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Jose-Abrego A, Trujillo-Trujillo ME, Laguna-Meraz S, Roman S, Panduro A. Epidemiology of Hepatitis C Virus in HIV Patients from West Mexico: Implications for Controlling and Preventing Viral Hepatitis. Pathogens 2024; 13:360. [PMID: 38787212 PMCID: PMC11123714 DOI: 10.3390/pathogens13050360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
The complex epidemiology of hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV) patients in West Mexico remains poorly understood. Thus, this study aimed to investigate the HCV prevalence, HCV-associated risk factors, and HCV genotypes/subtypes and assess their impacts on liver fibrosis in 294 HIV patients (median age: 38 years; 88.1% male). HCV RNA was extracted and amplified by PCR. Hepatic fibrosis was assessed using three noninvasive methods: transient elastography (TE), the aspartate aminotransferase (AST)-to-platelets ratio index score (APRI), and the fibrosis-4 score (FIB4). Patients with liver stiffness of ≥9.3 Kpa were considered to have advanced liver fibrosis. HCV genotypes/subtypes were determined by line probe assay (LiPA) or Sanger sequencing. The prevalence of HIV/HCV infection was 36.4% and was associated with injection drug use (odds ratio (OR) = 13.2; 95% confidence interval (CI) = 5.9-33.6; p < 0.001), imprisonment (OR = 3.0; 95% CI = 1.7-5.4; p < 0.001), the onset of sexual life (OR = 2.6; 95% CI = 1.5-4.5; p < 0.001), blood transfusion (OR = 2.5; 95% CI = 1.5-4.2; p = 0.001), tattooing (OR = 2.4; 95% CI = 1.4-3.9; p = 0.001), being a sex worker (OR = 2.3; 95% CI = 1.0-5.4; p = 0.046), and surgery (OR = 1.7; 95% CI = 1.0-2.7; p = 0.042). The HCV subtype distribution was 68.2% for 1a, 15.2% for 3a, 10.6% for 1b, 3.0% for 2b, 1.5% for 2a, and 1.5% for 4a. The advanced liver fibrosis prevalence was highest in patients with HIV/HCV co-infection (47.7%), especially in those with HCV subtype 1a. CD4+ counts, albumin, direct bilirubin, and indirect bilirubin were associated with liver fibrosis. In conclusion, HCV infection had a significant impact on the liver health of Mexican HIV patients, highlighting the need for targeted preventive strategies in this population.
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Affiliation(s)
- Alexis Jose-Abrego
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Maria E. Trujillo-Trujillo
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Saul Laguna-Meraz
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Arturo Panduro
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (A.J.-A.); (M.E.T.-T.); (S.L.-M.); (S.R.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
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Cessa-Zanatta JC, Cortez-Hernández CA, Goyes D, Bonder A. Epidemiology and health care burden of autoimmune liver diseases in Mexico. Clin Liver Dis (Hoboken) 2024; 23:e0089. [PMID: 38379766 PMCID: PMC10878547 DOI: 10.1097/cld.0000000000000089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 06/23/2023] [Indexed: 02/22/2024] Open
Affiliation(s)
- Jose C. Cessa-Zanatta
- Gastroenterology Service, Department of Internal Medicine, Faculty of Medicine, Hospital Universitario “Dr. José E. González,” Universidad Autónoma de Nuevo León Monterrey, Mexico
| | - Carlos A. Cortez-Hernández
- Gastroenterology Service, Department of Internal Medicine, Faculty of Medicine, Hospital Universitario “Dr. José E. González,” Universidad Autónoma de Nuevo León Monterrey, Mexico
| | - Daniela Goyes
- Department of Medicine, Liver Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Alan Bonder
- Department of Medicine, Liver Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Panduro A, Roman S, Laguna-Meraz S, Jose-Abrego A. Hepatitis B Virus Genotype H: Epidemiological, Molecular, and Clinical Characteristics in Mexico. Viruses 2023; 15:2186. [PMID: 38005864 PMCID: PMC10675821 DOI: 10.3390/v15112186] [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: 09/12/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
The hepatitis B virus (HBV), comprising of ten genotypes (A-J), has been a silent threat against humanity, constituting a public health problem worldwide. In 2016, the World Health Organization set forth an impressive initiative for the global elimination of viral hepatitis by 2030. As the target date approaches, many nations, particularly in the Latin American region, face challenges in designing and implementing their respective elimination plan. This review aimed to portray the state of knowledge about the epidemiological, molecular, and clinical characteristics of HBV genotype H (HBV/H), endemic to Mexico. PubMed, Scopus, Web of Science, and Google Scholar were searched to compile scientific literature over 50 years (1970-2022). A total of 91 articles were organized into thematic categories, addressing essential aspects such as epidemiological data, risk factors, HBV genotype distribution, HBV mixed infections, clinical characteristics, and vaccination. The prevalence and its associated 95% confidence interval (95% CI) were estimated using the Metafor package in R programming language (version 4.1.2). We provide insights into the strengths and weaknesses in diagnostics and prevention measures that explain the current epidemiological profile of HBV/H. Training, research, and awareness actions are required to control HBV infections in Mexico. These actions should contribute to creating more specific clinical practice guides according to the region's characteristics. Mexico's elimination plan for HBV will require teamwork among the government health administration, researchers, physicians, specialists, and civil society advocates to overcome this task jointly.
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Affiliation(s)
- Arturo Panduro
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (S.L.-M.); (A.J.-A.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (S.L.-M.); (A.J.-A.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Saul Laguna-Meraz
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (S.L.-M.); (A.J.-A.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Alexis Jose-Abrego
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico; (S.L.-M.); (A.J.-A.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
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Martinez-Castillo M, Altamirano-Mendoza I, Sánchez-Valle S, García-Islas L, Sánchez-Barragán M, Hernández-Santillán M, Hernández-Barragán A, Pérez-Hernández J, Higuera-de la Tijera F, Gutierrez-Reyes G. Immune dysregulation and pathophysiology of alcohol consumption and alcoholic liver disease. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2023; 88:136-154. [PMID: 36973122 DOI: 10.1016/j.rgmxen.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 01/13/2023] [Indexed: 03/28/2023] Open
Abstract
Alcoholic liver disease (ALD) is a clinical-pathologic entity caused by the chronic excessive consumption of alcohol. The disease includes a broad spectrum of anomalies at the cellular and tissual level that can cause acute-on-chronic (alcoholic hepatitis) or chronic (fibrosis, cirrhosis, hepatocellular cancer) injury, having a great impact on morbidity and mortality worldwide. Alcohol is metabolized mainly in the liver. During alcohol metabolism, toxic metabolites, such as acetaldehyde and oxygen reactive species, are produced. At the intestinal level, alcohol consumption can cause dysbiosis and alter intestinal permeability, promoting the translocation of bacterial products and causing the production of inflammatory cytokines in the liver, perpetuating local inflammation during the progression of ALD. Different study groups have reported systemic inflammatory response disturbances, but reports containing a compendium of the cytokines and cells involved in the pathophysiology of the disease, from the early stages, are difficult to find. In the present review article, the role of the inflammatory mediators involved in ALD progression are described, from risky patterns of alcohol consumption to advanced stages of the disease, with the aim of understanding the involvement of immune dysregulation in the pathophysiology of ALD.
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Roman S, Ramos-Lopez O, Panduro A. Genomic medicine in hepatology: Towards personalized medicine in obesity and chronic liver disease. Ann Hepatol 2023; 28:100875. [PMID: 36371076 DOI: 10.1016/j.aohep.2022.100875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, Fray Antonio Alcalde, University of Guadalajara, Guadalajara, Jalisco, 44270, Mexico.
| | - Omar Ramos-Lopez
- School of Medicine and Psychology, Autonomous University of Baja California, Tijuana, 22390, Baja California, Mexico
| | - Arturo Panduro
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, Fray Antonio Alcalde, University of Guadalajara, Guadalajara, Jalisco, 44270, Mexico
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Laguna-Meraz S, Roman S, Jose-Abrego A, Sigala-Arellano R, Panduro A. A hospital-based study of the prevalence of HBV, HCV, HIV, and liver disease among a low-income population in West Mexico. Ann Hepatol 2022; 27 Suppl 1:100579. [PMID: 34793967 DOI: 10.1016/j.aohep.2021.100579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES Viral hepatitis is a global health problem with unequal distribution of disease burden in which low-income people are at higher risk for acquisition and underlying liver diseases. This study aimed to seek the prevalence of hepatitis B and C viruses, HIV, and liver damage among low-income patients attending a public tertiary care hospital in West Mexico. METHODS A retrospective/cross-sectional study at the Department of Genomic Medicine in Hepatology was conducted between March 1, 2016 to March 30, 2017. A total of 10,352 patients tested for anti-HCV, HBsAg, or anti-HIV (n=23,074) were included. Age, gender, and hospital service were registered. Liver fibrosis was assessed using APRI and FIB-4 scores. RESULTS Overall, 3.9% were anti-HCV+ (305/7848), 1.0% were HBsAg+ (80/7894), and 2.9% were anti-HIV+ (210/7332). A 43.8% (750/1959) of patients negative for all viruses had either abnormal AST, ALT, or GGT (≥40 UI/L). Also, significant liver fibrosis (APRI ≥ 0.7) was prevalent in 10.6% (191/1804). In patients who tested positive for viral infections, liver fibrosis was detected in 20.4% (11/54) of HBsAg+, 34.2% (53/155) in anti-HCV+ and 15.5% (16/103) in anti-HIV+. Anti-HCV+ was highest in Geriatrics (11.1%), HBsAg+ in HIV patients (3.0%) and anti-HIV+ in Emergency room attendees (33.3%). CONCLUSION High seroprevalence of HCV, HBV, and HIV infections was found among the studied population. Significant liver fibrosis was detected in negative and positive patients for viral infections. Medical services need to continuously test for viral infections, promote early detection of chronic liver damage and identify target patients for elimination strategies to decrease disease burden.
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Affiliation(s)
- Saul Laguna-Meraz
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Alexis Jose-Abrego
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Ramon Sigala-Arellano
- Laboratory of Clinical Pathology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico
| | - Arturo Panduro
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
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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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Adherence to a Fish-Rich Dietary Pattern Is Associated with Chronic Hepatitis C Patients Showing Low Viral Load: Implications for Nutritional Management. Nutrients 2021; 13:nu13103337. [PMID: 34684338 PMCID: PMC8541240 DOI: 10.3390/nu13103337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 01/04/2023] Open
Abstract
Hepatitis C virus (HCV) infection is influenced by genetic (e.g., APOE polymorphisms) and environmental factors between the virus and the host. HCV modulates the host’s lipid metabolism but dietary components influence lipids and in vitro HCV RNA replication. Few data exist on the role of dietary features or patterns (DPs) in HCV infection. Herein, we aimed to evaluate the nutritional profiles of chronic HCV (CHC) and spontaneous clearance (SC) Mexican patients in the context of APOE alleles and their correlation with HCV-related variables. The fibrosis-related APOEε3 allele prevailed in CHC and SC patients, who had four DPs (“meat and soft drinks”, DP1; “processed animal and fried foods”, DP2; “Mexican-healthy”, DP3; and “fish-rich”, DP4). In CHC subjects, polyunsaturated fatty acid intake (PUFA ≥ 4.9%) was negatively associated, and fiber intake (≥21.5 g/day) was positively associated with a high viral load (p < 0.036). High adherence to fish-rich DP4 was associated with a higher frequency of CHC individuals consuming PUFA ≥ 4.9% (p = 0.004) and low viral load (p = 0.036), but a lower frequency of CHC individuals consuming fiber ≥21.5 g/day (p = 0.038). In SC and CHC individuals, modifying unhealthy DPs and targeting HCV-interacting nutrients, respectively, could be part of a nutritional management strategy to prevent further liver damage.
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Viera-Segura O, Panduro A, Trujillo-Ochoa JL, Copado-Villagrana E, Torres-Valadez R, Sepulveda-Villegas M, Roman S, Fierro NA. Evidence for Increased Inflammatory Cytokine Profile in Hepatitis E Virus-Infected Obese Patients: Implications for Chronic Liver Disease. Viral Immunol 2020; 33:600-609. [PMID: 32986530 DOI: 10.1089/vim.2020.0064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We aimed to characterize the contribution of hepatitis E virus (HEV) in perpetuating the cytokine-mediated inflammatory setting related to liver damage in the context of obesity. Herein, serum samples from patients with liver disease were retrospectively analyzed and categorized as normal-weight patients (NW), overweight patients (OW), obese patients (ObP), and high alcohol consumer patients (HAC), and biochemical, anthropometrical, and transient elastography measurements were obtained. The positivity for immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-HEV antibodies in samples was determined by enzyme-linked immunosorbent assay. Available samples from ObP were tested by reverse transcription-nested polymerase chain reaction for the presence of HEV-RNA. Cytokine profile in the serum of ObP was identified using a multiplexed immune assay. Globally, the highest frequency of IgG anti-HEV was found in ObP (57.5%), followed by HAC (20%), OW (15%), and NW (7.5%). A strong association between HEV serology and obesity was found (odds ratio = 4.21, confidence interval = 1.91.9.27) with a cutoff of 29.3 kg/m2 (area under curve [AUC] = 0-66; p = 0.003) and, a 23.7% of available samples of ObP provided amplification of HEV genome. Cytokine analysis revealed significantly higher levels of proinflammatory cytokines (interleukin [IL]-12, interferon [IFN]-γ, and IL-1β) in IgG anti-HEV-positive ObP than in IgG anti-HEV-negative ObP. Moreover, a high proportion of patients with positive serology showed advanced liver damage. In conclusion, the high percentage of anti-HEV antibodies and viral RNA detection in the setting of an excess of fat, along with an associated proinflammatory cytokine profile found in IgG anti-HEV-positive ObP with more severe liver disease, support an interplay between HEV and obesity.
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Affiliation(s)
- Oliver Viera-Segura
- Departamento de Biología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.,Servicio de Biologia Molecular en Medicina, Hospital Civil de Guadalajara "Fray Antonio Alcalde," Guadalajara, Mexico
| | - Arturo Panduro
- Departamento de Biología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.,Servicio de Biologia Molecular en Medicina, Hospital Civil de Guadalajara "Fray Antonio Alcalde," Guadalajara, Mexico
| | - Jorge L Trujillo-Ochoa
- Departamento de Biología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Edgar Copado-Villagrana
- Departamento de Biología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | | | | | - Sonia Roman
- Departamento de Biología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.,Servicio de Biologia Molecular en Medicina, Hospital Civil de Guadalajara "Fray Antonio Alcalde," Guadalajara, Mexico
| | - Nora A Fierro
- Departamento de Inmunologia, Instituto de Investigaciones Biomedicas, Universidad Nacional Autonoma de Mexico, Ciudad de México, Mexico
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Viera-Segura O, Realpe-Quintero M, Panduro A, Roman S, Jose-Abrego A, Gonzalez-Aldaco K, Trujillo-Ochoa JL, Fierro NA. First detection of hepatitis E virus genotype 3 as a common infectious agent in patients with chronic liver damage in Mexico. Ann Hepatol 2020; 18:571-577. [PMID: 31080055 DOI: 10.1016/j.aohep.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/08/2019] [Accepted: 03/26/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION AND OBJECTIVES To characterize the virological features of hepatitis E virus (HEV) in serum from patients exhibiting chronic liver damage. METHODS A data-base of 513 unrelated individuals from West-Mexico with liver-disease determined by clinical and biochemical tests and transient elastography between 2011 and 2016 were retrospectively analyzed. According to infectious etiologies, patients were classified as hepatitis B virus (HBV)-, hepatitis C virus (HCV)-infected patients, and patients exhibiting chronic liver damage with non-identified infectious etiological agent (NIIEA). Available serum samples from NIIEA-patients were tested by RT-nPCR for the presence of HEV-RNA and partially sequenced for genotyping. RESULTS Out of the 513 cases, 5.85% were patients infected with HBV, 67.64% with HCV, and 26.51% were NIIEA-patients. Among 76 available samples from NIIEA-cases, 30.26% tested positive for HEV-RNA. Twelve (15.79%) partial HEV sequences allowed phylogenetic analysis, revealing the classification of HEV as HEV-Gt3. Advanced fibrosis (F3-F4 stage) was found in a 26.1% of patients with HEV-active infection. CONCLUSION Although HCV is the main infectious agent related to chronic liver disease in Mexico, liver damage without an infectious etiology is common. Our findings reveal that an elevated rate of chronic liver disease might be represented by autochthonous infection of HEV-Gt3, whose detection makes Mexico unique in Latin-America with the circulation of HEV strains belonging to three genotypes (Gt1, Gt2, and Gt3). Thus, HEV infection should be a matter of health concern, and mandates for HEV screening to properly handle this commonly undiagnosed disease.
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Affiliation(s)
- Oliver Viera-Segura
- Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico; Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara, 44280 Jalisco, Mexico
| | - Mauricio Realpe-Quintero
- Department of Veterinarian Medicine, Biological-Agricultural Sciences, University of Guadalajara, Nextipac, Zapopan, 44600 Jalisco, Mexico
| | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara "Fray Antonio Alcalde", and Health Sciences Center, University of Guadalajara, Hospital #278, Col. El Retiro, Guadalajara, 44280 Jalisco, Mexico
| | - Sonia Roman
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara "Fray Antonio Alcalde", and Health Sciences Center, University of Guadalajara, Hospital #278, Col. El Retiro, Guadalajara, 44280 Jalisco, Mexico
| | - Alexis Jose-Abrego
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara "Fray Antonio Alcalde", and Health Sciences Center, University of Guadalajara, Hospital #278, Col. El Retiro, Guadalajara, 44280 Jalisco, Mexico
| | - Karina Gonzalez-Aldaco
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara "Fray Antonio Alcalde", and Health Sciences Center, University of Guadalajara, Hospital #278, Col. El Retiro, Guadalajara, 44280 Jalisco, Mexico
| | - Jorge L Trujillo-Ochoa
- Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara, 44280 Jalisco, Mexico
| | - Nora A Fierro
- Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara, 44280 Jalisco, Mexico.
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Sepulveda-Villegas M, Roman S, Rivera-Iñiguez I, Ojeda-Granados C, Gonzalez-Aldaco K, Torres-Reyes LA, Jose-Abrego A, Panduro A. High prevalence of nonalcoholic steatohepatitis and abnormal liver stiffness in a young and obese Mexican population. PLoS One 2019; 14:e0208926. [PMID: 30608932 PMCID: PMC6319733 DOI: 10.1371/journal.pone.0208926] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/26/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To identify nonalcoholic steatohepatitis (NASH) and liver stiffness in Mexican subjects with different body mass index (BMI). METHODS A cross-sectional study was conducted in 505 adults. Risk for NASH was defined as the presence of one or more of the following biochemical and metabolic parameters (BMPs): fasting glucose ≥100 mg/dl, triglycerides (TG) ≥150 mg/dl, homeostatic model assessment of insulin resistance (HOMA-IR) ≥2.5, aspartate aminotransferase (AST) >54 IU/L and alanine aminotransferase (ALT) >42 IU/L. Body mass index measurement and nutritional assessment were performed by standard procedures. Liver fibrosis stage was determined by liver stiffness measurement using transitional elastography (TE) or by liver biopsy (LB). RESULTS Risk for NASH was 57% (290/505). Most BMPs values incremented by BMI category. Among 171 at-risk patients, 106 subjects were evaluated by TE and 65 subjects by LB. Abnormal liver stiffness (≥6.0 kPa) was prevalent in 54% (57/106) of the cases, whereas by LB, 91% (59/65) of patients with obesity had NASH and liver fibrosis. Furthermore, liver fibrosis was prevalent in 46% (6/13) in normal weight individuals, whereas 4.6% (3/65) of patients with a BMI ≥ 35 kg/m2 showed no histopathological abnormalities. Overall, 67.8% (116/171) of the patients had abnormal liver stiffness or NASH. The normal weight patients with liver damage consumed relatively a higher fat-rich diet compared to the other groups whereas the remaining subgroups shared a similar dietary pattern. CONCLUSION Young patients with overweight and obesity showed a high prevalence of altered BMPs related to abnormal liver stiffness assessed by TE and NASH by LB. Early diagnostic strategies are required to detect the risk for NASH and avoid further liver damage in populations with a rising prevalence of obesity by defining the risk factors involved in the onset and progression of NASH.
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Affiliation(s)
- Maricruz Sepulveda-Villegas
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde,” Guadalajara, Jalisco, Mexico and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Sonia Roman
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde,” Guadalajara, Jalisco, Mexico and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Ingrid Rivera-Iñiguez
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde,” Guadalajara, Jalisco, Mexico and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Claudia Ojeda-Granados
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde,” Guadalajara, Jalisco, Mexico and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Karina Gonzalez-Aldaco
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde,” Guadalajara, Jalisco, Mexico and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Luis Alberto Torres-Reyes
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde,” Guadalajara, Jalisco, Mexico and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Alexis Jose-Abrego
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde,” Guadalajara, Jalisco, Mexico and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde,” Guadalajara, Jalisco, Mexico and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
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Méndez-Sánchez N, Zamarripa-Dorsey F, Panduro A, Purón-González E, Coronado-Alejandro EU, Cortez-Hernández CA, Higuera de la Tijera F, Pérez-Hernández JL, Cerda-Reyes E, Rodríguez-Hernández H, Cruz-Ramón VC, Ramírez-Pérez OL, Aguilar-Olivos NE, Rodríguez-Martínez OF, Cabrera-Palma S, Cabrera-Álvarez G. Current trends of liver cirrhosis in Mexico: Similitudes and differences with other world regions. World J Clin Cases 2018; 6:922-930. [PMID: 30568947 PMCID: PMC6288506 DOI: 10.12998/wjcc.v6.i15.922] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/19/2018] [Accepted: 11/14/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate the main current etiologies of cirrhosis in Mexico. METHODS We performed a cross-sectional retrospective multicenter study that included eight hospitals in different areas of Mexico. These hospitals provide health care to people of diverse social classes. The inclusion criteria were a histological, clinical, biochemical, endoscopic, or imaging diagnosis of liver cirrhosis. Data were obtained during a 5-year period (January 2012-December 2017). RESULTS A total of 1210 patients were included. The mean age was 62.5 years (SD = 12.1), and the percentages of men and women were similar (52.0% vs 48.0%). The most frequent causes of liver cirrhosis were hepatitis C virus (HCV) (36.2%), alcoholic liver disease (ALD) (31.2%), and nonalcoholic steatohepatitis (23.2%), and the least frequent were hepatitis B virus (1.1%), autoimmune disorders (7.3%), and other conditions (1.0%). CONCLUSION HCV and ALD are the most frequent causes of cirrhosis in Mexico. However, we note that non-alcoholic fatty liver disease (NAFLD) as an etiology of cirrhosis increased by 100% compared with the rate noted previously. We conclude that NAFLD will soon become one of the most frequent etiologies of liver cirrhosis in Mexico.
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Affiliation(s)
- Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City 14050, Mexico
| | | | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico
| | - Emma Purón-González
- Department of Internal Medicine, “Christus Muguerza “Super Specialty” Hospital” Monterrey, Monterrey 64060, Nuevo León, Mexico
| | - Edgar Ulises Coronado-Alejandro
- Department of Internal Medicine, “Christus Muguerza “Super Specialty” Hospital” Monterrey, Monterrey 64060, Nuevo León, Mexico
| | | | - Fátima Higuera de la Tijera
- Department of Gastroenterology, “General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico
| | - José Luis Pérez-Hernández
- Department of Gastroenterology, “General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico
| | - Eira Cerda-Reyes
- Department of Gastroenterology, “Central Military Hospital”, Mexico City 11200, Mexico
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Wang JB, Gu Y, Zhang MX, Yang S, Wang Y, Wang W, Li XR, Zhao YT, Wang HT. High expression of type I inositol 1,4,5-trisphosphate receptor in the kidney of rats with hepatorenal syndrome. World J Gastroenterol 2018; 24:3273-3280. [PMID: 30090007 PMCID: PMC6079285 DOI: 10.3748/wjg.v24.i29.3273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/19/2018] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To detect the expression of type I inositol 1,4,5-trisphosphate receptor (IP3RI) in the kidney of rats with hepatorenal syndrome (HRS). METHODS One hundred and twenty-five Sprague-Dawley rats were randomly divided into four groups to receive an intravenous injection of D-galactosamine (D-GalN) plus lipopolysaccharide (LPS; group G/L, n = 50), D-GalN alone (group G, n = 25), LPS alone (group L, n = 25), and normal saline (group NS, n = 25), respectively. At 3, 6, 9, 12, and 24 h after injection, blood, liver, and kidney samples were collected. Hematoxylin-eosin staining of liver tissue was performed to assess hepatocyte necrosis. Electron microscopy was used to observe ultrastructural changes in the kidney. Western blot analysis and real-time PCR were performed to detect the expression of IP3RI protein and mRNA in the kidney, respectively. RESULTS Hepatocyte necrosis was aggravated gradually, which was most significant at 12 h after treatment with D-galactosamine/lipopolysaccharide, and was characterized by massive hepatocyte necrosis. At the same time, serum levels of biochemical indicators including liver and kidney function indexes were all significantly changed. The structure of the renal glomerulus and tubules was normal at all time points. Western blot analysis indicated that IP3RI protein expression began to rise at 3 h (P < 0.05) and peaked at 12 h (P < 0.01). Real-time PCR demonstrated that IP3RI mRNA expression began to rise at 3 h (P < 0.05) and peaked at 9 h (P < 0.01). CONCLUSION IP3RI protein expression is increased in the kidney of HRS rats, and may be regulated at the transcriptional level.
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MESH Headings
- Animals
- Disease Models, Animal
- Galactosamine/toxicity
- Hepatocytes/pathology
- Hepatorenal Syndrome/chemically induced
- Hepatorenal Syndrome/pathology
- Humans
- Inositol 1,4,5-Trisphosphate Receptors/genetics
- Inositol 1,4,5-Trisphosphate Receptors/metabolism
- Kidney/blood supply
- Kidney/cytology
- Kidney/pathology
- Kidney/ultrastructure
- Lipopolysaccharides/toxicity
- Liver/cytology
- Liver/drug effects
- Liver/pathology
- Male
- Microscopy, Electron
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/pathology
- Myocytes, Smooth Muscle/ultrastructure
- Necrosis
- RNA, Messenger/metabolism
- Rats
- Rats, Sprague-Dawley
- Specific Pathogen-Free Organisms
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Affiliation(s)
- Jing-Bo Wang
- Liver Cirrhosis Ward, the Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
| | - Ye Gu
- Liver Cirrhosis Ward, the Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
| | - Ming-Xiang Zhang
- Liver Cirrhosis Ward, the Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
| | - Shun Yang
- Liaoning Cancer Hospital & Institute, Shenyang 110042, Liaoning Province, China
| | - Yan Wang
- Liver Cirrhosis Ward, the Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
| | - Wei Wang
- Liver Cirrhosis Ward, the Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
| | - Xi-Ran Li
- Liver Cirrhosis Ward, the Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
| | - Yi-Tong Zhao
- Liver Cirrhosis Ward, the Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
| | - Hai-Tao Wang
- Department of General Surgery, the Second Affiliated Hospital of Shenyang Medical College, Shenyang 110002, Liaoning Province, China
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Ramos-Lopez O, Panduro A, Rivera-Iñiguez I, Roman S. Dopamine D2 receptor polymorphism (C957T) is associated with sugar consumption and triglyceride levels in West Mexicans. Physiol Behav 2018; 194:532-537. [PMID: 30008437 DOI: 10.1016/j.physbeh.2018.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 02/08/2023]
Abstract
Genetic variations in the dopamine receptor D2 (DRD2) may alter dopamine signaling and modify the rewarding effects of food. This study aimed to analyze the association of the C957T DRD2 polymorphism with sugar consumption in West Mexican subjects. In a cross-sectional and analytical study, a total of 215 Mexican subjects were enrolled. DRD2 genotyping was performed by an allelic discrimination assay. Habitual dietary intake and the biochemical profile were evaluated. Genotype frequencies of the C957T DRD2 polymorphism were CC (12.1%), CT (40.9%) and TT (47.0%). Carriers of the CC genotype had a higher intake of sugar (g/day) than heterozygotes (67.4 g vs. 41.3 g, p = 0.001) and TT homozygotes (67.4 g vs. 45.2 g, p = 0.004). Also, the habitual consumption of soda (daily or at least 3 times per week) was more frequent among CC genotype carriers compared with heterozygotes (81% vs. 51%, p = 7.5 × 10-6) and TT homozygotes (81% vs. 57%, p = 2.4 × 10-4). Furthermore, the CC genotype was associated with elevated serum triglyceride levels (>150 mg/dL) than the CT genotype (OR = 2.80, 95% CI 1.08-7.24, p = 0.034). In conclusion, our results suggest a genetic background associated with sugar consumption among West Mexicans, which may contribute to increases in serum triglyceride levels.
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Affiliation(s)
- Omar Ramos-Lopez
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Ingrid Rivera-Iñiguez
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Sonia Roman
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
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Abstract
Based on high seroprevalence, null surveillance, and lack of diagnostics, Mexico is a high-risk region for hepatitis E Virus (HEV) infection. However, few local news on infection are available. Clinicians and general population are in need of increasing awareness, and preventive measures should be emphasized.
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Affiliation(s)
- Mauricio Realpe-Quintero
- Laboratory of Biological Development, Veterinary Hospital of Small Species, University Center of Biological and Agricultural Sciences, University of Guadalajara, Mexico
| | - Oliver Viera-Segura
- Immunovirology Unit, Molecular Biology Service, Civil Hospital of Guadalajara Fray Antonio Alcalde, Center University of Health Sciences, University of Guadalajara, Mexico
| | - Nora A Fierro
- Immunovirology Unit, Molecular Biology Service, Civil Hospital of Guadalajara Fray Antonio Alcalde, Center University of Health Sciences, University of Guadalajara, Mexico
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