Review article
Epidemiology of Hepatitis Virus B and C

https://doi.org/10.1016/j.arcmed.2007.03.001Get rights and content

Hepatitis B and C virus infections constitute a significant health problem in Latin America. Approximately 400,000 new cases of hepatitis B per year and 10 million people infected with hepatitis C are estimated to occur. HBV and HCV genotype distribution may reflect the different patterns of migration to the Americas: Genotype F and H of HBV correspond to the Amerindian genotype. Overall, Genotype 1 is the most prevalent HCV genotype in the Caribbean and in South and Central America. Hepatitis B and C epidemiology needs to be considered in the context of dissimilar social and economic aspects among the countries of the region. Behaviors, cultural and ethical aspects, as well as environmental and organizational processes affect directly the way these diseases are approached in their diagnosis, treatment and prevention.

Introduction

Globalization is radically changing the way transmissable viral diseases shape their epidemiology. Hepatitis B and C represent a global health problem with a wide spectrum of clinical manifestations. Immigrants from different countries endemic for chronic hepatitis constitute a significant source of worldwide infection in Latin America. Hepatitis B and C epidemiology needs to be considered in the context of dissimilar social and economic aspects among the countries of the region. Behaviors, cultural and ethical aspects, as well as environmental and organizational processes affect directly the way these diseases are approached in their diagnosis, treatment, and prevention.

Section snippets

Epidemiology

Hepatitis B is one of the most common infections worldwide. It is considered that there are approximately 400 million hepatitis B carriers (1). Every year, approximately one million people die of HBV infection, 33% caused by hepatocellular carcinoma and the rest with terminal complications of liver disease (2). It is estimated that approximately 400,000 new cases occur in Latin America each year (3). Data to estimate the frequency of hepatitis B in the region vary whether the results come from

Epidemiology

It is estimated that, worldwide, the number of people with positive hepatitis C antibody is 170 million, with a prevalence of 3%. Considering that approximately 75% have a chronic disease, there would be 127 million people with the disease; therefore, a general prevalence may be 2.2%. It is probable that approximately 10 million cases occur in Latin America 38, 39.

Most of the European countries, America, and Southeast Asia have a prevalence <2.5%. In the Western Pacific region the frequency is

Genotypes of HCV in the Latin American Region

In a comprehensive review, Cristina has recently summarized the situation in Latin America regarding the six major genetic groups (64). Overall, genotype 1 is the most prevalent genotype in the Caribbean and in South and Central America 65, 66. Difference in genotype distribution can be observed in a number of countries of the region as well as in different areas between a given nation 66, 67, 68. Particularly important differences can be observed among HCV strains isolated in the Caribbean

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