How are HCV-infected patients being identified in Brazil: a multicenter study

Portari-Filho, Luiz H.; Álvares‐da‐Silva, Mário Reis; Gonzalez, A.C.; Ferreira, Adalgisa P.; Villela-Nogueira, Cristiane Alves; Mendes-Corrêa, Maria Cássia; Lima, João L. M. P. de; Lopes, Edmundo Pessoa; Brandão, Carlos Eduardo; Ivantes, Cláudia; Lyra, André Castro; Lindenberg, Andreia; Ferraz, Maria Lúcia Cardoso Gomes

doi:10.1016/j.bjid.2019.01.006

Cited by 4 publications

(8 citation statements)

References 11 publications

(10 reference statements)

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“…The most common genotypes in the present study were genotypes 1 (1a and 1b), 3, and 2, similar to those reported in several previous studies in Brazil, including a multicenter evaluation [13,[38][39][40][41].…”

Section: Discussionsupporting

confidence: 90%

“…A recent Brazilian study demonstrated that among 2000 HCV-infected patients in Brazil, 31.3% had cirrhosis, of which 29.1% of cases were F0/F1, 19.1% were F2, and 18.6% were F3. Most of them were evaluated by liver biopsy (61.5%), followed by liver elastography (24.5%) and clinical diagnosis of cirrhosis (13.9%) [37,38]. Another Brazilian study reported that hepatic fibrosis increased with advancing age [37].…”

Section: Discussionmentioning

confidence: 99%

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Hepatitis C screening, diagnosis, and cascade of care among people aged > 40 years in Brasilia, Brazil

et al. 2020

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Background: Identifying patients with hepatitis C virus (HCV) infection and enhancing the cascade of care are essential for eliminating HCV infection. This study aimed to estimate the prevalence of positive anti-HCV serology in Brasilia, Brazil, and evaluate the efficiency of the cascade of care for HCV-positive individuals.Methods: This cross-sectional study analyzed 57,697 rapid screening tests for hepatitis C in individuals aged > 40 years between June 2018 and June 2019. HCV-positive patients were contacted and scheduled to undergo the HCV RNA viral test, genotyping, and transient elastography.Results: The prevalence of positive serology was 0.27%. Among 161 patients with positive anti-HCV serology, 124 (77%) were contacted, 109 (67.7%) were tested for HCV RNA viral load, and 69 (42.8%) had positive results. Genotype 1 (75%) was the most prevalent genotype. Among 65 patients (94.2%) who underwent transient elastography, 30 (46.2%) presented with advanced fibrosis. Additionally, of the 161 patients, 55 (34.1%) were referred for treatment, but only 39 (24.2%) complied, with 36 (22.4%) showing sustained virological response. By the end of the study, 16 patients were still awaiting to receive medication. Conclusions:The prevalence of HCV-positive patients was low in Brasilia, and the gaps in the cascade of care for these patients were significantly below the targets of HCV infection elimination. This study opens new avenues for eliminating HCV infection and suggests that partnerships with clinical laboratories to conduct anti-HCV tests are a useful strategy to improve HCV diagnosis.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Hepatitis C screening, diagnosis, and cascade of care among people aged > 40 years in Brasilia, Brazil

et al. 2020

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“…Entre os indivíduos em tratamento para hepatite C, a maior prevalência é de homens, maiores de 55 anos, brancos, casados e de baixa escolaridade, como já demonstrado em outros estudos 10,11,12 . O perfil genotípico viral 1b foi predominante.…”

Section: Discussionunclassified

“…O perfil genotípico viral 1b foi predominante. Em geral, os genótipos 1, 2, e 3 têm ampla distribuição mundial e parecem ser predominantes no Brasil 11 .…”

Section: Discussionunclassified

“…De acordo com a Organização Mundial de Saúde (OMS), aproximadamente 1% da população mundial está infectada pelo vírus de hepatite C. No caso do Brasil, ele é considerado um país que possui endemicidade intermediária, com taxas de prevalência variando entre 1,4 a 2,5% conforme regiões 11,13 . Valores estes que também se enquadram na realidade encontrada na América Latina (1,4%).…”

Section: Discussionunclassified

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Efeito dos Antivirais de Ação Direta nos parâmetros bioquímicos da Síndrome Metabólica em pessoas com hepatite C

et al. 2021

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Na fase crônica da hepatite C pode ocorrer manifestações extra-hepáticas, como doenças cardiometabólicas, que estão entre as principais causas de morte por doenças crônicas não transmissíveis no mundo. Objetivo: Avaliar a prevalência de Síndrome Metabólica (SM) e as características de uma coorte de pacientes com hepatite C de Uruguaiana/RS e prever o efeito dos Antivirais de Ação Direta nos parâmetros bioquímicos da SM. Métodos: Trata-se de um estudo de Coorte Retrospectiva, em que as variáveis sociodemográficas, antropométricas, pressóricas e bioquímicas foram coletadas a partir de prontuários. Foi utilizado os critérios da International Diabetes Federation para a classificação da SM. A análise estatística envolveu os testes de Kolmogorov-Smirnov, teste t de Student e qui-quadrado de Pearson, regressão logística binária. Resultados: Foi possível verificar alta prevalência de SM na maioria dos pacientes e traçar um perfil dos indivíduos. O tratamento composto por Sofosbuvir e Daclatasvir não influenciou na glicemia e HDL-c, mas apresentou menores chances de hipertrigliceridemia após o tratamento. Considerações finais: Os resultados demonstram relevância e permitem criar metas eficazes de cuidado aos pacientes com hepatite C e comorbidades. O desenvolvimento de ações de prevenção, planejamento e estratégias econômicas influenciam positivamente no bem-estar dos pacientes e na alocação de recursos públicos, reduzindo os custos com essas doenças.

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Simultaneous determination of HCV genotype and NS5B resistance associated substitutions using dried serum spots from São Paulo state, Brazil

Adeboyejo

Grosche

José

et al. 2022

Access Microbiology

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Hepatitis C virus (HCV) is responsible for more than 180 million infections worldwide, and about 80 % of infections are reported in Low and Middle-income countries (LMICs). Therapy is based on the administration of interferon (INF), ribavirin (RBV) or more recently Direct-Acting Antivirals (DAAs). However, amino acid substitutions associated with resistance (RAS) have been extensively described and can contribute to treatment failure, and diagnosis of RAS requires considerable infrastructure, not always locally available. Dried serum spots (DSS) sampling is an alternative specimen collection method, which embeds drops of serum onto filter paper to be transported by posting to a centralized laboratory. Here, we assessed feasibility of genotypic analysis of HCV from DSS in a cohort of 80 patients from São Paulo state Brazil. HCV RNA was detected on DSS specimens in 83 % of samples of HCV infected patients. HCV genotypes 1a, 1b, 2a, 2c and 3a were determined using the sequence of the palm domain of NS5B region, and RAS C316N/Y, Q309R and V321I were identified in HCV 1b samples. Concerning therapy outcome, 75 % of the patients who used INF +RBV as a previous protocol of treatment did not respond to DAAs, and 25 % were end-of-treatment responders. It suggests that therapy with INF plus RBV may contribute for non-response to a second therapeutic protocol with DAAs. One patient that presented RAS (V321I) was classified as non-responder, and combination of RAS C316N and Q309R does not necessarily imply in resistance to treatment in this cohort of patients. Data presented herein highlights the relevance of studying circulating variants for a better understanding of HCV variability and resistance to the therapy. Furthermore, the feasibility of carrying out genotyping and RAS phenotyping analysis by using DSS card for the potential of informing future treatment interventions could be relevant to overcome the limitations of processing samples in several location worldwide, especially in LMICs.

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How are HCV-infected patients being identified in Brazil: a multicenter study

Cited by 4 publications

References 11 publications

Hepatitis C screening, diagnosis, and cascade of care among people aged > 40 years in Brasilia, Brazil

Hepatitis C screening, diagnosis, and cascade of care among people aged > 40 years in Brasilia, Brazil

Efeito dos Antivirais de Ação Direta nos parâmetros bioquímicos da Síndrome Metabólica em pessoas com hepatite C

Simultaneous determination of HCV genotype and NS5B resistance associated substitutions using dried serum spots from São Paulo state, Brazil

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