Pathogens

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Dear Colleagues,

The World Health Organization established the Global Health Sector Strategy on Viral Hepatitis in 2016, aiming to reduce liver-related mortality by 65%, increase detection rates to 90%, and reduce new infections to 90% by 2030. To meet these goals, the public health approach to hepatitis must change drastically, giving it a higher priority. Moreover, this strategy addresses all five hepatitis viruses (A, B, C, D, and E), with a focus on chronic hepatitis B and C due to the relative public health burden, in order to reduce viral hepatitis transmission and ensure that everyone living with viral hepatitis has access to safe, affordable, and effective care and treatment. Countries across the world enthusiastically supported this idea to eliminate viral hepatitis. However, it has become evident since its inception that such tactics will be feasible in countries with economic and infrastructural strength in their national healthcare systems, medical societies, and the culture of the people and members of each country’s medical communities. In contrast, the task will be more difficult for countries with poor and middle-income economies.

Latin America comprises 30 countries with approximately 626 million inhabitants, each with a different economy and healthcare infrastructure. The geographic diversity of Latin America, as well as the genetic and social heterogeneity of its native and admixed populations, has resulted in heterogeneity of the profile of viral hepatitis with high, intermediate, and low endemicity for VHB, VHE, and VHA, as well as co-infections with HIV. Studies related to the epidemiology, molecular epidemiology, and degree of viral hepatitis-related liver disease are scarcely documented. Furthermore, an additional problem was the global COVID-19 pandemic, which has delayed this program’s objectives even further.

This Special Issue is aimed at providing selected contributions on the progress of elimination strategies based on the regional characteristics of the host population and the HBV genotypes that circulate in the countries of Latin America. Potential topics include, but are not limited to, the following:

Current state of the strategies for elimination of viral hepatitis in countries of Latin America.
New epidemiological studies of viral hepatitis, either local, regional, or national.
Qualitative or quantitative analysis related to establishing elimination strategies involving health authorities, civilians, and medical communities.
Financial and pharmacoeconomic analysis related to antiviral treatments.
The needs and recommendations for future basic and clinical research in hepatitis viruses in Latin America.
Studies examining the clinical aspects of managing HBV infection and its natural history based on the host and virus genetics among Latin American populations.
The role of medical societies and the medical community in eliminating viral hepatitis.
The role of government and civil society in elimination programs.
Strategies or experiences in training or awareness campaigns of viral hepatitis among doctors, specialists, and society.
Access to treatment and coverage of vaccination schemes.

Dr. Arturo Panduro
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

viral hepatitis
genotypes
HAV
HBV
HCV
HDV
HEV
molecular epidemiology
incidence
prevalence
elimination strategies
training
awareness campaigns
healthcare policies
vaccination

Published Papers (2 papers)

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Research

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18 pages, 3165 KiB

Open AccessArticle

Epidemiology of Hepatitis C Virus in HIV Patients from West Mexico: Implications for Controlling and Preventing Viral Hepatitis

by Alexis Jose-Abrego, Maria E. Trujillo-Trujillo, Saul Laguna-Meraz, Sonia Roman and Arturo Panduro

Pathogens 2024, 13(5), 360; https://doi.org/10.3390/pathogens13050360 - 27 Apr 2024

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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. Full article

(This article belongs to the Special Issue Elimination Strategies for Viral Hepatitis in Latin America)

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12 pages, 688 KiB

Open AccessReview

Chronic Hepatitis C Virus Infection, Extrahepatic Disease and the Impact of New Direct-Acting Antivirals

by Nahum Méndez-Sánchez, Carlos E. Coronel-Castillo and Mariana Michelle Ramírez-Mejía

Pathogens 2024, 13(4), 339; https://doi.org/10.3390/pathogens13040339 - 19 Apr 2024

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Abstract

Chronic hepatitis C virus infection is an important cause of liver cirrhosis, hepatocellular carcinoma and death. Furthermore, it is estimated that about 40–70% of patients develop non-hepatic alterations in the course of chronic infection. Such manifestations can be immune-related conditions, lymphoproliferative disorders and metabolic alterations with serious adverse events in the short and long term. The introduction of new Direct-Acting Antivirals has shown promising results, with current evidence indicating an improvement and remission of these conditions after a sustained virological response. Full article

(This article belongs to the Special Issue Elimination Strategies for Viral Hepatitis in Latin America)

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