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Goble S, Mattos AZ, Mendizabal M, Debes JD. Hepatitis C and hepatocellular carcinoma in Latin America: Elimination as a path to cancer prevention. Ann Hepatol 2023; 28:101149. [PMID: 37660995 DOI: 10.1016/j.aohep.2023.101149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Spencer Goble
- Division of Gastroenterology & Hepatology, Hennepin Healthcare, Minneapolis, MN, USA
| | - Angelo Z Mattos
- Graduate Program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Manuel Mendizabal
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina
| | - Jose D Debes
- Division of Gastroenterology & Hepatology, Hennepin Healthcare, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
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Pavinati G, de Lima LV, Palmieri IGS, Magnabosco GT. Distribution and spatial autocorrelation of viral hepatitis B and C in Paraná, Brazil: an ecological study, 2011-2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2022888. [PMID: 37556709 PMCID: PMC10408250 DOI: 10.1590/s2237-96222023000200015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/15/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE to analyze the distribution and spatial autocorrelation of hepatitis B and C detection rates in the state of Paraná, Brazil. METHODS this was an ecological study of hepatitis B and C notifications held on the Notifiable Health Conditions Information System, between 2011 and 2019. Percentage change in detection rates between the first and last three-year periods was estimated. Spatial autocorrelation was analyzed using Moran's index. RESULTS there were 16,699 notifications of hepatitis B, with a greater reduction in detection in the North (-30.0%) and Northwest (-25.9%) macro-regions. There were clusters of high occurrence in the Foz do Iguaçu, Francisco Beltrão and Cascavel regions between 2011 and 2019. There were 10,920 notifications of hepatitis C, with a greater reduction in detection in the Northwest macro-region (-18.9%) and an increase in the West (51.1%). The Paranaguá region recorded a high detection cluster between 2011 and 2016. CONCLUSION hepatitis B and C showed heterogeneous distribution between health regions.
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Affiliation(s)
- Gabriel Pavinati
- Universidade Estadual de Maringá, Programa de Pós-Graduação em Enfermagem, Maringá, PR, Brazil
| | - Lucas Vinícius de Lima
- Universidade Estadual de Maringá, Programa de Pós-Graduação em Enfermagem, Maringá, PR, Brazil
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Ramirez-Gonzalez LE, Camiro-Zúñiga A, Piñeirua-Menendez A, Sánchez-Avila JF, Hirata-Hernández AH, Marañón-Solorio KA, Zamora-Tapia I, Pérez-Carrizosa A, Simental-Aldaba E, Sierra-Madero JG. Risk factors associated with HCV co-infection amongst MSM and transgender women living with HIV in Mexico City: A case-control study. Ann Hepatol 2022; 27:100758. [PMID: 36096295 DOI: 10.1016/j.aohep.2022.100758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Hepatitis C virus infection (HCV) is a major cause of co-morbidity in people living with HIV (PLWHIV). The modes of HCV transmission in the local population of PLWHIV are still unclear. We conducted this study to identify risk factors for HCV transmission amongst PLWHIV in central Mexico. MATERIAL AND METHODS We enrolled HIV/HCV co-infected cases and HIV controls receiving care in two outpatient clinics in Mexico City. Structured questionnaires were applied, covering demographics, history of percutaneous exposures, sexual behaviors, self-reported STD and recreational drug use. The statistical analysis for between-group comparisons were multivariate logistic regression models to assess the risk factors associated with HCV co-infection. We limited the final analysis to men who have sex with men (MSM) to avoid confounders potentially related to HCV acquisition in other populations. RESULTS Three hundred and thirty-four MSM with HIV (175 with HCV co-infection and 159 without) were analysed. We did not identify percutaneous exposures as risk factors for HCV. Intravenous drug use (IVDU) occurred in two cases and one control case. Risk factors independently associated with acquiring HCV co-infection were: history of an ulcerative STD (aOR=2.65, 95%CI=1.44-4.88), a HCV positive partner (aOR=5.25, 95%CI=2.78-9.91), having practiced insertive fisting (aOR=2.62, 95%CI=1.01-6.90), and rectal administration of drugs during sex (aOR=2.46, 95%CI=1.25-4.84). CONCLUSIONS Risky sexual behaviors and chemsex seem to be the main drivers of HIV/HCV co-infection amongst PLWHIV in Central Mexico. IVDU and percutaneous exposures have a minor role in the local HCV epidemic. These findings highlight the importance of testing for HCV in sexually active MSMs.
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Affiliation(s)
- Luis E Ramirez-Gonzalez
- Clínica Especializada Condesa Iztapalapa, Combate de Celaya, U.H. Vicente Guerrero, Iztapalapa, 09730 Mexico City, Mexico
| | - Antonio Camiro-Zúñiga
- Centro Médico ABC, Sur 136. 116 Col. Las Americas Del, Álvaro Obregón, 01120, Mexico City, Mexico
| | - Alicia Piñeirua-Menendez
- Clínica Especializada Condesa Iztapalapa, Combate de Celaya, U.H. Vicente Guerrero, Iztapalapa, 09730 Mexico City, Mexico
| | - Juan F Sánchez-Avila
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Campus Ciudad de México, C. Puente 222, Coapa, Arboledas del Sur, Tlalpan, 14380 Mexico City, Mexico
| | - A Harumi Hirata-Hernández
- Centro de Atención Transgénero Integral (CATI), Filadelfia 128-Interior 501, Nápoles, Benito Juárez, 03810 Mexico City, Mexico
| | - Karen A Marañón-Solorio
- Departament of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico
| | - Irwin Zamora-Tapia
- Departament of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico
| | - Areli Pérez-Carrizosa
- Hospital General de México, Dr. Balmis 148, Doctores, Cuauhtémoc, 06720, Mexico City, Mexico
| | - Emmanuel Simental-Aldaba
- Instituto Nacional de Rehabilitación, Calz México-Xochimilco 289, Coapa, Guadalupe Tlalpan, Tlalpan, 14389, Mexico City, Mexico
| | - Juan G Sierra-Madero
- Departament of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, 14080, Mexico City, Mexico.
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Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2022; 20:261-278. [PMID: 35729970 PMCID: PMC9202671 DOI: 10.1007/s11938-022-00382-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 02/07/2023]
Abstract
Purpose of review
To assess the current challenges regarding liver diseases, including the burden of disease, access to care, screening, and treatment needs in Latin America. Recent findings Latin America is a region with a rich multicultural heritage and important socioeconomic differences. The burden of liver diseases is high and mainly determined by a high level of alcohol intake and the surge of risk factors associated with NAFLD (i.e., sedentary lifestyles, broader access to highly processed foods, obesity, and type 2 diabetes mellitus). Hepatotropic viruses also play a role in the development of chronic liver diseases, although their comparative frequency has been decreasing over the last decades. There are important disparities in access to screening and treatment for liver diseases in Latin America, which are reflected in low access to critical treatments such as direct-acting antiviral agents and drugs to treat hepatocellular carcinoma. Also, important barriers to liver transplantation are present in multiple countries, including a low deceased donors’ rate and a lack of availability in several countries (especially in Central America). Our region also has disadvantages in research and education in liver diseases, which limits regional academic development and improvement in quality of care of liver diseases. Summary In order to tackle an increasing health burden due to liver diseases, Latin America urgently needs tailored interventions aiming to control the main risk factors for these disorders through the establishment of effective public health policies. Also, development of liver transplantation programs and improvement of medical education and research capabilities as well as extensive collaboration between all stakeholders are keys to address the liver disease agenda in the region.
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De la Torre Rosas A, Kershenobich D, Svarch AE, López‐Gatell H. Eliminating Hepatitis C in Mexico: A Primary Health Care Approach. Clin Liver Dis (Hoboken) 2021; 18:219-224. [PMID: 34840722 PMCID: PMC8605696 DOI: 10.1002/cld.1180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 02/04/2023] Open
Affiliation(s)
| | | | | | - Hugo López‐Gatell
- Subsecretaria de Prevención y Promoción de la SaludSecretaria de SaludMexico CityMexico
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Sedeño-Monge V, Laguna-Meraz S, Santos-López G, Panduro A, Sosa-Jurado F, Jose-Abrego A, Meléndez-Mena D, Muñoz-Ramírez MA, Cosme-Chávez M, Roman S. A comprehensive update of the status of hepatitis C virus (HCV) infection in Mexico-A systematic review and meta-analysis (2008-2019). Ann Hepatol 2021; 20:100292. [PMID: 33259949 DOI: 10.1016/j.aohep.2020.100292] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES HCV infection is targeted by the WHO's Global Health Sector Strategy on Viral Hepatitis to be reduced notably by 2030. However, renovated epidemiological data is needed to line up with such goals. Herein, we provide an updated review of incidence, prevalence, genotypes (GTs), and risk factors (RFs) of HCV infection in Mexico to build elimination strategies. MATERIAL AND METHODS HCV incidence was charted using the cumulative new cases/year at week 52. Prevalence, GTs, and RFs data from low-risk (LR-G) and high-risk (HR-Gs) groups were searched in PubMed/MEDLINE/Medigraphic/Scielo databases from January 2008 to December 2019 as per PRISMA guidelines. Weighted mean prevalence (WMP) was estimated; GTs and RFs were registered. RESULTS In this study, 25,247 new cases were reported. Ten states accumulated 76.32% of HCV incidence that peaked in men at 50-59 years and women at 60-64 years. Thirty-four studies revealed a WMP between 0.774%-2.5% in LR-Gs and 11.8%-39.6% in HR-Gs that included mainly prison inmates, drug users, and dialyzed patients. GT1 and GT2 were predominant; GT3a emerged. Subtypes 1a and 1b circulate differentially, whereas novel GT2 subtypes appeared. Unsafe blood transfusion was infrequent in younger groups, but parenteral/intravenous transmission through drug-related risk behaviors has arisen. CONCLUSIONS HCV transmission increased notably among LR-Gs and HR-Gs in Mexico. Novel genotypes/subtypes emerged as well as risky behavioral routes of transmission. A national elimination strategy will require pro-active screening in designated risk groups, research in molecular epidemiology, medical training, robust epidemiological databases, and antiviral treatment available to all eligible HCV-infected patients.
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Affiliation(s)
- Virginia Sedeño-Monge
- Decanato de Ciencias Médicas, Universidad Popular Autónoma del Estado de Puebla, Puebla, Puebla, Mexico
| | - Saul Laguna-Meraz
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Gerardo Santos-López
- Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Metepec, Atlixco, Puebla, Mexico
| | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Francisca Sosa-Jurado
- Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Metepec, Atlixco, Puebla, Mexico
| | - Alexis Jose-Abrego
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Daniel Meléndez-Mena
- Servicio de Gastroenterología, Unidad Médica de Alta Especialidad, Centro Médico Nacional "General de División Manuel Ávila Camacho", Instituto Mexicano del Seguro Social, Puebla, Puebla, Mexico; Centro Interdisciplinario de Posgrados, Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, Mexico
| | - Marco A Muñoz-Ramírez
- Decanato de Ciencias Médicas, Universidad Popular Autónoma del Estado de Puebla, Puebla, Puebla, Mexico
| | - Monserrat Cosme-Chávez
- Decanato de Ciencias Médicas, Universidad Popular Autónoma del Estado de Puebla, Puebla, Puebla, Mexico
| | - Sonia Roman
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
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Roblero JP, Arab JP, Mezzano G, Mendizabal M. Hepatitis C Virus Infection: What Are We Currently Doing in Latin America About WHO's Proposals for 2030? Clin Liver Dis (Hoboken) 2021; 18:72-75. [PMID: 34584671 PMCID: PMC8450463 DOI: 10.1002/cld.1084] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 02/04/2023] Open
Affiliation(s)
- Juan Pablo Roblero
- Departamento de Medicina, Sección Gastroenterología, Hospital ClínicoUniversidad de Chile, Escuela de MedicinaUniversidad de ChileSantiagoChile
| | - Juan Pablo Arab
- Departamento de GastroenterologíaEscuela de MedicinaPontificia Universidad Católica de ChileSantiagoChile
- Division of Gastroenterology and HepatologyMayo ClinicRochesterMN
| | - Gabriel Mezzano
- Departamento de Medicina, Sección Gastroenterología, Hospital del Salvador, Escuela de MedicinaUniversidad de Chile, Hospital Clínico Universidad de ChileSantiagoChile
| | - Manuel Mendizabal
- Hepatology and Liver Transplant UnitHospital Universitario AustralPilarArgentina
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