Hepatitis C: evaluation of outcomes and georeferencing of cases in Santa Cruz do Sul, Brazil, between 2002 and 2015. A cross-sectional study
Keywords:
Hepatitis C, Genotype, Prevalence, DeathAbstract
BACKGROUND: Hepatitis C virus infection is one of the main causes of chronic liver disease, with high death rates. The aim here was to analyze case outcomes, sociodemographic and clinical characteristics and spatial distribution among patients diagnosed with hepatitis C in the city of Santa Cruz do Sul (RS), Brazil. DESIGN AND SETTING: Cross-sectional study on 200 cases of hepatitis C in Santa Cruz do Sul that were notified between 2002 and 2015. METHODS: Secondary data including sociodemographic and clinical variables and type of outcome (death, follow-up, abandonment or clinical cure) were gathered. The spatial distribution analysis on hepatitis C virus cases according to outcome was based on information regarding residential address. RESULTS: 58.5% of the patients were 41 years of age and over, 67% were males and 92.5% had the chronic form of the disease. The most frequent transmission route was illicit drug injection (29%); 15.1% of the patients presented coinfection with the human immunodeficiency virus (HIV). Regarding outcomes, 31% achieved clinical cure, 10% died and 20% abandoned follow-up. The cases studied were mainly located in regions of the city characterized by lower socioeconomic status, with high frequency of places used for drug trafficking. CONCLUSION: The population consisted of adults aged 41 years and over, mostly with chronic hepatitis C. The most common transmission routes were illicit drug injection and blood transfusions. There were high rates of HIV coinfection and abandonment of disease monitoring and predominance of cases in neighborhoods with low socioeconomic status.
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Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Ministério da Saúde. Hepatites Virais. Boletim epidemiológico. 2017;48(24). Available from: Available from: http://www.aids.gov.br/system/tdf/pub/2017/64626/boletim_hepatites_virais2017_pdf_25238.pdf?file=1&type=node&id=64626&force=1 Accessed in 2017 (Sep 27).
Mandell G, Bennett J, Dolin R. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Philadelphia: Elsevier; 2010.
World Health Organization. Hepatitis C. Fact sheet No. 164. Available from: Available from: http://www.who.int/mediacentre/factsheets/fs164_apr2014/en/ Accessed in 2017 (Sep 27).
Lingala S, Ghany MG. Natural History of Hepatitis C. Gastroenterol Clin North Am. 2015;44(4):717-34.
World Health Organization. Global hepatitis report, 2017. Geneva: World Health Organization; 2017. Available from: Available from: http://apps.who.int/iris/bitstream/10665/255016/1/9789241565455-eng.pdf?ua=1 Accessed in 2017 (Sep 27).
Jesus-Nunes AP, Moreira TM, Morais-de-Jesus M, Araujo-de-Freitas L, Quarantini LC. Brazilian manicure: a potential dangerous behavior. Braz J Infect Dis. 2016;20(1):109-10.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Ministério da Saúde. Protocolo clínico e diretrizes terapêuticas para hepatite C e coinfecções. Brasília: Ministério da Saúde; 2015. Available from: Available from: http://bvsms.saude.gov.br/bvs/publicacoes/protocolo_clinico_diretrizes_hepatite_co_coinfeccoes.pdf Accessed in 2017 (Sep 27).
Silva GF, Nishimura NF, Coelho KI, Soares EC. Grading and staging of chronic hepatitis C and its relation to genotypes and epidemiological factors in Brazilian blood donors. Braz J Infect Dis. 2005;9(2):142-9.
Lefton HB, Rosa A, Cohen M. Diagnosis and epidemiology of cirrhosis. Med Clin North Am. 2009;93(4):787-99.
Enel C, Minello A, Jooste V, Pinoit JM, Hillon P. [In chronic hepatitis C, delays between diagnosis and treatment are linked to the doctor-patient relationship]. Med Sci (Paris). 2009;25(5):519-23.
Taherkhani R, Farshadpour F. Epidemiology of hepatitis C virus in Iran. World J Gastroenterol. 2015;21(38):10790-810.
Brasil. Instituto Brasileiro de Geografia e Estatística (IBGE). Censo 2015. Rio Grande do Sul - Santa Cruz do Sul. Available from: Available from: http://cidades.ibge.gov.br/xtras/temas.php?lang=&codmun=431680&idtema=16&search=rio-grande-do-sul|santa-cruz-do-sul|sintese-das-informacoes Accessed in 2017 (Sep 27).
Costi C, Grandi T, Halon ML, et al. Prevalence of hepatitis C virus and human immunodeficiency virus in a group of patients newly diagnosed with active tuberculosis in Porto Alegre, Southern Brazil. Mem Inst Oswaldo Cruz. 2017;112(4):255-9.
Margreiter S, Ferreira JM, Vieira IL, et al. Estudo de prevalência das hepatites virais B e C no Município de Palhoça - SC. Revista de Saúde Pública Santa Catarina. 2015;8(2):21-32. Available from: Available from: http://esp.saude.sc.gov.br/sistemas/revista/index.php/inicio/article/view/297/308 Accessed in 2017 (Sep 27).
Macedo FRM, Terra FS, Santos SVM, Miranda RPR. Perfil sociodemográfico e epidemiológico de candidatos de a doação de sangue [Sociodemographic and epidemiologic profile of candidates for blood donation]. Arquivos de Ciências da Saúde. 2015;22(4):87-91. Available from: Available from: http://www.cienciasdasaude.famerp.br/index.php/racs/article/view/313/140 Accessed in 2017 (Sep 27).
Tizzot MR, Grisbach C, Beltrame MH, Messias-Reason IJT. Soroprevalência de marcadores do vírus da hepatite C (HCV) em pacientes infectados com HIV de Curitiba e Região Metropolitana [Seroprevalence of HCV markers among HIV infected patients from Curitiba and metropolitan region]. Rev Assoc Med Bras (1992). 2016;62(1):65-71.
Rosa F, Carneiro M, Duro LN, et al. Prevalência de anti-HCV em uma população privada de liberdade [Prevalence of anti-HCV in an inmate population]. Rev Assoc Med Bras (1992). 2012;58(5):557-60.
van de Laar TJ, Matthews GV, Prins M, Danta M. Acute hepatitis C in HIV-infected men who have sex with men: an emerging sexually transmitted infection. AIDS. 2010;24(12):1799-812.
Tengan FM, Ibrahim KY, Dantas BP, et al. Seroprevalence of hepatitis C virus among people living with HIV/AIDS in Latin America and the Caribbean: a systematic review. BMC Infect Dis. 2016;16(1):663.
Platt L, Easterbrook P, Gower E, et al. Prevalence and burden of HCV co-infection in people living with HIV: a global systematic review and meta-analysis. Lancet Infect Dis. 2016;16(7):797-808.
European Association for Study of Liver. EASL Recommendations on Treatment of Hepatitis C 2015. J Hepatol. 2015;63(1):199-236.
Mohd Hanafiah KM, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatology. 2013;57(4):1333-42.
Stanaway JD, Flaxman AD, Naghavi M, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet. 2016;388(10049):1081-8.
Oliveira CV, Barbosa WF, Silveira LVA, et al. Prevalência do vírus da hepatite C em funcionários universitários do Estado de São Paulo, Brasil: fatores preditivos e análise espacial por geoprocessamento [Prevalence of the hepatitis C virus among university employees in São Paulo, southeastern Brazil: predictive factors and geoprocessing spatial analysis]. Arq Gastroenterol. 2015;52(1):9-13.
Sulkowski MS, Cooper C, Hunyady B, et al. Management of adverse effects of Peg-IFN and ribavirin therapy for hepatitis C. Nat Rev Gastroenterol Hepatol. 2011;8(4):212-23.
World Health Organization. Guidelines for the Screening, Care and Treatment of Persons with Hepatitis C Infection. Geneva: World Health Organization ; 2014. Available from: Available from: http://apps.who.int/iris/bitstream/10665/111747/1/9789241548755_eng.pdf?ua=1&ua=1 Accessed in 2017 (Sep 27).
Sun X, Patnode CD, Williams C, et al. Interventions to Improve Patient Adherence to Hepatitis C Treatment: Comparative Effectiveness. Rockville: Agency for Healthcare Research and Quality (US); 2012.
Kubota K, Campos MSA, Pereira LRL. Análise da assistência à saúde aos pacientes com hepatites virais B e C no estado do Amapá. Revista de Ciências Farmacêuticas Básica e Aplicada. 2014;35(4):597-605. Available from: Available from: http://serv-bib.fcfar.unesp.br/seer/index.php/Cien_Farm/article/viewFile/3199/3199 Accessed in 2017 (Sep. 27).
Petruzziello A, Marigliano S, Loquercio G, Cozzolino A, Cacciapuoti C. Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016;22(34):7824-40.
Silva CMD, Costi C, Krug LP, et al. High proportion of hepatitis C virus genotypes 1 and 3 in a large cohort of patients from Southern Brazil. Mem Inst Oswaldo Cruz. 2007;102(7):867-70.
World Health Organization. Combating hepatitis B and C to reach elimination by 2030. Geneva: World Health Organization ; 2016. Available from: Available from: http://apps.who.int/iris/bitstream/10665/206453/1/WHO_HIV_2016.04_eng.pdf?ua=1 Accessed in 2017 (Sep 27).