The incidence of the infection by the viruses of the human immunodeficiency (HIV), hepatitis B (HBV) and hepatitis C (HCV) has diminished enormously in developed countries during the last 20 years; nevertheless, in our country we do not know such an incidence and, therefore, the safety of our blood supply.
We performed a retrospective analysis at the Centro Nacional de la Transfusión Sanguínea (CNTS) assessing 17,176,298 serologic tests including HIV, HCV and HBV carried on 5,725,432 blood units collected and informed to the CNTS from January 1999 to December 2003 by all the Mexican blood banks. Prevalence, incidence and residual risk of each one of the aforementioned serologic markers were calculated.
The five years mean prevalence for HIV, HBV and HCV has remained steady. The residual risk (RR) when hemagglutination test was employed was 1:977 for HCV; 1:1,564 for HBV and 1:1,262 for HIV. Whereas the RR when ELISA was performed decreased to 1:2,781 for HCV; 1:3,185 for HBV and 1:9,969 for HIV. If nucleic acid amplification test were employed, RR would be 1:8,170 for HBV; 1:9,915 for HCV and 1:19,939 for HIV.
The theoretical risk for transfusion-transmitted diseases in our country is still worrisome.
[Show abstract][Hide abstract] ABSTRACT: Chronic hepatitis C (CHC) is the second cause of endstage liver disease in our country and one of the main indications of liver transplantation. Hepatitis C virus (HCV) genotype is the principal prognostic factor and the determinant of the therapeutic scheme. In our country few data exist regarding the prevalence of HCV infection and genotype distribution in the Mexican Republic has not been determined. The aim of this study was to characterize the prevalence of the different HCV genotypes and to explore their geographical distribution.
Mexican patients with hepatitis C infection, detected throughout the country between 2003 and 2006, were included. All samples were analyzed by a central laboratory and Hepatitis C genotype was identified by Line Immuno Probe Assay in PCR positive samples (Versant Line Probe Assay Quest Diagnostics Nichols Institute, San Juan Capistrano CA). Data were analyzed according to the four geographical areas in Mexico.
One thousand three hundred and ninety CHC patients were included. The most frequent genotype detected was genotype 1 (69%) followed by genotype 2 (21.4%) and genotype 3 (9.2%). Genotype 4 and 5 were infrequent. There was no subject infected with genotype 6. Genotype 1 and 2 exhibit very similar distribution in all geographical areas. Genotype 3 infected patients were more frequent in the North region (52%) compared with other areas:center-western (30%), center (17%), South-South east (1%) (p < 0.001).
The most prevalent HCV genotype in Mexico is genotype 1. Geographical distribution of HCV genotypes in the four geographical areas in Mexico is not homogenous with a greater frequency of genotype3 in the north region. This difference could be related to the global changes of risk factors for HCV infection.
Annals of hepatology: official journal of the Mexican Association of Hepatology 01/2007; 6(3):156-60. · 2.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To make a preliminary determination of hepatitis C virus (HCV) genotype prevalence and possible genotype associations with risk factors and severity of associated liver disease in patients from Yucatan, Mexico.
Sera from 54 patients with positive anti-HCV and HCV RNA were genotyped using reverse transcription-polymerase chain reaction. Risk factors were evaluated using a questionnaire. The evaluations also included serum ALT levels and liver biopsies in some participants.
HCV genotype 1 was detected in 37%, genotype 2 in 33.3%, genotype 3 in 16.7% and mixed genotypes in 7.4%. Subtype 2b was the most frequent (33.3%), followed by 1b (18.5%), 3a (16.7%) and 1a (14.8%). Surgeries (53.7%) and transfusion (38.9%) were the main risk factors. Liver biopsies were available in 24 (44.4%) patients. Severe liver disease was present in 6 (54.5%) of the patients with genotype 1 and in none of those with genotype 2. A statistically significant association was observed between patients with a family history of liver disease and genotype 2 (P = 0.021). Liver damage severity increased with longer duration of infection (P = 0.007). No statistically significant association was observed between severe liver damage and the different genotypes.
Subtype 2b was the most prevalent. This contrasts with the studies done in different states of Mexico in that this subtype was not identified or had prevalence approximately 2 times less than reported here.
Annals of hepatology: official journal of the Mexican Association of Hepatology 10/2008; 7(4):345-9. · 2.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To address the relationship between hepatitis B virus (HBV) endemicity and HBV-related liver diseases in Mexico. Research literature reporting on HBsAg and antibody to hepatitis B core antigen (anti-HBc) prevalence in Mexican study groups were searched in NLM Gateway, PubMed, IMBIOMED, and others. Weighted mean prevalence (WMP) was calculated from the results of each study group. A total of 50 studies were analyzed. Three nationwide surveys revealed an HBsAg seroprevalence of less than 0.3%. Horizontal transmission of HBV infection occurred mainly by sexual activity and exposure to both contaminated surgical equipment and body fluids. High-risk groups exposed to these factors included healthcare workers, pregnant women, female sex workers, hemodialysis patients, and emergency department attendees with an HBsAg WMP ranging from 1.05% (95% confidence interval [CI], 0.68-1.43) to 14.3% (95% CI, 9.5-19.1). A higher prevalence of anti-HBc in adults than those younger than 20 years was associated with the main risk factors. Anti-HBc WMP ranged from 3.13% (95% CI, 3.01-3.24) in blood donors to 27.7% (95% CI, 21.6-33.9) in hemodialysis patients. A heterogeneous distribution of HBV infection was detected, mainly in native Mexican groups with a high anti-HBc WMP of 42.0% (95% CI, 39.5-44.3) but with a low HBsAg WMP of 2.9% (95% CI 2.08-3.75). Estimations of the Mexican population growth rate and main risk factors suggest that HBsAg seroprevalence has remained steady since 1974. A low HBsAg prevalence is related to the low incidence of HBV-related liver cirrhosis and hepatocellular carcinoma (HCC) previously reported in Mexico.
Hepatology International 07/2009; 3(2):343-55. DOI:10.1007/s12072-008-9115-9 · 1.78 Impact Factor
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