A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management

Vorobioff, Julio; Contreras, F.; Tanno, Federico; Hernández, Lucía; Bessone, Fernando; Colombato, Luis; Adi, José; Fassio, E; Felgueres, Mirta; Fernández, Guillermo; Gaite, Luis; Gibelli, Diana; Darrichon, Hernán Gómez; Lafage, Matías; Lombardo, Daniel J.; López, Susana; Alejandro, Mateo; Mendizábal, Manuel; Pecoraro, Julieta; Ruf, Andrés E.; Ruiz, Pablo; Severini, Javier Martín; Stieben, Teodoro E.; Sixto, Marcela; Zárate, Fabián; Barraza, Sergio de la Barra; Sierra, Irene Donoso; Rivas, Violeta; Roblero, Juan Pablo; Rojas, Juan O.; González, Patricio Ruiz; Rodríguez, Diego San Martín; Sierralta, Armando; Manchego, Álvaro Urzúa; Valdés, Eliana; Yaquich, Pamela; Wolff, Rodrigo; Valdivia, Flor Beltran; Gallegos, Roxana C.; Galloso, Rocío; Marcelo, Julio Santiago; Montes, Pedro; Tenorio, Laura; Veramendi, Isabel; Alava, Elizabeth; Armijos, Ximena; Benalcazar, Gonzalo; Carrera, Enrique; Pazmiño, Galo; Diaz, Eduardo M.; Garassini, M; Marrero, Rosalía P.; Infante, Mirta; Suárez, Dayron Paez; Gutierrez, José; Reyes, Carmen María; Serrano, Yoel Mario Ricardo; Hernández, Rivardo Hernández; Martínez, Orelvis Martínez; González, Teresita Pérez; Andara, Maria Teresa; Hernández, Marco Sánchez; Gerona, Solange; García, Iván; Tijera, Fátima de la; López, Edmundo Pessoa; Torres, Kenia Urra; Garzón, Martín

doi:10.1016/j.aohep.2020.03.007

Cited by 8 publications

(3 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Access to advanced treatments is a particular issue for liver disease care. Recent progress in HCC and viral hepatitis care may not be available to a significant proportion of patients who live in deprived or rural areas [74,75]. For example, in the GIDEON study, fewer patients with HCC from Latin America received TACE before sorafenib initiation versus the global cohort [75,76].…”

Section: Socioeconomic Differences Healthcare Access and Treatments A...mentioning

confidence: 99%

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Díaz

Ayares

Arnold

et al. 2022

Curr Treat Options Gastro

View full text Add to dashboard Cite

Purpose of review To assess the current challenges regarding liver diseases, including the burden of disease, access to care, screening, and treatment needs in Latin America. Recent findings Latin America is a region with a rich multicultural heritage and important socioeconomic differences. The burden of liver diseases is high and mainly determined by a high level of alcohol intake and the surge of risk factors associated with NAFLD (i.e., sedentary lifestyles, broader access to highly processed foods, obesity, and type 2 diabetes mellitus). Hepatotropic viruses also play a role in the development of chronic liver diseases, although their comparative frequency has been decreasing over the last decades. There are important disparities in access to screening and treatment for liver diseases in Latin America, which are reflected in low accessLiver (E Tapper, Section Editor) to critical treatments such as direct-acting antiviral agents and drugs to treat hepatocellular carcinoma. Also, important barriers to liver transplantation are present in multiple countries, including a low deceased donors' rate and a lack of availability in several countries (especially in Central America). Our region also has disadvantages in research and education in liver diseases, which limits regional academic development and improvement in quality of care of liver diseases. Summary In order to tackle an increasing health burden due to liver diseases, Latin America urgently needs tailored interventions aiming to control the main risk factors for these disorders through the establishment of effective public health policies. Also, development of liver transplantation programs and improvement of medical education and research capabilities as well as extensive collaboration between all stakeholders are keys to address the liver disease agenda in the region. AbbreviationsACLF Acute-on-chronic liver failure ALD Alcohol-associated liver disease ALF Acute liver failure AUD Alcohol use disorder DALYs Disability-adjusted life-years DILI Drug-induced liver injury GDP Gross domestic product HBV Hepatitis B virus HCV Hepatitis C virus HDV Hepatitis delta virus HCC Hepatocellular carcinoma LT Liver transplantation MAFLD Metabolic dysfunction-associated fatty liver disease NAFLD Non-alcoholic fatty liver disease NASH Non-alcoholic steatohepatitis PHP Public health policies PNPLA3 Patatin-like phospholipase domain-containing 3 US United States USD United States Dollars WHO World Health Organization * Updated to 2019 + Updated to 2020 Country Population in 2019 GDP + Gini index* Life expectancy from birth (years)* Deceased donors' rate* DDLT rate* LDLT rate* Argentina 44,938,712

show abstract

Section: Socioeconomic Differences Healthcare Access and Treatments A...mentioning

confidence: 99%

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Díaz

Ayares

Arnold

et al. 2022

Curr Treat Options Gastro

View full text Add to dashboard Cite

show abstract

“…These units were predominantly referral centers in urban regions. 29 As such, even countries with high LT rates, such as Brazil and Argentina, might not be able to provide follow-up care for citizens living in rural or marginalized areas after LT. 30 Post-LT patients are a complex group that requires close monitorization, and access to adequate healthcare facilities is essential. Immunosuppressants place these patients at risk for opportunistic infections and drug-associated toxicity, particularly early after transplant.…”

Section: Challenges Of Liver Transplantation In Latin American Countriesmentioning

confidence: 99%

Liver transplantation in Latin America: reality and challenges

Aguirre-Villarreal,

Servin-Rojas,

Sánchez-Cedillo

et al. 2023

The Lancet Regional Health - Americas

View full text Add to dashboard Cite

“…Results from a multicenter survey of hospitalized patients with cirrhosis from Latin America showed that NASH was among the most prevalent conditions associated with end-stage liver disease, accounting for 23% of cases. [54] A large observational study (n = 708) conducted in 14 regional hospitals from Argentina showed that NAFLD was present in 11.4% of the HCC cases with underlying cirrhosis and 10.1% of the HCC cases in patients without cirrhosis. In this hospital-based series of patients, the proportion of patients with and without cirrhosis accounted for 87.4% (n = 619) and 12.6% (n = 89), respectively.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Geographical similarity and differences in the burden and genetic predisposition of NAFLD

et al. 2022

View full text Add to dashboard Cite

NAFLD has become a major public health problem for more than 2 decades with a growing prevalence in parallel with the epidemic of obesity and type 2 diabetes (T2D). The disease burden of NAFLD differs across geographical regions and ethnicities. Variations in prevalence of metabolic diseases, extent of urban–rural divide, dietary habits, lifestyles, and the prevalence of NAFLD risk and protective alleles can contribute to such differences. The rise in NAFLD has led to a remarkable increase in the number of cases of cirrhosis, hepatocellular carcinoma, hepatic decompensation, and liver‐related mortality related to NAFLD. Moreover, NAFLD is associated with multiple extrahepatic manifestations. Most of them are risk factors for the progression of liver fibrosis and thus worsen the prognosis of NAFLD. All these comorbidities and complications affect the quality of life in subjects with NAFLD. Given the huge and growing size of the population with NAFLD, it is expected that patients, healthcare systems, and the economy will suffer from the ongoing burden related to NAFLD. In this review, we examine the disease burden of NAFLD across geographical areas and ethnicities, together with the distribution of some well‐known genetic variants for NAFLD. We also describe some special populations including patients with T2D, lean patients, the pediatric population, and patients with concomitant liver diseases. We discuss extrahepatic outcomes, patient‐reported outcomes, and economic burden related to NAFLD.

show abstract

A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management

Cited by 8 publications

References 44 publications

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Liver transplantation in Latin America: reality and challenges

Geographical similarity and differences in the burden and genetic predisposition of NAFLD

Contact Info

Product

Resources

About