RESUMEN
Hepatitis C virus (HCV) infection poses a significant public health challenge and often leads to long-term health complications and even death. Parkinson's disease (PD) is a progressive neurodegenerative disorder with a proposed viral etiology. HCV infection and PD have been previously suggested to be related. This work aimed to identify potential biomarkers and pathways that may play a role in the joint development of PD and HCV infection. Using BioOptimatics-bioinformatics driven by mathematical global optimization-, 22 publicly available microarray and RNAseq datasets for both diseases were analyzed, focusing on sex-specific differences. Our results revealed that 19 genes, including MT1H, MYOM2, and RPL18, exhibited significant changes in expression in both diseases. Pathway and network analyses stratified by sex indicated that these gene expression changes were enriched in processes related to immune response regulation in females and immune cell activation in males. These findings suggest a potential link between HCV infection and PD, highlighting the importance of further investigation into the underlying mechanisms and potential therapeutic targets involved.
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Hepatitis C , Enfermedad de Parkinson , Femenino , Humanos , Masculino , Biomarcadores , Biología Computacional/métodos , Perfilación de la Expresión Génica , Redes Reguladoras de Genes , Hepacivirus/genética , Hepatitis C/complicaciones , Hepatitis C/virología , Enfermedad de Parkinson/genética , Enfermedad de Parkinson/virología , Factores SexualesRESUMEN
OBJECTIVE: In the hepatitis C virus (HCV) diagnostic algorithm, an anti-HCV screening test is recommended first. In countries with low HCV prevalence, anti-HCV testing can often give false-positive results. This may lead to unnecessary retesting, increased costs, and psychological stress for patients. METHODS: In this study, the most appropriate S/Co (signal-cutoff) value to predict HCV viremia in anti-HCV test(+) individuals was determined, and the effect of genotype differences was evaluated. Of the 96,515 anti-HCV tests performed between 2020 and 2023, 934 were reactive. A total of 332 retests and 65 patients without HCV-ribonucleic acid (RNA) analysis were excluded. Demographic data were calculated for 537 patients, and 130 patients were included in the study. RESULTS: The average age of 537 patients was 55±18 years, and 57.1% were women. The anti-HCV positivity rate was 0.62% (602/96,515), and the actual anti-HCV positivity rate was 0.13% (130/96,515). Anti-HCV levels were higher in HCV-RNA(+) patients than in HCV-RNA-negative individuals (p<0.0001) (Table 1). Receiver operating characteristic curve analysis identified the optimal S/Co value to be 10.86 to identify true positive cases. Sensitivity was 96.1%, specificity was 61.2%, positive predictive value (PPV) was 44.2%, and negative predictive value (NPV) was 98% (Figure 2). A total of 107 (82.3%) of the patients were identified as GT1, and the most common subtype was GT1b (n=100). CONCLUSION: If anti-HCV S/Co is ≥10.86, direct HCV RNA testing may be recommended; However, the possibility of false positivity should be considered in patients with a S/Co value below 10.86.
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Genotipo , Hepacivirus , Anticuerpos contra la Hepatitis C , Hepatitis C , Valor Predictivo de las Pruebas , ARN Viral , Viremia , Humanos , Femenino , Masculino , Persona de Mediana Edad , Hepacivirus/genética , ARN Viral/sangre , ARN Viral/análisis , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C/genética , Hepatitis C/sangre , Adulto , Anciano , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: Routine screening for viral infections at blood donation is important to avoid transfusion-transmitted infections. It also offers an opportunity to detect an asymptomatic infection. OBJECTIVE: To study changes in serology positivity for viral infections (B and C hepatitis, HTLV-1/2, and HIV) at blood donation in a blood bank from Southern Brazil, comparing two periods of 5 years: the period from 2013 to 2017 with the period from 2018 to 2022. In addition, data on the donor fidelity rate during the studied period were sought. METHODS: Retrospective study using data from 2013 to 2022 from a single blood center electronic database from Curitiba, Southern Brazil. RESULTS: A significant drop in positive serology for all studied viruses was observed: highest in HIV (OR=0.39; 95% CI=0.27-0.57) and lowest in total anti HBc (0.56; 95 CI=0.50-0.63). Anti HBc serology became more commonly seen in women in the period of 2018-2022 when compared to men. No changes in the distribution of positive serology according to donors' ages were observed. Loyalty rates had a median of 70%, with the lowest being 60% in 2013, while the highest was 73% in 2018 and 2022. CONCLUSION: A significant reduction in discarded blood bags due to viral serology was observed when the period of 2013-2017 was compared to 2018-2022 on this blood bank; the highest reduction was observed in HIV serology and the lowest in HBc serology, which became more common in women in the second period. High rates of donor fidelity were observed during the period studied.
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Bancos de Sangre , Donantes de Sangre , Humanos , Donantes de Sangre/estadística & datos numéricos , Brasil/epidemiología , Masculino , Femenino , Estudios Retrospectivos , Adulto , Bancos de Sangre/estadística & datos numéricos , Persona de Mediana Edad , Adulto Joven , Infecciones por VIH/sangre , Infecciones por VIH/diagnóstico , Tamizaje Masivo/métodos , Adolescente , Hepatitis B/sangre , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Virosis/diagnóstico , Virosis/sangre , Hepatitis C/sangre , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Pruebas Serológicas/estadística & datos numéricos , Pruebas Serológicas/métodosRESUMEN
Chronic viral infections caused by the human immunodeficiency virus (HIV), hepatitis C (HCV), and hepatitis B (HBV) are common among patients with end-stage renal disease (ESKD). These infections were once considered contraindications to kidney transplantation due to potential risks associated with long-term immunosuppression. Improved management and antiviral therapies have changed the prognosis and survival of this group of patients, along with an increased experience in transplanting people with these viral infections. We report the first successful kidney transplant in an ESKD patient on hemodialysis with a history of concomitant HIV, HCV and HBV infection in Mexico.
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Infecciones por VIH , Fallo Renal Crónico , Trasplante de Riñón , Humanos , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Fallo Renal Crónico/cirugía , Fallo Renal Crónico/complicaciones , Masculino , Hepatitis B/complicaciones , Hepatitis C/complicaciones , Hepatitis C/tratamiento farmacológico , México , Persona de Mediana Edad , Adulto , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/tratamiento farmacológico , Resultado del Tratamiento , Diálisis RenalRESUMEN
It is critical to address hepatitis C virus (HCV) in carceral settings to achieve worldwide elimination of the virus. We describe New Mexico's (NM) experience expanding HCV treatment in state prisons, supplemented with Project ECHO (ECHO; virtual mentorship through guided practice) and the NM Peer Education Program (NMPEP). We describe how using these programs may be a model for expanding treatment in prisons globally. ECHO, NM Corrections Department (NMCD) and Wexford Health Services (WHS) collaborate to treat HCV in state prisons and increase HCV knowledge among incarcerated persons using NMPEP. Each person arriving in prison is tested for HCV and those with active infection receive baseline labs, which are reviewed. Patients not meeting criteria for simplified treatment are presented to ECHO for expert guidance. Otherwise, patients are treated by WHS without consultation. NMPEP provides patient-to-patient education in prisons, addressing HCV myths and exploring treatment refusals. From December 2020 to June 2023, 3603 people had HCV viremia. In this study, 1685 people started treatment: 1280 were treated using the simplified algorithm and 405 were presented to ECHO. Of the 988 people who completed treatment and had sustained virologic response (SVR) labs drawn, 89.2% achieved SVR (i.e., cure). Most of the 107 people who did not achieve SVR had presumed reinfection. NMPEP trained 148 peer educators who educated 3832 peers about HCV prevention and treatment. HCV treatment in prisons can be expanded by implementing simplified treatment algorithms, use of the ECHO model for patients with advanced disease and peer education.
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Hepatitis C , Prisiones , Humanos , New Mexico , Hepatitis C/tratamiento farmacológico , Grupo Paritario , Prisioneros , Antivirales/uso terapéutico , Masculino , Femenino , Hepacivirus , Educación del Paciente como Asunto/métodosRESUMEN
OBJECTIVE: To estimate the prevalence and factors associated with hepatitis A, B, and C in transgender women and travestis's networks, in 5 regions of Brazil. METHODS: This cross-sectional study includedtransgender women and travestis in five Brazilian capitals (Campo Grande, Manaus, Porto Alegre, Salvador, and São Paulo), between December/2019 and July/2021. All samples were subjected to detection of serological markers of hepatitis virus A (HAV), B (HBV), and C (HCV) infections through rapid tests and chemiluminescent microparticle immunoassays. Positive samples in the screening tests were submitted to detect HBV DNA and HCV-RNA by real-time PCR and genotyped by Sanger sequencing. RESULTS: Analysis of 1,317 samples showed network prevalence rates of 69.1%, 25.1%, and 1.5% for HAV, HBV, and HCV exposure, respectively. A high susceptibility rate to HBV infection (35.7%) and low prevalence of vaccine response markers (40%) were also observed. Age greater than 26 years, self-declared black/brown skin color, having only primary education, history of incarceration, and use of a condom in the last sexual intercourse with a casual partner were associated with total anti-HAV. Exposure to HBV was associated with age greater than 26 years, self-declared black/brown, history of being a sex worker, and incarceration. Age > 37 years, history of sexual abuse, and frequent alcohol consumption were associated with hepatitis C infection. CONCLUSION: The highest prevalence of HAV in this population was found in the North and Northeast regions, and the prevalence found was higher than that in the general population, suggesting greater vulnerability. The prevalence of HCV infection in our study was similar to that observed in the general population.
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Hepatitis A , Hepatitis B , Hepatitis C , Personas Transgénero , Humanos , Brasil/epidemiología , Femenino , Estudios Transversales , Adulto , Prevalencia , Personas Transgénero/estadística & datos numéricos , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Adulto Joven , Masculino , Hepatitis A/epidemiología , Adolescente , Persona de Mediana Edad , Factores de RiesgoRESUMEN
OBJECTIVE: To investigate the prior testing for HIV, syphilis, hepatitis B (HBV), and hepatitis C (HCV) among transgender women and travestis (TGW) in five Brazilian cities and identify factors associated with each of these previous tests. METHODS: This is a cross-sectional study with the recruitment of TGW through respondent-driven sampling (TransOdara Study). The investigated outcome variable was prior testing for HIV, syphilis, HBV, and HCV in the last 12 months. The association between sociodemographic and behavioral factors with the outcome was analyzed using a binomial logistic regression with mixed effects. Adjusted odds ratios (aOR) and 95% confidence intervals (CI95%) were estimated. RESULTS: The proportions of individuals with prior testing in the past year were as follows: 56.3% for HIV, 58.0% for syphilis, 42.1% for HBV, and 44.7% for HCV. Negative associations with prior testing were observed for individuals aged 35 years or older, whereas positive associations were found for those with high school education, those who experienced verbal or psychological violence in the last 12 months, and those who had commercial or casual partners in the last 6 months. CONCLUSION: There was low frequency of testing in the 12 months preceding the study for HIV, syphilis, HBV, and HCV compared to the guidelines established by the Ministry of Health. Expanding access to and engagement with healthcare and prevention services for TGW is an essential strategy in reducing the transmission chain of HIV and other sexually transmitted infections (STIs).
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Infecciones por VIH , Hepatitis B , Hepatitis C , Sífilis , Personas Transgénero , Humanos , Estudios Transversales , Brasil/epidemiología , Personas Transgénero/estadística & datos numéricos , Femenino , Sífilis/diagnóstico , Sífilis/epidemiología , Adulto , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Masculino , Adulto Joven , Adolescente , Persona de Mediana Edad , Factores Socioeconómicos , Factores Sociodemográficos , Factores de RiesgoRESUMEN
The Hepatitis C Virus (HCV), with its diverse genotypes and subtypes, has significantly impacted the health of millions of people worldwide. Analyzing the risk factors is essential to understanding the spread of the disease and developing appropriate prevention strategies. This study aimed to identify risk factors associated with HCV subtype transmission and calculate the emergence time of subtype 1a in Mexico. A cross-sectional study was conducted from January 2014 to December 2018, involving 260 HCV-infected adults. HCV infection was confirmed via Enzyme-Linked Immunosorbent Assay, and viral load was measured by real-time PCR. Genotyping/subtyping tools were the Line Probe Assay and Sanger sequencing of the non-structural region 5B (NS5B). The most frequent HCV subtype was 1a (58.5%), followed by subtypes 1b (19.2%), 3a (13.1%), 2b (5.4%), 2a/2c (2.7%), 2a (0.8%), and 4a (0.4%). Intravenous drug use and tattoos were significant risk factors for subtypes 1a and 3a, while hemodialysis and blood transfusion were linked with subtype 1b. For the evolutionary analysis, 73 high-quality DNA sequences of the HCV subtype 1a NS5B region were used, employing a Bayesian coalescent analysis approach. This analysis suggested that subtype 1a was introduced to Mexico in 1976, followed by a diversification event in the mid-1980s. An exponential increase in cases was observed from 1998 to 2006, stabilizing by 2014. In conclusion, this study found that HCV subtypes follow distinct transmission routes, emphasizing the need for targeted prevention strategies. Additionally, the findings provide valuable insights into the origin of HCV subtype 1a. By analyzing the history, risk factors, and dynamics of the HCV epidemic, we have identified these measures: limiting the harm of intravenous drug trafficking, enhancing medical training and infrastructure, and ensuring universal access to antiviral treatments. The successful implementation of these strategies could lead to an HCV-free future in Mexico.
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Genotipo , Hepacivirus , Hepatitis C , Filogenia , Humanos , México/epidemiología , Hepacivirus/genética , Hepacivirus/clasificación , Factores de Riesgo , Masculino , Femenino , Hepatitis C/epidemiología , Hepatitis C/virología , Hepatitis C/transmisión , Adulto , Estudios Transversales , Persona de Mediana Edad , Evolución Molecular , Carga Viral , Proteínas no Estructurales Virales/genética , Adulto JovenRESUMEN
OBJECTIVE: To estimate the probability of infection with hepatitis B (HBV) and C (HCV) viruses in different socioeconomic strata of the population of Recife, Northeast Brazil. METHODS: Study carried out from samples obtained in a survey of residents of a large urban center that had a population base and stratified sampling with random selection of households using the "Brazil Sample" package in the R software. HBV (HBsAg) and anti-HCV was performed using immunochromatographic tests. In cases positive for HBsAg, anti-HBc and HBeAg were tested using chemiluminescence, as well as HBV-DNA using real-time PCR. For cases positive for anti-HCV, the search for this antibody was repeated by chemiluminescence and for HCV-RNA by real-time PCR. The occurrence of HBsAg and anti-HCV cases in the general population was estimated based on a theoretical negative binomial distribution. RESULTS: Among 2,070 samples examined, 5 (0.24%) were HBsAg and 2 (0.1%) anti-HCV positive. The majority of cases had self-reported skin color as black/brown (6/7), education level up to high school (6/7), a steady partner (5/7) and lived in an area of low socioeconomic status (5/7). CONCLUSION: The occurrence of HBsAg and anti-HCV was lower than those previously found in population-based studies and slightly lower than the most recent estimates. Individuals with lower socioeconomic status should be a priority target of public health policies.
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Hepatitis B , Hepatitis C , Factores Socioeconómicos , Humanos , Brasil/epidemiología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Femenino , Masculino , Adulto , Persona de Mediana Edad , Adolescente , Adulto Joven , NiñoRESUMEN
BACKGROUND: Illicitly manufactured fentanyl (IMF) increases overdose mortality, but its role in infectious disease transmission is unknown. We examined whether IMF use predicts hepatitis C virus (HCV) and human immunodeficiency virus (HIV) incidence among a cohort of people who inject drugs (PWID) in San Diego, California and Tijuana, Mexico. METHODS: PWID were recruited during 2020-2022, undergoing semi-annual interviewer-administered surveys and HIV and HCV serological rapid tests through 2024. Cox regression was conducted to examine predictors of seroconversion considering self-reported IMF use as a 6-month lagged, time-dependent covariate. RESULTS: Of 398 PWID at baseline, 67% resided in San Diego, 70% were male, median age was 43 years, 42% reported receptive needle sharing, and 25% reported using IMF. HCV incidence was 14.26 per 100 person-years (95% confidence interval [CI]: 11.49-17.02), and HIV incidence was 1.29 (95% CI: .49-2.10). IMF was associated with HCV seroconversion, with a univariable hazard ratio (HR) of 1.64 (95% CI: 1.09-2.40), and multivariable HR of 1.57 (95% CI: 1.03-2.40). The direction of the relationship with HIV was similar, albeit not significant (HR 2.39; 95% CI: .66-8.64). CONCLUSIONS: We document a novel association between IMF and HCV seroconversion among PWID in Tijuana-San Diego. Few HIV seroconversions (n = 10) precluded our ability to assess if a similar relationship held for HIV. IMF's short half-life may destabilize PWID-increasing the need for repeat dosing and sharing smoking materials and syringes. New preventive care approaches may reduce HCV transmission in the fentanyl era.
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Fentanilo , Hepatitis C , Seroconversión , Abuso de Sustancias por Vía Intravenosa , Humanos , Masculino , Adulto , Femenino , Hepatitis C/epidemiología , Fentanilo/administración & dosificación , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/epidemiología , California/epidemiología , México/epidemiología , Persona de Mediana Edad , Incidencia , Estudios de Cohortes , Infecciones por VIH/epidemiología , Hepacivirus/inmunología , Drogas IlícitasRESUMEN
Safe injection self-efficacy (SISE) is negatively associated with injection risk behaviors among people who inject drugs (PWID) but has not been examined in differing risk environments. We compared responses to a validated SISE scale between PWID in San Diego, California and Tijuana, Mexico, and examine correlates of SISE among PWID in Tijuana. PWID were recruited via street outreach for a longitudinal cohort study from October 2020-September 2021. We compared SISE scale items by city. Due to low variability in SISE scores among San Diego residents, we restricted analysis of factors associated with SISE to Tijuana residents and identified correlates of SISE score levels (low, medium, high) using ordinal logistic regression. Of 474 participants, most were male (74%), Latinx (78%) and Tijuana residents (73%). Mean age was 44. Mean SISE scores among San Diego residents were high (3.46 of 4 maximum) relative to Tijuana residents (mean: 1.93). Among Tijuana residents, White race and having previously resided in San Diego were associated with higher SISE scores. HCV and HIV seropositivity, homelessness, fentanyl use, polysubstance co-injection, and greater injection frequency were associated with lower SISE scores. We found profound inequalities between Tijuana and San Diego SISE, likely attributable to differential risk environments. Associations with fentanyl and polysubstance co-injection, injection frequency, and both HIV and HCV seropositivity suggest that SISE contribute to blood-borne infection transmission risks in Tijuana. SISE reflects an actionable intervention target to reduce injection risk behaviors, but structural interventions are required to change the risk environment.
RESUMEN: La autoeficacia de inyección segura (SISE, por sus siglas en inglés) se asocia negativamente con conductas de riesgo de inyección entre las personas que se inyectan drogas (PWID, por sus siglas en inglés), pero no se ha examinado en diferentes entornos de riesgo. Comparamos las respuestas a una escala validada de SISE entre PWID en San Diego, California, y Tijuana, México, y examinamos los correlatos de SISE entre PWID en Tijuana. Participantes fueron reclutados por medio de alcance callejero para un estudio de cohorte longitudinal entre octubre 2020 septiembre de 2021. Comparamos los ítems de la escala SISE por ciudad. Debido a la baja variabilidad en los puntajes SISE entre los residentes de San Diego, restringimos el análisis de factores asociados con SISE a los residentes de Tijuana e identificamos factores correlacionados con niveles de SISE (bajo, medio, alto) mediante regresión logística ordinal. De 474 participantes, la mayoría eran hombres (74%), latinx (78%) y residentes de Tijuana (73%). La edad promedio fue de 44 años. Los puntajes medios de SISE entre los residentes de San Diego fueron altos (3.46 de un máximo de 4) en comparación con los residentes de Tijuana (media: 1.93). Entre los residentes de Tijuana, la raza blanca y haber residido previamente en San Diego se asociaron con puntajes más altos de SISE. La seropositividad para HCV y VIH, la falta de vivienda, el uso de fentanilo, la co-inyección de múltiples sustancias y una mayor frecuencia de inyecciónes se asociaron con puntajes más bajos de SISE. Encontramos profundas desigualdades entre SISE en Tijuana y San Diego, probablemente atribuibles a diferentes entornos de riesgo. Las asociaciones con fentanilo y la co-inyección de múltiples sustancias, la frecuencia de inyección y la seropositividad tanto para VIH como para HCV sugieren que SISE contribuye a los riesgos de transmisión de infecciones transmitidas por la sangre en Tijuana. SISE refleja un objetivo de intervención accionable para reducir las conductas de riesgo de inyección, pero se requieren intervenciones estructurales para cambiar el entorno de riesgo.
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Infecciones por VIH , Hepatitis C , Asunción de Riesgos , Autoeficacia , Abuso de Sustancias por Vía Intravenosa , Humanos , Masculino , Abuso de Sustancias por Vía Intravenosa/epidemiología , Abuso de Sustancias por Vía Intravenosa/psicología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Femenino , Adulto , California/epidemiología , México/epidemiología , Hepatitis C/epidemiología , Estudios Longitudinales , Infecciones por VIH/epidemiología , Seropositividad para VIH/epidemiología , Persona de Mediana EdadRESUMEN
INTRODUCTION AND AIM: Timely detection and diagnosis of hepatitis C virus (HCV) involves identifying the population that is predisposed to treatment and prevention, thus limiting complications and preventing infection. The aim of this study was to analyze and describe risk factors associated with anti-HCV antibody detection in a population with access to public healthcare that participated in a national screening program. MATERIAL AND METHODS: An analytic cross-sectional study was conducted that utilized data related to rapid tests carried out between September 2021 and October 2022 in 26 of the 32 states of Mexico. Anti-HCV reactive tests were selected, according to age and sex, for analyzing and comparing possible risk factors through descriptive and inferential statistics. The geographic distribution and density of the screening program at the state and municipal levels was analyzed. RESULTS: There were 75,185 anti-HCV antibody detections, 2,052 reactive tests, and mean participant age was 44.3 years (±15.1). Occupation: 32.3% were employees, 19% were housewives, and 18.2% were healthcare workers. Five out of every 10 cases had no indication of risk factors, but there was a 1.4 and 5-times greater likelihood of anti-HCV detection in men with a history of sharps injury or intravenous psychoactive substance use, compared with women. Regarding place of residence, 80% of the reactive tests were concentrated in the State of Mexico, Mexico City, and Guanajuato. CONCLUSIONS: The evidence herein helps determine the population and risk factors that should be focused on in carrying out the HCV microelimination strategy of continuous screening, diagnosis, medical treatment access, and epidemiologic surveillance.
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Accesibilidad a los Servicios de Salud , Anticuerpos contra la Hepatitis C , Hepatitis C , Humanos , México/epidemiología , Masculino , Femenino , Estudios Transversales , Factores de Riesgo , Adulto , Persona de Mediana Edad , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Anticuerpos contra la Hepatitis C/sangre , Adulto Joven , Anciano , Adolescente , Tamizaje MasivoRESUMEN
INTRODUCTION: The prevalence of hepatitis C (HCV) is high among prisoners. If untreated, a substantial number of patients progress to cirrhosis, hepatocarcinoma, or liver failure. World Health Organization aims to reduce the incidence of infection by 90% by 2030. OBJECTIVE: To describe the prevalence of anti-HCV and sociodemographic and clinical aspects, related to the presence of the antibody, in the population deprived of liberty. METHODS: Cross-sectional and epidemiological survey, with exploratory, observational, quantitative-analytical components. A simple random sample of 233 participants, with 95% Confidence Interval (CI) and, a 4% margin of error, was calculated for a population of 1,564 prisoners. The relationship between sociodemographic and clinical variables was evaluated, considering as outcome of the rapid test for anti-HCV results, using the associative measure Prevalence Ratio (PR) with a 95% CI. RESULTS: 240 people participated. The prevalence of anti-HCV was 2%, and the use of injectable drugs (PR 14.75; PRIC95% 2.09-104.28), being born in the decades of 1951 to 1980 (PR 9.28; PRIC95% 1.06-81.57) and be co-infected with hepatitis B virus (PR 10.75; PRIC95% 1.66-69.65) were the aspects that presented a relevant prevalence ratio for the presence of the virus, which could be generalized to the population. CONCLUSION: This is a population that is difficult to access, the study is relevant because it contributes to preventive measures of public health in the prison system. Moreover, it shows the need to implement measures to prevent and contain the spread of HCV, aiming at the elimination of hepatitis C in this population.
INTRODUÇÃO: A prevalência da hepatite C (HCV) é elevada entre os prisioneiros. Se não tratada, proporção substancial das infecções progride para cirrose, hepatocarcinoma ou insuficiência hepática. Organização Mundial de Saúde tem a meta de reduzir a incidência da infecção em 90% até 2030. OBJETIVO: Descrever a prevalência do anti-HCV e os aspectos sociodemográficos e clínicos, relacionados à presença do anticorpo, na população privada de liberdade. MÉTODOS: Estudo transversal por inquérito epidemiológico, com componente exploratório, observacional, quantitativo-analítico. Foi calculada amostra aleatória simples de 233 pessoas, Intervalo de Confiança (IC) 95%, margem de erro 4% para população de 1564 prisioneiros. Foi avaliada a relação entre os aspectos sociodemográficos e clínicos com o desfecho obtido pelo teste rápido para anti-HCV por meio da medida associativa Razão de Prevalência (RP) e IC de 95% para essa estimativa. RESULTADOS: Participaram 240 pessoas. A prevalência do anti-HCV foi de 2%, sendo que o uso de drogas injetáveis (RP 14,75; RPIC95% 2,09-104,28), ter nascido nas décadas de 1951 a 1980 (RP 9,28; RPIC95% 1,06-81,57) e ser coinfectado com o vírus da hepatite B (RP 10,75; RPIC95% 1,66-69,65) foram os aspectos que apresentaram razão de prevalência para a presença do vírus, passível de generalização para a população. CONCLUSÃO: Trata-se de população de difícil acesso, o estudo é relevante por contribuir para medidas preventivas de saúde pública no sistema prisional. Outrossim, mostra a necessidade de se implementar medidas para evitar e conter a disseminação de HCV, visando a microeliminação da hepatite C na população carcerária.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Prisioneros , Hepatitis C/epidemiología , Anticuerpos contra la Hepatitis C , Factores Sociodemográficos , Estudios Transversales , Factores de Riesgo , Determinantes Sociales de la SaludRESUMEN
Boletim com o objetivo de demonstrar o perfil epidemiológico dos casos que foram notificados entre 2019 a 2023, apresentando os indicadores epidemiológicos e operacionais de relevância do estado, para fins de tomada de decisão em relação às ações do Programa para Eliminação das Hepatites Virais até 2030. Trata-se de uma análise de dados secundários obtidos do Sistema de Informação de Agravos de Notificações (SINAN), referentes aos casos diagnosticados e notificados, por município de residência entre 2019 e 2023 pelos serviços de saúde do Estado de Goiás
Bulletin with the aim of demonstrating the epidemiological profile of cases that were reported between 2019 and 2023, presenting epidemiological and operational indicators of relevance to the state, for decision-making purposes in relation to the actions of the Program for the Elimination of Viral Hepatitis by 2030. This is an analysis of secondary data obtained from the Notifiable Diseases Information System (SINAN), referring to cases diagnosed and notified, by municipality of residence between 2019 and 2023 by the health services of the State of Goiás
Asunto(s)
Humanos , Hepatitis/epidemiología , Hepatitis C/diagnóstico , Hepatitis C/mortalidad , Hepatitis C/epidemiología , Hepatitis B/diagnóstico , Hepatitis B/mortalidad , Hepatitis B/epidemiologíaRESUMEN
This study aims to explore the influence of coinfection with HCV and HIV on hepatic fibrosis. A coculture system was set up to actively replicate both viruses, incorporating CD4 T lymphocytes (Jurkat), hepatic stellate cells (LX-2), and hepatocytes (Huh7.5). LX-2 cells' susceptibility to HIV infection was assessed through measurements of HIV receptor expression, exposure to cell-free virus, and cell-to-cell contact with HIV-infected Jurkat cells. The study evaluated profibrotic parameters, including programed cell death, ROS imbalance, cytokines (IL-6, TGF-ß, and TNF-α), and extracellular matrix components (collagen, α-SMA, and MMP-9). The impact of HCV infection on LX-2/HIV-Jurkat was examined using soluble factors released from HCV-infected hepatocytes. Despite LX-2 cells being nonsusceptible to direct HIV infection, bystander effects were observed, leading to increased oxidative stress and dysregulated profibrotic cytokine release. Coculture with HIV-infected Jurkat cells intensified hepatic fibrosis, redox imbalance, expression of profibrotic cytokines, and extracellular matrix production. Conversely, HCV-infected Huh7.5 cells exhibited elevated profibrotic gene transcriptions but without measurable effects on the LX-2/HIV-Jurkat coculture. This study highlights how HIV-infected lymphocytes worsen hepatic fibrosis during HCV/HIV coinfection. They increase oxidative stress, profibrotic cytokine levels, and extracellular matrix production in hepatic stellate cells through direct contact and soluble factors. These insights offer valuable potential therapies for coinfected individuals.
Asunto(s)
Efecto Espectador , Técnicas de Cocultivo , Coinfección , Citocinas , Infecciones por VIH , Hepacivirus , Células Estrelladas Hepáticas , Hepatitis C , Cirrosis Hepática , Humanos , Células Estrelladas Hepáticas/metabolismo , Infecciones por VIH/complicaciones , Infecciones por VIH/metabolismo , Infecciones por VIH/virología , Infecciones por VIH/inmunología , Hepacivirus/fisiología , Hepatitis C/metabolismo , Hepatitis C/virología , Hepatitis C/complicaciones , Hepatitis C/inmunología , Células Jurkat , Cirrosis Hepática/metabolismo , Cirrosis Hepática/patología , Cirrosis Hepática/virología , Cirrosis Hepática/etiología , Citocinas/metabolismo , Hepatocitos/metabolismo , Hepatocitos/virología , VIH/fisiología , Estrés Oxidativo , Comunicación Celular , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/metabolismo , Matriz Extracelular/metabolismoRESUMEN
Objetivo: Analisar a prevalência de positividade de Anti-HCV e fatores associados em detentos de unidades prisionais do Estado do Piauí, Brasil. Métodos: Estudo epidemiológico, transversal, realizado com 2.131 detentos, em doze unidades prisionais do Piauí. Na estatística inferencial foram aplicados testes de hipóteses, com a utilização de regressão logística. O nível de significância utilizado foi de 5%. Resultados: A prevalência de positividade ao Anti-HCV foi de 0,3% (IC95% = 0,1-0,6). Na análise bivariada observou-se associação entre a hepatite C e as variáveis: cor da pele, idade, anos de estudo, uso de drogas ilícitas, transfusão de sangue antes de 1993, uso de seringa de vidro, relação sexual com pessoas do mesmo sexo, seleção do parceiro de confiança, uso de bebidas alcoólicas antes da relação, sexo vaginal e as informações sobre as formas de transmissão da hepatite C. No modelo multivariado permaneceu associada apenas a variável transfusão de sangue antes de 1993. Conclusão: Os detentos apresentaram comportamentos de risco relacionados à infecção pela hepatite C, entretanto o estudo identificou uma prevalência inferior à estimativa encontrada na população geral e mundial. Faz-se relevante o investimento de ações de educação em saúde no ambiente prisional e o fortalecimento de ações de vigilância em saúde. (AU)
Objective: To analyze the prevalence of anti-HCV positivity and associated factors in inmates of prison units in the State of Piauí, Brazil. Methods: Epidemiological, cross-sectional study carried out with 2,131 inmates in twelve prison units in Piauí. Hypothesis tests were applied in inferential statistics, using logistic regression. The significance level used was 5%. Results: The prevalence of anti-HCV positivity was 0.3% (95%CI = 0.1-0.6). In the bivariate analysis, an association was observed between hepatitis C and the variables: skin color, age, years of education, use of illicit drugs, blood transfusion before 1993, use of glass syringe, same-sex sexual intercourse , selection of the trusted partner, use of alcoholic beverages before intercourse, vaginal sex and information on the forms of transmission of hepatitis C. In the multivariate model, only the variable blood transfusion before 1993 remained associated. Conclusion: The inmates showed risk behaviors related to hepatitis C infection, however the study identified a lower prevalence than the estimate found in the general and world population. It is relevant to invest in health education actions in the prison environment and to strengthen health surveillance actions. (AU)
Objetivo: Analizar la prevalencia de positividad anti-VHC y factores asociados en internos de unidades carcelarias del Estado de Piauí, Brasil. Métodos: Estudio epidemiológico, transversal, realizado con 2.131 internos en doce unidades penitenciarias de Piauí. Se aplicaron pruebas de hipótesis en estadística inferencial, mediante regresión logística. El nivel de significancia utilizado fue del 5%. Resultados: La prevalencia de positividad anti-VHC fue del 0,3% (IC95% = 0,1-0,6). En el análisis bivariado se observó asociación entre la hepatitis C y las variables: color de piel, edad, años de educación, uso de drogas ilícitas, transfusión de sangre antes de 1993, uso de jeringa de vidrio, relaciones sexuales entre personas del mismo sexo, selección de la persona de confianza. pareja, consumo de bebidas alcohólicas antes del coito, sexo vaginal e información sobre las formas de transmisión de la hepatitis C. En el modelo multivariado sólo permaneció asociada la variable transfusión de sangre antes de 1993. Conclusión: Los internos mostraron conductas de riesgo relacionadas con la infección por hepatitis C, sin embargo el estudio identificó una prevalencia menor a la estimada encontrada en la población general y mundial. Es relevante invertir en acciones de educación para la salud en el ámbito penitenciario y fortalecer las acciones de vigilancia de la salud. (AU)
Asunto(s)
Hepatitis C , Prisiones , Enfermería en Salud Pública , Prevalencia , Factores de RiesgoRESUMEN
The local manufacture of advanced pharmaceutical products has been a long-standing objective of health and industry policy in many developing countries, including in Latin America. This strategy has been applied to fight epidemics such as HIV/AIDS, malaria, and the COVID-19 pandemic. However, we still know little about the politics and governance that enable such arrangements, especially when there is no consent from the originator company. This study focuses on the case of Brazil, a country that is well-known for its health-industry policy, which includes the local production of direct-acting antivirals (DAAs), a new treatment for hepatitis C. We seek to explain the factors that have contributed to Brazil's successful production of generic versions of DAAs, and, later, to the decision by the Ministry of Health (MoH) to procure drugs from multinational pharmaceutical companies rather than from local laboratories. A lack of support for domestic production by important stakeholders, the patent holder's attempt to block domestic production and the MoH's adoption of more modern treatment guidelines under a different procurement logic all created an unfavourable environment for local production and procurement of DAAs. Our study draws implications for middle-income countries that wish to produce drugs domestically without voluntary license agreements.
Asunto(s)
Antivirales , Industria Farmacéutica , Hepatitis C , Política , Asociación entre el Sector Público-Privado , Brasil , Humanos , Hepatitis C/tratamiento farmacológico , Antivirales/uso terapéutico , COVID-19/epidemiología , SARS-CoV-2 , Política de SaludRESUMEN
The serological markers for the diagnosis of COVID-19 plays an important role in the epidemiological investigation of the pandemic. This study aims to assess the prevalence of anti-SARS-CoV-2 in hepatitis B and C patients in a pre-vaccination of COVID-19 period. Between March 2020 and January 2021, 199 serum samples from individuals with HBsAg/HBV DNA or anti-HCV/HCV RNA positivity were tested for antibodies (IgM and IgG) against SARS-CoV-2 using Electrochemiluminescent Immunoassay (ECLIA). Among these, 50.3 % (100/199) tested positive for hepatitis C virus infection and 49.7 % (99/199) for hepatitis B virus, confirmed through molecular and serological diagnosis. The anti-SARS-CoV-2 seroprevalence was 24.1 % (48/199) in this population, with 23.23 % (23/99) hepatitis B and 25 % (25/100) hepatitis C patients tested positive for anti-SARS-CoV-2. The higher seroprevalence of anti-SARS-CoV-2 (16.58 %, 33/199) was detected among those over-40 years of age and the month of November 2020 had the highest number of detections 9 % (18/199) with the majority living in impoverished and neglected neighborhoods in the city of Rio de Janeiro. We found a high prevalence of anti-SARS-CoV-2 in patients with viral hepatitis before COVID-19 vaccination. This demonstrates the high exposure of this population during the period of social isolation.
Asunto(s)
Anticuerpos Antivirales , COVID-19 , Hepatitis B , Hepatitis C , SARS-CoV-2 , Humanos , Estudios Seroepidemiológicos , COVID-19/epidemiología , COVID-19/inmunología , COVID-19/prevención & control , Femenino , Masculino , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hepatitis B/inmunología , Adulto , SARS-CoV-2/inmunología , Persona de Mediana Edad , Hepatitis C/epidemiología , Anticuerpos Antivirales/sangre , Brasil/epidemiología , Adulto Joven , Anciano , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , AdolescenteRESUMEN
Hepatitis C virus (HCV) remains a significant global health challenge, affecting millions of people worldwide, with chronic infection a persistent threat. Despite the advent of direct-acting antivirals (DAAs), challenges in diagnosis and treatment remain, compounded by the lack of an effective vaccine. The HCV genome, characterized by high genetic variability, consists of eight distinct genotypes and over ninety subtypes, underscoring the complex dynamics of the virus within infected individuals. This study delves into the intriguing realm of HCV genetic diversity, specifically exploring the phenomenon of mixed infections and the subsequent detection of recombinant forms within the conserved internal ribosome entry site (IRES) region. Previous studies have identified recombination as a rare event in HCV. However, our findings challenge this notion by providing the first evidence of 1a/3a (and vice versa) inter-genotypic recombination within the conserved IRES region. Utilizing advanced sequencing methods, such as deep sequencing and molecular cloning, our study reveals mixed infections involving genotypes 1a and 3a. This comprehensive approach not only confirmed the presence of mixed infections, but also identified the existence of recombinant forms not previously seen in the IRES region. The recombinant sequences, although present as low-frequency variants, open new avenues for understanding HCV evolution and adaptation.