medigraphic.com
ISSN 1729-519X (Print)

2020, Number 1

<< Back Next >>

Revista Habanera de Ciencias Médicas 2020; 19 (1)

Chronic hepatitis B virus infection. Institute of Gastroenterology, Havana, Cuba; 2016-2018

Castellanos FMI, Teixeira BEM, La Rosa HD, Dorta GZ, Rodríguez PC, Vega SH

Language: Spanish
References: 19
Page: 48-62
PDF size: 676.51 Kb.


ABSTRACT

Introduction: The effectiveness of the national immunization program has impacted on the reduction of the incidence of hepatitis B virus (HBV) infection in Cuba; however, the number of chronically infected patients is not negligible. These patients are diagnosed in the clinical practice, although the epidemiological studies that indicate the presence of the disease are insufficient.
Objective: To describe the main clinical, biomolecular and immunological characteristics of patients with chronic hepatitis B virus infection treated at the National Institute of Gastroenterology, Havana, Cuba.
Materials and methods: A total of 97 patients who had at least a 6-month history of chronic HBV infection were recruited at the above mentioned institution from January 2016 to January 2018. Descriptive statistical analyzes were performed to identify the clinical characteristics. Biochemical and virological studies, analysis of both liver stiffness values measured by transient elastography and use of antiviral therapy were also carried out.
Results: All patients completed the follow-up. It was observed that 61,9 % of them were male and the median (range) age was 46 (18-84) years. The mean time since the diagnosis of the infection was 11.7 ± 8,9 years. Inactive disease without liver fibrosis or light fibrosis was present in 61,9 %. Only 2 % were negative for hepatitis B surface antigen with quantitative analysis of HBV DNA; also, 81,4 % of patients had detectable viral load and 85,5 % received one or more antiviral treatments, mainly nucleotide analogues.
Conclusions: The patients with chronic HBV infection studied are mostly in the inactive phase of their disease, without significant evidence of liver damage and detectable levels of viremia. All of them have received some antiviral treatment.


REFERENCES

  1. Locarnini S, Hatzakis A, Chen D-S, Lok A. Strategies to control hepatitis B: Public policy, epidemiology, vaccine and drugs. Journal of Hepatology [Internet]. 2015 [citado 04/06/2019]; 62(1):[S76-S86 pp.]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/259200 93.

  2. Loureiro CL, Aguilar JC, Aguiar J, Muzio V, Pentón E, Garcia D, et al. HBV Genotypic variability in Cuba. PloS one [Internet]. 2015 [citado 04/06/2019]; 10(3). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C4351247/.

  3. World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection Geneva [Internet]. Geneva: World Health Organization; 2015. [citado 04/06/2019]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK30555 3/.

  4. MINSAP. Anuario Estadistico de Salud 2017 [internet] La Habana: MINSAP; 2019 [citado 04/06/2019]. Disponible en: http://www.sld.cu/sitios/dne/.

  5. Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology [Internet]. 2018 [citado 04/06/2019]; 67(4):[1560-99 pp.]. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/2940532 9.

  6. Gordillo Hernández A. Marcadores serológicos de infección por el virus de la hepatitis B en estudiantes de la Escuela Latinoamericana de Medicina. Revista Archivo Médico de Camagüey [Internet]. 2018 [citado 04/06/2019]; 22:694-707. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext &pid=S1025-02552018000500694&nrm=iso.

  7. Sanchez Onoro M, Lopez MJ, Santana MA, Andes JM, Campelo FA. Primary antiretroviral drug resistance among patients diagnosed with HIV infection in Gran Canaria (Spain) between 2002 and 2005. Enfermedades infecciosas y microbiologia clinica [Internet]. 2007 [citado 04/06/2019]; 25(7):437-40. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/1769221 1.

  8. Marcellin P, Ziol M, Bedossa P, Douvin C, Poupon R, de Ledinghen V, et al. Non-invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B. Liver international : official journal of the International Association for the Study of the Liver [Internet]. 2009 [citado 04/06/2019]; 29(2):242-7. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/1863706 4.

  9. Cardoso AC, Carvalho-Filho RJ, Stern C, Dipumpo A, Giuily N, Ripault MP, et al. Direct comparison of diagnostic performance of transient elastography in patients with chronic hepatitis B and chronic hepatitis C. Liver international : official journal of the International Association for the Study of the Liver [Internet]. 2012 [citado 04/06/2019]; 32(4):612-21. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/2210376 5.

  10. Liver EAFTSOT. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. Journal of hepatology [Internet]. 2012 [citado 04/06/2019]; 57(1):167-85. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/224368 45.

  11. Tapper EB, Lok AS. Use of liver imaging and biopsy in clinical practice. N Engl J Med [Internet]. 2017 [citado 06/12/2019]; 377(8):756- 68 . Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/288344 67.

  12. The Helsinki Declaration of the World Medical Association (WMA). Ethical principles of medical research involving human subjects. Pol Merkur Lekarski. [Internet] 2014. [citado 04/06/2019] ;36(215):298-301. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/2496450 4.

  13. Marlen Ivon CF, Zaily DG, Conde-Eduardo Leda Patricia DS, Enrique GG, Enrique AS, Yadina MP. Current condition of chronic hepatitis B virus infection in cuban adults. Curr Ther Res Clin Exp. 2017 [Internet] ;85:15-9.[citado 04/06/2019]. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/2915885 4

  14. European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol [Internet]. 2017 [citado 04/06/2019]; 67(2):370-98. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/2842787 5.

  15. Loomba R, Liang TJ. Hepatitis B reactivation associated with immune suppressive and biological modifier therapies: current concepts, management strategies, and future directions. Gastroenterology [Internet]. 2017 [citado 04/06/2019]; 152(6):1297-309. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/2821969 1.

  16. Wang T, Shao C, Zhang G, Xu Y. Real-time elastography (RTE): a valuable sonography-based non-invasive method for the assessment of liver fibrosis in chronic hepatitis B. Abdom Radiol (NY) [Internet]. 2017 [citado 04/06/2019]; 42(11):2632-8. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/2852714 6.

  17. Lok AS, McMahon BJ, Brown RS, Jr., Wong JB, Ahmed AT, Farah W, et al. Antiviral therapy for chronic hepatitis B viral infection in adults: A systematic review and meta-analysis. Hepatology [Internet]. 2016 [citado 04/06/2019]; 63(1):284- 306 . Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/2656624 6.

  18. MINSAP. Cuadro basico de medicamentos y productos naturales 2018. La Habana: MINSAP; 2018 Disponible en: https://www.cecmed.cu/sites/default/files/adju ntos/vigilancia/farmacov/cuadro_basico_medica mentos_2018.pdf

  19. Xu CJ, Zhang CP, Luo BF, Liu LJ, Wang YZ, Wang XH, et al. Prevalence and characterization of hepatitis B and C virus infections in a needlesharing population in Northern China. BMC public health [Internet]. 2015 [citado 04/06/2019]; 15(1):460. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/259339 22.




2020     |     www.medigraphic.com