Hepatitis C in key populations in Latin America and the Caribbean: systematic review and meta-analysis

Abstract

ObjectivesSummarize hepatitis C virus (HCV) prevalence in injecting (IDU) and non-injecting drug users (NIDU), men who have sex with men (MSM), sex workers, and prison inmates in Latin America and the Caribbean (LAC).MethodsSystematic review on HCV prevalence in sub-populations in LAC. Databases searched from 1-1-2000 to 10-30-2013. Inclusion criteria: prevalence studies in sub-populations in LAC. HCV-antibody was marker for prevalence of current/past HCV infection and HCV-RNA for prevalence of HCV current infection.ResultsIDU HCV current/past infection presented highest prevalence, from 1.7 % in Colombia to over 95 % in Ciudad Juarez and Tijuana, Mexico and pooled regional anti-HCV prevalence was 49 % (CI 95 % 22.6–76.3 %). NIDU, MSM and sex workers anti-HCV prevalence was below 10 %, and pooled regional prevalence of 4 % (CI 95 % 2.6–4.5 %), 3 % (CI 95 % 1.7–4.5 %) and 2 % (CI 95 % 1.0–3.4 %), respectively. Prison inmates presented higher values, but prevalence decreased over the 15-year time span (p < 0.001). Current HCV infection from three countries showed prevalence under 10 % in prison inmates and 1–46 % among drug users.ConclusionsDisease burden is high and surveillance, prevention and treatment should target these groups in LAC.Electronic supplementary materialThe online version of this article (doi:10.1007/s00038-015-0708-5) contains supplementary material, which is available to authorized users.

Who to test and how to test for chronic hepatitis C infection – 2016 WHO testing guidance for low- and middle-income countries

“…HCV prevalence is nearly universally high among PWID (ranging from 30% to 75% in cohorts in North America, Europe, and Asia [35], and in many high-income countries, active injecting drug use drives ongoing HCV transmission. MSMs (especially those who are HIV infected [36], commercial sex workers and prisoners related to both drug use and perhaps sexual transmission) [37,38], also have increased prevalence.…”

“…WHO recommended the use of two main potential testing approaches for HCV infection: focused testing in most affected populations; and birth cohort testing, based on consideration of limited evidence including various systematic reviews on seroprevalence rates in different populations and regions [35][36][37][38][39][40], and a review of costeffectiveness studies of different HCV testing approaches [39,, as well as of programmatic feasibility from reported experience in countries using these approaches [34].…”

“…Table 3. Different types of HCV epidemic patterns [18,34] with corresponding testing approaches and service delivery models [35][36][37][38].…”

Emergence of New Epidemiological Hepatitis B and C Profiles in High Risk Groups in Latin America

“…Studies conducted in alcohol abusers found 5.6% of anti-HCV in Southeast Brazil [37] and 15% in Southern Brazil [43] what could reflect the diminish in anti-HCV prevalence in this group. The pooled value for HCV prevalence in NIDU was 3.6% (95% CI 2.6-4.5%) [38].…”

“…In Northern Brazil, HBV prevalence (anti-HBc positivity) was 36.7% in ISU, genotypes A, D and F were found and risk factors were: (i) male gender, (ii) age above 35 years, (iii) anti-HIV positivity, (iv) tattoos, (v) the use of injected drugs, (vi) the use of illicit drugs for more than 3 years, (vii) sexual relations without protection, (viii) sexual relations with another DU, and (ix) more than 10 sexual partners in the past 24 months [29]. [38]. Anti-HCV prevalence in ISU was below 7% in the majority of studies included in this review, but anti-HCV rates from 30 to 67% were found in ISU in Argentina and Brazil [39][40][41].…”