How far is Mexico from Viral Hepatitis Global Health Sector Strategy 2030 targets.

In 2016 WHO member states endorsed the 69th World Health Assembly's Global Health Sector Strategies (GHSS) towards eliminating Hepatitis B (HBV) infections by 2030. Substantial progress has been made in Mexico regarding HBV vaccination, blood safety and health-care setting injection safety but minor progress has been identified regarding timely HBV birth-dose coverage, access to diagnostic testing and treatment. Most importantly, Mexico's lack of a national plan for the fight against viral hepatitis was identified as a major obstacle for the development and implementation of actions and procuring funding. Insight of these deficiencies, we propose six actions that are in line with GHSS strategic directions to better allow Mexico to reach the goal of eliminating viral hepatitis by 2030. 1) the creation of a National Viral Hepatitis Task Group capable of providing direction, recommendations as well as innovative solutions in the fight against viral hepatitis in Mexico; 2) the drafting of a National Plan for viral hepatitis; 3) establishing a national viral hepatitis information database; 4) development of Clinical Practice Guidelines; 5) appeal for governmental responsibility and accountability; 6) promote basic, applied science projects as well as clinical research to determine the viral, epidemiological, genomic, ethnic and cultural peculiarities of viral hepatitis infections in Mexico. These basic actions will better equip Mexico to meet GHSS targets, lead to high-impact health interventions and ultimately enhance the cascade of care, from diagnosis to chronic care. Political commitment is a requirement to the implementation of these actions but civil society involvement is also seen to be crucial.

High prevalence of HBV infection, detection of subgenotypes F1b, A2, and D4, and differential risk factors among Mexican risk populations with low socioeconomic status.

Hepatitis B virus (HBV) infection may be underestimated among high-risk individuals in regions of low HBs antigenemia. This study aimed to assess HBV serological markers, genotypes, and risk factors in Mexican patients with risk of HBV infection and low socioeconomic status. Demographics, clinical, and risk factor data were collected in patients with HIV (n = 289), HCV (n = 243), deferred blood donors (D-BD) (n = 83), and two native populations, Mixtecos (n = 57) and Purepechas (n = 44). HBV infection was assessed by HBsAg, anti-HBc, and HBV-DNA testing. Overall, patients had low education and very-low income. Totally, HBsAg prevalence was 16.5% (113/684) ranging from 0.7% (HCV) to 37.3% (D-BD), while anti-HBc was 30.2% (207/684). Among 52 sequences, genotypes H (n = 34, 65.4%), G (n = 4, 7.7%), subgenotypes F1b (n = 7, 13.5%), A2 (n = 6, 11.5%), and D4 (n = 1, 1.9%) were detected. Surgeries, sexual promiscuity, and blood transfusions had a differential pattern of distribution. In HCV patients, single (OR = 5.84, 95%Cl 1.91-17.80, P = 0.002), MSM (OR = 4.80, 95%Cl 0.75-30.56, P = 0.097), and IDU (OR = 2.93, 95%CI 1.058-8.09, P = 0.039) were predictors for HBV infection. While IDU (OR = 2.68, 95%CI 1.08-6.61, P = 0.033) and MSM (OR = 2.64, 95%CI 1.39-5.04, P = 0.003) were predictors in HIV patients. In this group, MSM was associated with HBsAg positivity (OR = 3.45, 95%CI 1.48-8.07, P = 0.004) and IDU with anti-HBc positivity (OR = 5.12, 95%CI 2.05-12.77, P < 0.001). In conclusion, testing with a combined approach of three different HBV markers, a high prevalence of HBV infection, a differential distribution of HBV genotypes, including subgenotypes F1b, A2, and D4, as well as risk factors in low-income Mexican risk groups were detected.

Need of righteous attitudes towards eradication of hepatitis C virus infection in Latin America.

Over the last few years, we have expanded our knowledge on numerous facets of the hepatitis C virus (HCV). Beginning with its discovery and viral life cycle, its impact on health, the development of liver disease and currently, effective antiviral treatments. The latter point has become of great interest throughout the developed world, where the possible eradication of HCV through specific strategies to reach all HCV-infected people has been announced. However, this scenario is very different in the countries of Latin America (LA), in which < 2% of infected patients requiring treatment have access to HCV medications. It has been estimated that at least ten million Latin Americans may be infected with HCV. Despite the numbers, viral hepatitis does not seem to be considered a health problem in this region of the world. This reality poses a challenge for politicians and governments of these countries, as well as to the pharmaceutical industry, the medical practitioners, and academics in LA. In this editorial, we state the need for alterations in the attitudes of the integral players involved in this situation. A recognition shift could help to create preventive strategies of viral hepatitis and to advocate for accessibility to new HCV treatments.