Oxford Outcomes Ltd., Canada.
Ann Hepatol. 2012 Sep-Oct;11(5):623-35.
Chronic infection with hepatitis C virus (HCV) is a major and growing public health concern worldwide, including in Latin America. With more efficacious therapies becoming available, decision-makers will require accurate estimates of disease prevalence to assess the potential impact of new treatments. However, few estimates of the epidemiologic burden, either overall or by country, are available for Latin America; and the potential impact of currently-available treatments on the epidemiologic burden of HCV in Latin America has not been assessed. To address this, we systematically reviewed twenty-five articles presenting population-based estimates of HCV prevalence from general population or blood donor samples, and supplemen- ted those with publically-available data, to estimate the total number of persons infected with HCV in Latin America at 7.8 million (2010). Of these, over 4.6 million would be expected to have genotype 1 chronic HCV, based on published data on the risk of progression to chronic disease and the HCV genotype distribution of Latin America. Finally, we calculated that between 1.6 and 2.3 million persons with genotype 1 chronic HCV would potentially benefit from current treatments, based on published estimates of genotype-specific treatment responsiveness. In conclusion, these estimates demonstrate the substantial present epidemiologic burden of HCV, and quantify the impending societal and clinical burden from untreated HCV in Latin America.
慢性丙型肝炎病毒（HCV）感染是全球范围内一个日益严重的重大公共卫生问题，包括拉丁美洲。随着更有效的治疗方法的出现，决策者将需要准确估计疾病的流行率，以评估新治疗方法的潜在影响。然而，拉丁美洲提供的关于疾病负担的总体或国家估计数很少；并且目前可用的治疗方法对拉丁美洲 HCV 疾病负担的潜在影响尚未得到评估。为了解决这个问题，我们系统地回顾了二十五篇文章，这些文章提供了来自一般人群或献血者样本的 HCV 流行率的基于人群的估计数，并补充了可公开获得的数据，以估计拉丁美洲感染 HCV 的总人数为 780 万人（2010 年）。其中，根据已发表的关于进展为慢性疾病的风险和拉丁美洲 HCV 基因型分布的数据，预计超过 460 万人将患有基因型 1 慢性 HCV。最后，我们根据已发表的基因型特异性治疗反应估计数计算出，拉丁美洲有 160 万至 230 万人可能从目前的治疗方法中受益。总之，这些估计数表明 HCV 的目前疾病负担很大，并量化了拉丁美洲未治疗 HCV 的即将出现的社会和临床负担。
