Hepatitis C in Laos: A 7-Year Retrospective Study on 1765 Patients

Abstract

Hepatitis C virus (HCV) is a global health concern, notably in Southeast Asia, and in Laos the presentation of the HCV-induced liver disease is poorly known. Our objective was thus to describe a comprehensive HCV infection pattern in order to guide national health policies. A study on a group of 1765 patients formerly diagnosed by rapid test in health centres was conducted at the Centre of Infectiology Lao Christophe Merieux in Vientiane. The demographic information of patients, their infection status (viral load: VL), liver function (aminotransferases) and treatments were analysed. Results showed that gender distribution of infected people was balanced; with median ages of 53.8 for men and 51.6 years for women (13-86 years). The majority of patients (72%) were confirmed positive (VL > 50 IU/mL) and 28% of them had high VL (> 6log). About 23% of patients had level of aminotransferases indicative of liver damage (> 40 IU/mL); but less than 20% of patients received treatment. Patients rarely received a second sampling or medical imaging. The survey also showed that cycloferon, pegylated interferon and ribavirin were the drugs prescribed preferentially by the medical staff, without following any international recommendations schemes. In conclusion, we recommend that a population screening policy and better management of patients should be urgently implemented in the country, respecting official guidelines. However, the cost of biological analysis and treatment are significant barriers that must be removed. Public health resolutions should be immediately enforced in the perspective of meeting the WHO HCV elimination deadline by 2030.

The Threat of Multiple Liver Carcinogens in the Population of Laos: A Review

“…Among the patients, 10.6% had both a high level of HBV DNA over 10,000 IU/mL and elevated aminotransferases. However, only 2.4% of them received treatment for chronic hepatitis [10,11].…”

“…More recently, a retrospective study conducted on 1765 HCV-infected patients showed that, in Vientiane, 28% had high viral loads (>6log10). About 23% of patients had levels of aminotransferases indicative of liver damage >40 IU/mL, but less than 20% of them received antiviral drugs [10,11]. In Laos, circulating strains overwhelmingly belong to genotype 6 >95%, the Southeast Asian version of HCV, with frequent viral isolates specific to the local population [18][19][20].…”

“…Altogether, for both HBV and HCV, the medical literature describing disease presentation in Laos is scarce, while references describing the roles of the viruses in terminal diseases such as liver cirrhosis or PLC are non-existent [10,11].…”

Hepatitis C Virus NS2 Protein Suppresses RNA Interference in Cells

“…HCV infection causes acute and chronic hepatitis in humans with a high propensity for chronicity. A large number of HCV-infected patients fail to clear this virus and remain asymptomatic for years to develop severe liver diseases such as cirrhosis and hepatocellular carcinoma (Paboriboune et al 2018). The capability of establishing chronic infection by HCV is partly due to its ability to evade host innate immune responses (Horner and Gale 2013).…”