Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
Laboratory of Clinical Pathology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico.
Ann Hepatol. 2022 Jan;27 Suppl 1:100579. doi: 10.1016/j.aohep.2021.100579. Epub 2021 Nov 15.
Viral hepatitis is a global health problem with unequal distribution of disease burden in which low-income people are at higher risk for acquisition and underlying liver diseases. This study aimed to seek the prevalence of hepatitis B and C viruses, HIV, and liver damage among low-income patients attending a public tertiary care hospital in West Mexico.
A retrospective/cross-sectional study at the Department of Genomic Medicine in Hepatology was conducted between March 1, 2016 to March 30, 2017. A total of 10,352 patients tested for anti-HCV, HBsAg, or anti-HIV (n=23,074) were included. Age, gender, and hospital service were registered. Liver fibrosis was assessed using APRI and FIB-4 scores.
Overall, 3.9% were anti-HCV+ (305/7848), 1.0% were HBsAg+ (80/7894), and 2.9% were anti-HIV+ (210/7332). A 43.8% (750/1959) of patients negative for all viruses had either abnormal AST, ALT, or GGT (≥40 UI/L). Also, significant liver fibrosis (APRI ≥ 0.7) was prevalent in 10.6% (191/1804). In patients who tested positive for viral infections, liver fibrosis was detected in 20.4% (11/54) of HBsAg+, 34.2% (53/155) in anti-HCV+ and 15.5% (16/103) in anti-HIV+. Anti-HCV+ was highest in Geriatrics (11.1%), HBsAg+ in HIV patients (3.0%) and anti-HIV+ in Emergency room attendees (33.3%).
High seroprevalence of HCV, HBV, and HIV infections was found among the studied population. Significant liver fibrosis was detected in negative and positive patients for viral infections. Medical services need to continuously test for viral infections, promote early detection of chronic liver damage and identify target patients for elimination strategies to decrease disease burden.
病毒性肝炎是一个全球性的健康问题，疾病负担在不同人群中的分布不均，低收入人群感染和潜在肝脏疾病的风险更高。本研究旨在调查墨西哥西部一家公立三级保健医院的低收入患者中乙型肝炎和丙型肝炎病毒、艾滋病毒以及肝损伤的流行情况。
2016 年 3 月 1 日至 2017 年 3 月 30 日，在肝病基因组医学科进行了回顾性/横断面研究。共纳入了 10352 例接受抗 HCV、HBsAg 或抗 HIV 检测的患者（n=23074）。记录了年龄、性别和医院服务情况。使用 APRI 和 FIB-4 评分评估肝纤维化。
总体而言，抗 HCV+的患者占 3.9%（305/7848），HBsAg+的患者占 1.0%（80/7894），抗 HIV+的患者占 2.9%（210/7332）。43.8%（750/1959）的所有病毒均为阴性的患者的 AST、ALT 或 GGT（≥40 UI/L）异常。此外，显著的肝纤维化（APRI≥0.7）在 10.6%（191/1804）的患者中较为常见。在病毒感染检测呈阳性的患者中，HBsAg+患者的肝纤维化检出率为 20.4%（11/54），抗 HCV+患者为 34.2%（53/155），抗 HIV+患者为 15.5%（16/103）。抗 HCV+在老年科（11.1%）中最高，HBsAg+在 HIV 患者中（3.0%），抗 HIV+在急诊科就诊患者中（33.3%）最高。
在所研究的人群中，HCV、HBV 和 HIV 感染的血清阳性率很高。在病毒感染阴性和阳性患者中均发现了显著的肝纤维化。医疗服务需要不断检测病毒感染，促进慢性肝损伤的早期发现，并确定消除策略的目标患者，以减轻疾病负担。
