patients diagnosed with positive HCV-RNA, 2.4 per 1000 inhabitants, and at the end of 2017 the prevalence had decreased by 47%. In the study period, 333 (18 per 100,000 person-years) new positive HCV-RNA cases were detected, but only 76 (23%; 4.2 per 100,000 person-years) did not have anti-HCV antibodies previously detected. Prevalent cases and new diagnoses of active infection were more frequent in men, people born in 1950-1979, HIV-infected patients and in those with lower income levels. Among patients with HCV-RNA, 984 achieved PTVC (22.7 per 100 person-years). PTVC was less frequent in patients born before 1940, in immigrants and in patients with lower income levels. Conclusions: The prevalence of diagnosed active HCV infection has dropped by almost half over three years, because the number of patients with PTVC was much higher than the number of new diagnoses. Interventions specifically targeted at population groups with less favourable trends may be necessary.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antiviral Agents/therapeutic use ; Cohort Studies ; Databases, Factual ; Female ; Hepacivirus/genetics ; Hepacivirus/isolation & purification ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Hepatitis C Antibodies/blood ; Humans ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; RNA, Viral/blood ; Spain/epidemiology ; Young Adult
Chemical Substances	Antiviral Agents ; Hepatitis C Antibodies ; RNA, Viral
Language	English
Publishing date	2018-12-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0208554
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Article ; Online: Estimación de la prevalencia de infección diagnosticada y no diagnosticada por el virus de la hepatitis C en Navarra, 2014-2016

Aguinaga, Aitziber / Díaz-González, Jorge / Pérez-García, Alejandra / Barrado, Laura / Martínez-Baz, Iván / Casado, Itziar / Juanbeltz, Regina / Ezpeleta, Carmen / Castilla, Jesús

Enfermedades Infecciosas y Microbiologia Clinica. 2016,

2016

Abstract: To estimate the prevalence of hepatitis C virus (HCV) infection in Navarra, Spain, as well as to distinguish between diagnosed and undiagnosed infections.A study was conducted on patients scheduled for surgery unrelated to HCV infection. They were all ... ...

Abstract	To estimate the prevalence of hepatitis C virus (HCV) infection in Navarra, Spain, as well as to distinguish between diagnosed and undiagnosed infections.A study was conducted on patients scheduled for surgery unrelated to HCV infection. They were all tested for HCV antibodies, under a routine scheme, from January 2014 to September 2016. Patients with a positive result by enzyme immunoassay were confirmed using immunoblot and/or HCV-RNA. Previous laboratory results were also taken into account. The prevalence was adjusted to the sex and age structure of the Navarra population.The study included a total of 7,378 patients with a median age 46 years, of whom 50% women. HCV antibodies were detected in 69 patients, which is a prevalence in the population of 0.83% (95% confidence interval: 0.64-1.05), and was higher in men (1.11%) than in women (0.56%; P=.0102). Among the HCV positive patients, 67 (97%) had had another previous positive result. Population prevalence of previous positive HCV was 0.80%, and was 0.03% for a new diagnosis. Of the HCV positive patients, 78% had detectable HCV-RNA. It was estimated that 0.65% of the population had had detectable HCV-RNA, and 0.51% continued to have it when recruited into the study.Previous estimates of prevalence of HCV infection should be revised downwards. Only a small proportion of HCV positive patients remain undiagnosed, and only a small part have active infection.
Keywords	Virus de la hepatitis C ; Epidemiología ; Seroprevalencia ; Carga viral ; Encuesta seroepidemiológica ; España ; Hepatitis C virus ; Epidemiology ; Seroprevalence ; Viral load ; Seroepidemiological survey ; Spain
Language	English
Publishing place	Elsevier España, S.L.U.
Document type	Article ; Online
Note	Pre-press version
ZDB-ID	1070941-1
ISSN	1578-1852 ; 0213-005X
ISSN (online)	1578-1852
ISSN	0213-005X
DOI	10.1016/j.eimc.2016.12.008
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: The prevalence of diagnosed and undiagnosed hepatitis C virus infection in Navarra, Spain, 2014-2016.

Aguinaga, Aitziber / Díaz-González, Jorge / Pérez-García, Alejandra / Barrado, Laura / Martínez-Baz, Iván / Casado, Itziar / Juanbeltz, Regina / Ezpeleta, Carmen / Castilla, Jesús

Enfermedades infecciosas y microbiologia clinica (English ed.)

2017 Volume 36, Issue 6, Page(s) 325–331

Abstract: Objective: To estimate the prevalence of hepatitis C virus (HCV) infection in Navarra, Spain, as well as to distinguish between diagnosed and undiagnosed infections.: Methods: A study was conducted on patients scheduled for surgery unrelated to HCV ... ...

Title translation	Estimación de la prevalencia de infección diagnosticada y no diagnosticada por el virus de la hepatitis C en Navarra, 2014-2016.
Abstract	Objective: To estimate the prevalence of hepatitis C virus (HCV) infection in Navarra, Spain, as well as to distinguish between diagnosed and undiagnosed infections. Methods: A study was conducted on patients scheduled for surgery unrelated to HCV infection. They were all tested for HCV antibodies, under a routine scheme, from January 2014 to September 2016. Patients with a positive result by enzyme immunoassay were confirmed using immunoblot and/or HCV-RNA. Previous laboratory results were also taken into account. The prevalence was adjusted to the sex and age structure of the Navarra population. Results: The study included a total of 7,378 patients with a median age 46 years, of whom 50% women. HCV antibodies were detected in 69 patients, which is a prevalence in the population of 0.83% (95% confidence interval: 0.64-1.05), and was higher in men (1.11%) than in women (0.56%; P=.0102). Among the HCV positive patients, 67 (97%) had had another previous positive result. Population prevalence of previous positive HCV was 0.80%, and was 0.03% for a new diagnosis. Of the HCV positive patients, 78% had detectable HCV-RNA. It was estimated that 0.65% of the population had had detectable HCV-RNA, and 0.51% continued to have it when recruited into the study. Conclusion: Previous estimates of prevalence of HCV infection should be revised downwards. Only a small proportion of HCV positive patients remain undiagnosed, and only a small part have active infection.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cross-Sectional Studies ; Diagnosis-Related Groups ; Female ; Hepatitis C/diagnosis ; Hepatitis C/epidemiology ; Hepatitis C Antibodies/blood ; Humans ; Infant ; Male ; Middle Aged ; Preoperative Care ; Prevalence ; RNA, Viral/blood ; Seroepidemiologic Studies ; Spain/epidemiology ; Viral Load ; Young Adult
Chemical Substances	Hepatitis C Antibodies ; RNA, Viral
Language	Spanish
Publishing date	2017-01-19
Document type	Journal Article
ISSN	2529-993X
ISSN (online)	2529-993X
DOI	10.1016/j.eimc.2016.12.008
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Article: Diarrea del viajero por Cyclospora cayetanensis.

Portillo, M Eugenia / Pérez-García, Alejandra / Fernández-Alonso, Mirian / Rubio, Manuel

Medicina clinica

2010 Volume 134, Issue 8, Page(s) 377–378

Title translation	Cyclospora cayetanensis in a patient with traveller's diarrhoea.
MeSH term(s)	Adult ; Cyclosporiasis/complications ; Diarrhea/parasitology ; Humans ; Male ; Travel
Language	Spanish
Publishing date	2010-03-20
Publishing country	Spain
Document type	Case Reports ; Letter
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2009.01.003
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Article ; Online: Combined effectiveness of prior and current season influenza vaccination in northern Spain: 2016/17 mid-season analysis.

Castilla, Jesús / Navascués, Ana / Casado, Itziar / Díaz-González, Jorge / Pérez-García, Alejandra / Fernandino, Leticia / Martínez-Baz, Iván / Aguinaga, Aitziber / Pozo, Francisco / Ezpeleta, Carmen / Primary Health Care Sentinel Network And The Network For Influenza Surveillance In Hospitals Of Navarre

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

2017 Volume 22, Issue 7

Abstract: The 2016/17 mid-season vaccine effectiveness estimate against influenza A(H3N2) was 15% (95% confidence interval: -11 to 35) in Navarre. Comparing to individuals unvaccinated in the current and four prior seasons, effectiveness was 24% for current and 3- ... ...

Abstract	The 2016/17 mid-season vaccine effectiveness estimate against influenza A(H3N2) was 15% (95% confidence interval: -11 to 35) in Navarre. Comparing to individuals unvaccinated in the current and four prior seasons, effectiveness was 24% for current and 3-4 prior doses, 61% for current and 1-2 prior doses, 42% for only current vaccination, and 58% for 3-4 prior doses. This suggests moderate effectiveness for different combinations of vaccination in the current and prior seasons.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Child ; Female ; Humans ; Influenza A Virus, H3N2 Subtype/immunology ; Influenza Vaccines/immunology ; Influenza Vaccines/therapeutic use ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Male ; Middle Aged ; Rural Population ; Seasons ; Sentinel Surveillance ; Spain/epidemiology ; Urban Population ; Vaccination/statistics & numerical data ; Young Adult
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2017-02-23
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	1338803-4
ISSN	1560-7917 ; 1025-496X
ISSN (online)	1560-7917
ISSN	1025-496X
DOI	10.2807/1560-7917.ES.2017.22.7.30465
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