Chronic Hepatitis C: An Overview of Evidence on Epidemiology and Management from a Brazilian Perspective

Castro, Rodolfo; Perazzo, Hugo; Grinsztejn, Beatriz; Veloso, Valdiléa G.; Hyde, Chris

doi:10.1155/2015/852968

Cited by 11 publications

(13 citation statements)

References 100 publications

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“…Nucleos(t)ide analogues (NUCs) are available for chronic hepatitis B treatment since 2009. In addition, hepatitis C has been considered as a public health issue by Brazilian health authorities [ 36 ]. Despite the absence of a vaccine, point-of-care tests have been used for screening [ 37 ] and non-invasive tests have been available for fibrosis staging in Brazilian citizens living with chronic hepatitis C [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Age-standardized mortality rates related to viral hepatitis in Brazil

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Age-standardized mortality rates related to viral hepatitis in Brazil

et al. 2017

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“…This is partly explained by the scarcity of specialist centers compared with the societal needs. Of those who are diagnosed, only 60% receive specialized treatment[ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C

Paranaguá‐Vezozzo

Andrade

Mazo

et al. 2017

WJH

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AIMTo determine the sensitivity and specificity of liver stiffness measurement (LSM) and serum markers (SM) for liver fibrosis evaluation in chronic hepatitis C.METHODSBetween 2012 and 2014, 81 consecutive hepatitis C virus (HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography (TE) [FibroScan®/ARFI technology (Virtual Touch®)] and SM [FIB-4/aspartate aminotransferase-to-platelet ratio index (APRI)]. The diagnostic performance of these tests was assessed using receiver operating characteristic curves. The optimal cut-off levels of each test were chosen to define fibrosis stages F ≥ 2, F ≥ 3 and F = 4. The Kappa index set the concordance analysis.RESULTSFifty point six percent were female and the median age was 51 years (30-78). Fifty-six patients (70%) were treatment-naïve. The optimal cut-off values for predicting F ≥ 2 stage fibrosis assessed by TE were 6.6 kPa, for acoustic radiation force impulse (ARFI) 1.22 m/s, for APRI 0.75 and for FIB-4 1.47. For F ≥ 3 TE was 8.9 kPa, ARFI was 1.48 m/s, APRI was 0.75, and FIB-4 was 2. For F = 4, TE was 12.2 kPa, ARFI was 1.77 m/s, APRI was 1.46, and FIB-4 was 3.91. The APRI could not distinguish between F2 and F3, P = 0.92. The negative predictive value for F = 4 for TE and ARFI was 100%. Kappa index values for F ≥ 3 METAVIR score for TE, ARFI and FIB-4 were 0.687, 0.606 and 0.654, respectively. This demonstrates strong concordance between all three screening methods, and moderate to strong concordance between them and APRI (Kappa index = 0.507).CONCLUSIONGiven the costs and accessibility of LSM methods, and the similarity with the outcomes of SM, we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis. This is of particular importance to developing countries.

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“…In Brazil, treatments for hepatitis B and C have been provided since 2002 and are guided by protocols that have been modified and updated over the years and establish the criteria for diagnosis, the treatment flow chart with the respective doses and mechanisms for clinical monitoring of the disease (Brasil, 2017). Access to chronic hepatitis C treatment is covered by the public health system, but by 2017 current treatment was only offered to patients with more advanced disease, with total treatment being one of the main barriers to access (Castro et al, 2015;Brasil, 2017). Intense negotiations with the pharmaceutical industry allowed the expansion of access to treatment for all those infected, as it was considered that the high burden of accumulated comorbidities and the development of cirrhosis and hepatocellular carcinoma would have a high future impact on the health system (Mesquita et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Liver diseases affect the lives of millions of people in the world, leading to a lower quality of life and productivity (Malekzadeh et al, 2015;Peery et al, 2015;Sepanlou et al, 2015;Nader et al, 2014). It is estimated that 2% to 3% of the world's population is infected with the hepatitis C virus and that 60% to 79% of the patients will develop chronic liver disease requiring specialized and highly complex health care (Polaris, 2017;Petruzziello et al, 2016;Castro et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Hospital expenses and liver disease in Brazil

Schwambach¹,

Becker²,

Paz³

et al. 2020

JBES

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Objective: This study aims at describing the values and morbimortality of hospital admissions for liver disease in the Brazilian public health system. Methods: The study was carried out in the DATASUS, for a period of five years. The number, causes, time, mortality rate and values of hospitalizations in the period were investigated. Results: In five years, there were 67,561,584 hospitalizations, of which 461,431 were due to liver diseases. The value of hospitalizations in the period was US$ 23 billion, and liver diseases accounted for US$ 384 million, which corresponds to 76 million per year. In liver diseases, the mean length of hospital stay was 8 days whereas for other hospitalizations the mean time was 5 days. The mortality rate from liver diseases was 14% while the general mortality rate was 4%. The average cost of hospitalizations was US$ 531 for liver diseases and US$ 84 for other causes of hospitalization. Conclusion: In the Brazilian public health system, liver diseases have a higher average value, a longer average hospital stay, and a higher mortality rate when compared to all causes of hospitalization. RESUMO Objetivo: Este estudo tem como objetivo descrever os valores e a morbimortalidade das internações por doenças hepáticas no sistema público de saúde brasileiro. Métodos: O estudo foi realizado no Sistema de Informações Hospitalares do Datasus, por um período de cinco anos. Foram investigados o número, as causas, o tempo, a taxa de mortalidade e os valores das internações no período. Resultados: Em cinco anos houve 67.561.584 internações, das quais 461.431 foram por hepatopatias. O valor das internações no período foi de US$ 23 bilhões, e as doenças do fígado representaram US$ 384 milhões, o que corresponde a 76 milhões por ano. Nas hepatopatias, o tempo médio de internação hospitalar foi de 8 dias, enquanto para outras internações o tempo médio foi de 5 dias. A taxa de mortalidade por doenças do fígado foi de 14%, enquanto a taxa geral de mortalidade foi de 4,0%. O custo médio das hospitalizações foi de US$ 531 para doenças do fígado, enquanto para outras causas de hospitalização foi de US$ 84. Conclusão: No sistema público de saúde brasileiro, as hepatopatias têm maior valor médio, maior tempo de internação e maior mortalidade quando comparadas a todas as causas de internação. Hospital expenses and liver disease in Brazil Gastos hospitalares e doença hepática no Brasil

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Chronic Hepatitis C: An Overview of Evidence on Epidemiology and Management from a Brazilian Perspective

Cited by 11 publications

References 100 publications

Age-standardized mortality rates related to viral hepatitis in Brazil

Age-standardized mortality rates related to viral hepatitis in Brazil

Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C

Hospital expenses and liver disease in Brazil

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