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Pathogens
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Elimination Strategies for Viral Hepatitis in Latin America
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Elimination Strategies for Viral Hepatitis in Latin America

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Viral Pathogens".

Deadline for manuscript submissions: 31 March 2025 | Viewed by 7030

Special Issue Editor

Dr. Arturo Panduro

E-Mail Website
Guest Editor
Department of Genomic Medicine in Hepatology, Health Sciences Center, University of Guadalajara, Guadalajara 44100, Mexico
Interests: viral hepatitis

Special Issue Information

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

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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 2200 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

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Published Papers (6 papers)

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Research

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13 pages, 293 KiB  
Article
Viral Hepatitis in Pregnant Mexican Women: Its Impact in Mother–Child Binomial Health and the Strategies for Its Eradication
by Carmen Selene García-Romero, Carolina Guzmán, Alejandra Martínez-Ibarra, Alicia Cervantes and Marco Cerbón
Pathogens 2024, 13(8), 651; https://doi.org/10.3390/pathogens13080651 - 2 Aug 2024
Cited by 1 | Viewed by 988
Abstract
Viral hepatitis is the main cause of infectious liver disease. During pregnancy, a risk of vertical transmission exists both during gestation and at birth. HAV, HBV, and HCV might progress similarly in pregnant and non-pregnant women. In this study, we found a prevalence [...] Read more.
Viral hepatitis is the main cause of infectious liver disease. During pregnancy, a risk of vertical transmission exists both during gestation and at birth. HAV, HBV, and HCV might progress similarly in pregnant and non-pregnant women. In this study, we found a prevalence of 0.22% of viral hepatitis in pregnant women, with a light preponderance of HCV over HAV and HBV. Here, it was observed that acute HAV infection is more symptomatic and has higher risks for the mother and fetus, in a similar manner to what has been reported for HEV. Histopathological alterations were observed in all except one placenta, indicating that it is an important tissue barrier. Regarding the Mexican strategies for viral hepatitis eradication, success may be related to vaccination at birth, whereas for HCV, the national program for eradication is aimed at treating the infection via direct-acting antiviral agents. The HBV strategy has positively impacted pregnant women and their children, diminishing the risk of vertical transmission. The HCV strategy is still in its early years, and it is expected to be just as successful. For acute hepatitis, HAV and HEV, programs promoting hand washing and those aimed at providing clean food and water are applicable as preventive strategies, alongside other programs such as vaccination. Full article
(This article belongs to the Special Issue Elimination Strategies for Viral Hepatitis in Latin America)
10 pages, 745 KiB  
Article
Hepatitis E Virus Genotype 3 among Hemodialysis Patients in Mexico: First Identification of Chronic Infection
by Edgar D. Copado-Villagrana, Ilsy X. Duarte-López, Arturo Calderón-Flores, Isidro Loera-Robles, Oliver Viera-Segura and Nora A. Fierro
Pathogens 2024, 13(7), 578; https://doi.org/10.3390/pathogens13070578 - 11 Jul 2024
Cited by 1 | Viewed by 789
Abstract
The global distribution of hepatitis E virus (HEV) is attributed to its capacity to spread through several routes of transmission; hemodialysis has gained increased amounts of attention in recent years. Although Mexico is considered a hyperendemic region for hepatitis E, no HEV surveillance [...] Read more.
The global distribution of hepatitis E virus (HEV) is attributed to its capacity to spread through several routes of transmission; hemodialysis has gained increased amounts of attention in recent years. Although Mexico is considered a hyperendemic region for hepatitis E, no HEV surveillance is performed in the country. The frequency of HEV in hemodialysis (HD) patients has not been determined. Herein, we conducted a cross-sectional single-center analytical study including 67 serum samples from HD patients. Anti-HEV IgG and IgM antibodies and the viral genome were determined; partial regions within the HEV genome were sequenced for further phylogenetic analysis. Globally, 14.9% of the tested patients exhibited reactivity for IgG antibodies against HEV, and none showed reactivity to IgM. A total of 5.9% of the samples showed HEV genome amplification, and sequencing confirmed the identity of genotype 3; subsequent analysis of positive cases revealed two acute cases and chronic hepatitis E infection in one patient. Notably, the chronic patient was negative for anti-HEV IgG antibodies. Our findings highlight the importance of viral genome testing in HD patients and the need to establish guidelines for HEV detection in Mexico. Full article
(This article belongs to the Special Issue Elimination Strategies for Viral Hepatitis in Latin America)
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18 pages, 3165 KiB  
Article
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
Cited by 1 | Viewed by 1471
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 [...] Read more.
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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Review

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13 pages, 644 KiB  
Review
Occult Hepatitis B Virus Infection in Hepatic Diseases and Its Significance for the WHO’s Elimination Plan of Viral Hepatitis
by Leticia Bucio-Ortiz, Karina Enriquez-Navarro, Angélica Maldonado-Rodríguez, Jesús Miguel Torres-Flores, Ana María Cevallos, Mauricio Salcedo and Rosalia Lira
Pathogens 2024, 13(8), 662; https://doi.org/10.3390/pathogens13080662 - 6 Aug 2024
Viewed by 966
Abstract
Liver damage can progress through different stages, resulting in cirrhosis or hepatocellular carcinoma (HCC), conditions that are often associated with viral infections. Globally, 42% and 21% of cirrhosis cases correlate with HBV and HCV, respectively. In the Americas, the prevalence ranges from 1% [...] Read more.
Liver damage can progress through different stages, resulting in cirrhosis or hepatocellular carcinoma (HCC), conditions that are often associated with viral infections. Globally, 42% and 21% of cirrhosis cases correlate with HBV and HCV, respectively. In the Americas, the prevalence ranges from 1% to 44%. The WHO has the goal to eliminate viral hepatitis, but it is important to consider occult HBV infection (OBI), a clinical condition characterized by the presence of HBV genomes despite negative surface antigen tests. This review aims to provide an overview of recent data on OBI, focusing on its role in the development of hepatic diseases and its significance in the WHO Viral Hepatitis Elimination Plan. Specific HBV gene mutations have been linked to HCC and other liver diseases. Factors related to the interactions between OBI and mutated viral proteins, which induce endoplasmic reticulum stress and oxidative DNA damage, and the potential role of HBV integration sites (such as the TERT promoter) have been identified in HCC/OBI patients. Health initiatives for OBI research in Latin American countries are crucial to achieving the WHO’s goal of eradicating viral hepatitis by 2030, given the difficulty in diagnosing OBI and its unclear association with hepatic diseases. 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  
Review
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
Cited by 1 | Viewed by 1404
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 [...] Read more.
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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Other

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18 pages, 938 KiB  
Perspective
Advances in the Elimination of Viral Hepatitis in Mexico: A Local Perspective on the Global Initiative
by Gerardo Santos-López, Arturo Panduro, Francisca Sosa-Jurado, Nora A. Fierro, Rosalía Lira, Luis Márquez-Domínguez, Marco Cerbón, Nahum Méndez-Sánchez and Sonia Roman
Pathogens 2024, 13(10), 859; https://doi.org/10.3390/pathogens13100859 - 1 Oct 2024
Viewed by 857
Abstract
Viral hepatitis (A–E) presents a major global health challenge. In 2015, the World Health Organization (WHO) launched an initiative to eliminate viral hepatitis, with the aim of reducing new infections by 90% and deaths by 65% by 2030. Mexico is one of 38 [...] Read more.
Viral hepatitis (A–E) presents a major global health challenge. In 2015, the World Health Organization (WHO) launched an initiative to eliminate viral hepatitis, with the aim of reducing new infections by 90% and deaths by 65% by 2030. Mexico is one of 38 focus countries identified by the WHO, collectively accounting for 80% of global infections and deaths. While hepatitis B and C are commonly diagnosed in Mexico, routine diagnosis for hepatitis D and E is lacking, with no specific epidemiological data available. In 2020, Mexico implemented the National Hepatitis C Elimination Program, focusing on preventing new infections, reducing complications like cirrhosis and hepatocellular carcinoma, ensuring access to treatment, and improving patient care. However, this program has not been extended to hepatitis B and E. Addressing the challenges of viral hepatitis control in Mexico requires increased resource allocation, expanded diagnosis, vaccination for hepatitis A and B, and treatment coverage for hepatitis B and C, along with multisectoral engagement. This work provides an overview of Mexico’s response to the global initiative, highlighting its progress, challenges, and areas of opportunity. Full article
(This article belongs to the Special Issue Elimination Strategies for Viral Hepatitis in Latin America)
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