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Objective: To report the natural history of patients with hepatitis C virus (HCV) infection and hepatocarcinoma (HCC) and to define clinico-biological variables with prognostic and predictive value of this complication., Materials and Methods: A total of 543 patients consecutively diagnosed of chronic infection with HCV were included and followed prospectively and observationally regarding the development of HCC by means of semestral abdominal ultrasonography and measurement of serum alpha-fetoprotein (AFP). To determine variables with predictive value of HCC, the parameters determined at the start were compared, and all subjects diagnosed of hepatoma during the first twelve months after admission were excluded from the analysis. The Kaplan-Meier method was used to evaluate both survival and accumulated probability of HCC., Results: During a mean follow-up period of 28.9 months, an incidence density of HCC of 2.6 per 100 inhabitants-year was obtained (n = 35). 52.6% of those with HCC in the first year were asymptomatic. The only initial variables associated with further development of HCC were age (64.6 vs 58.4 years; p = 0.0039) and alkaline phosphatase (373.5 vs 259 U/l; p = 0.001). Patients with cirrhosis at the start of the study had a higher risk of developing hepatoma than non-cirrhotic patients (RR: 11.5; 95% CI: 4.25-29.9; p < 0.0001). The presence of HCC decreased the survival of patients with cirrhosis (median 20 vs 75 months; log rank < 0.0001), with the exception of patients in stage C of the Child-Pugh classification., Conclusions: a) In the chronic infection with HCV, HCC showed to be an oligosymptomatic complication affecting almost exclusively patients with long-lasting cirrhosis. b) Survival in patients in the stage C of the Child-Pugh classification is independently associated with the coexistence of hepatoma; therefore, the early diagnosis of this complication should be restricted to those with a better liver functional reserve.

In a sample made up of 83 males and 68 females different parameters and external anthropometric indexes were compared (folds, perimeters and indexes of central fat distribution) with direct measurements of abdominal fat obtained by computerized tomography (visceral fat, subcutaneous fat and visceral/subcutaneous index). Anthropometric and tomographic differences between males and females were determined. Likewise, an analysis was made of variations in the fat pattern and subcutaneous and intra-abdominal visceral fat deposits, considering age and overweight. The results obtained in this study reveal different fat patterns for each sex, changes with age in body fat distribution, and different usefulness of external anthropometric measures in males and females to predict fat deposits and their distribution at the abdominal level.

The use of non-specific markers before 1989 (increased serum transaminase values and antibodies to hepatitis B core antigen) as a screening method for blood donors in an attempt to decrease the incidence of post-transfusional non-A non-B hepatitis (currently hepatitis C virus) was a matter of controversy. To determine the impact of the use of these markers on the detection of blood donors infected with hepatitis C virus, a prospective study was undertaken in Málaga (1988-1989) with 5,003 volunteer donors with two objectives: a) to know the prevalence of these non-specific markers (anti-HBc and increased serum transaminase) and antibodies to HCV (anti-C100) in our blood donor population; b) to determine whether the presence of some of these non specific markers in blood donors was associated with a higher rate of virus C infection. The prevalence of antibodies to HCV in blood donors with increased serum transaminase and/or anti-HBc was significantly higher than the prevalence found among the general blood donor population.

The distribution of apoprotein E phenotypes in a randomly chosen population sample of Málaga was compared to other published studies performed in other countries, observing minimal differences in Caucasian populations but significant differences with oriental ethnic groups. Cholesterol and triglyceride plasma levels were not significantly different in the different apo E phenotypes. A high proportion of subjects (26%) with hydrocarbon metabolism abnormalities (diabetic and glucose intolerant) was observed in phenotype E4/3 and very low (4.7%) in phenotype E3/2. The study of plasma triglyceride levels which were higher in the diabetic group, revealed a greater increase in phenotype E4/3 than in E3/3. These results support the idea about the complex relationship that exists between apo E phenotypes and some cardiovascular risk factors.