Vera DL, Juárez NJA, Díaz GM, Méndez NJ, Chirino SRA, Dehesa VM, Casillas DL, Rizo RMT, Torres IR, Cano DC, Nava EJ, Ramos GM, Hernández ME, Wong GS, Félix TM, Corona LMC, Zárate NAR, Rangel JM, Rodríguez HH, González OV, Tirado EMP, Villanueva CMA, Orta FR, Manteca AJL, Vázquez ÁI, González MJ, Razcón HO, Torres LP, Bazán PC

Language: Spanish
References: 22
Page: 25-32
PDF size: 101.44 Kb.

ABSTRACT

Objective: To determine the epidemiological situation of Chronic Hepatitis C (CHC) in our country. Background data: Chronic Hepatitis C affects 170 million people worldwide, and about 0.7% of Mexican population. There is no enough epidemiological information about CHC in our country, and it is very probable that some cases are not even detected. Methods: An investigation poll was performed. Age, gender, birthday, weight, race, residence and birth place, routes of transmission, ALT levels, histological, serological and molecular diagnosis, evidence of complications and previous treatments were recorded. A data recollection sheet was dispatched to different country provinces; they had 6 months to answer it, in order to recollect all information. Results: 831 patients were analized (58.6% female and 41.4% male) with the following distribution in our country provinces: Aguascalientes 15, Chihuahua 12, Distrito Federal 495, Durango 10, Jalisco 89, Guanajuato 78, Yucatán 8, Querétaro 11, Sonora 40 , Tabasco 15, Baja California 5, Veracruz 13, Tamaulipas 2 and 38 patients of Nuevo León. The highest incidence of CHC was found at fifth and sixth decade of life (28.5% y 26.7% respectively. The weight distribution was 36.2% ‹ 65kg, 34.6% 65-75 kg and 29.2% › 75 kg. 86.5% had chronic hepatitis and 13.2% cirrhosis. The risk factors for HCV infection analysis showed that the main route of transmission was via contaminated blood (64.2%); when we excluded the patients that were exposed before 1995, the incidence was lowered to 4.5%. The higher incidence was showed between 1970 and 1990 (68%). The intravenous drug users were predominantly male and on those patients in the provinces near the north border line of our country. The predominant genotype was gen- 1 no matter the province (72.2%), in the intravenous drug users genotype 3 was found in 25%. The viral load was similar in all the provinces. 75% of the patients had have treatment and 22.5% had have two cycles, 50% of cirrhotic patients had have treatment whereas only 28% of the patients with late complications had have it. The most common treatment was pegylated alpha-2a interferon plus ribavirine. Conclusions: 1. The main route of transmission was blood transfusion. There is a marked decrease in the incidence of post-transfusional hepatitis since the introduction of anti-VHC antibody screening of blood donors (4.5%). 2. The time between the infection and diagnosis was 23 years for chronic hepatitis and 26 years for cirrhosis. 3. Intravenous drugs use was an important route of transmission in the north of our country. 4. The predominant genotype was gen-1. 5. Almost all the patients with chronic hepatitis received treatment, the most common used was pegylated interferon alpha-2a and ribavirin. 6. 50% of the patients with CHC have late complications.

REFERENCES

1. Shimizu YK, Feinstone SM, Kohara M y col. Hepatitis C virus: detection of intracellular virus particles by electron microscopy. Hepatology 1996; 23: 205-209.

2. Memon MI, Memon MA. Hepatitis C: an epidemiological review. J Viral Hepat 2002; 9: 84-100.

3. Global Surveillance and Control of Hepatitis C. Report of a WHO Consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium. J Viral Hepat 1999; 6: 35-47.

4. Farrel GC, Weltman M, Dingley J y col. Epidemiology of hepatitis C virus infection in Australia. Gastroenterol Jpn 1993; 28(Suppl. 5): 32-6.

5. Guadagnino V, Stroffolini T, Rapicetta M y col. Prevalence, risk factors, and genotype distribution of hepatitis c virus infection in the general population: a community based survey in southern Italy. Hepatology 1997; 26: 1006-11.

6. Ishibasi M, Shinsawa H, Kuboki M y col. Prevalence on inhabitants with anti-hepatitis c virus antibody in an area following an acute hepatitis c epidemic: age and area related features. J Epidemiol 1996; 6: 1-7.

7. Abdel MF, Zakaria S, Kamel M y col. High seroprevalence of hepatitis c infection among risk groups in Egypt. Am J Trop Med Hyg 1994; 51: 563-7.

8. Armstrong GL, Alter MJ, McQuillian GM y col. The past incidence of hepatitis c infection: Implications for the future burden of chronic liver diseases in the United States. Hepatology 2000; 31: 777-82.

9. Alter MJ. Epidemiology of hepatitis C. Hepatology 1997; 26: 62s-5s.

10. Seeff LB. Natural history of chronic hepatitis C. Hepatology 2002; 36: 35s-46s.

11. Hoofnagle JH. Course and outcome of hepatitis C. Hepatology 2002; 36: 21s-9s.

12. Aach RD, Szmuness W, Mosley JW y col. Serum alanine aminotransferase of donors in relation to the risk of non-A, non-B hepatitis in recipients: the transfusion-transmited viruses study. N Eng J Med 1981; 304: 989-94.

13. Méndez-Sánchez N, Baptista-González H, Sánchez Gómez RH y col. The prevalence of hepatitis B and C in blood donors in a 3rd-level hospital of Mexico City. Sal Pub Mex 1999; 41(6): 475-8.

14. Ladrón de Guevara L, Gómez N, Vázquez-Cantarell M y col. Prevalencia y factores de riesgo para hepatitis C en donadores de sangre. Rev Gastroenterol Mex 2002; 67 (1): 11-16.

15. Guerrero-Romero JG, Castañeda A, Rodríguez-Morán M. Prevalence of risk factors associated with hepatitis C in blood donors in the municipality of Durango, México. Sal Pub Mex 1960; 38 (2): 94-100.

16. González-Michaca L, Mercado A, Gamba G. Hepatitis C viral in patients with termical chronic kidney failure. I. Prevalence. Rev Invest Clin 2000; 52(3): 246-54.

17. World Health Organization. Weekly Epidemiological Record 2000; 75(3): 17-28.

18. Garfein RS, Doherty MC, Monterroso ER y col. Prevalence and incidence of hepatitis C virus infection among young adult injection drug users. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 18(Suppl. 1): S11-S19.

19. Hahn JA, Page-Shafer K, Lum PJ y col. Hepatitis C virus infection and needle exchange use among young injection drug users in San Francisco. Hepatology 2001; 34: 180-7.

20. Schvarez R. Nosocomial transmisión of hepatitis C virus. Infection 1997; 25: 74-7.

21. Medin C, Allander T, Roll M y col. Seroconversion to hepatitis C virus in dialysis patient: a retrospective and prospective study. Nephron 1993; 64: 40-5.

22. Bedossa P, Poynard T. The METAVIR Cooperative Study Group. An algorithm for the grading of activity in chronic hepatitis C. Hepatology 1996; 24: 289-93.