La hepatitis en las Américas : informe del grupo colaborador de la OPS / Hepatitis in the Americas: report of the PAHO collaborating group

ABSTRACT

Viral hepatitis is a major public health problem throughout the Americas. Each of the several types of hepatitis (A, B, delta, non-A non B) causes significant morbidity and mortality in the Region. Hepatitis B (HB) infection, now a vaccine-preventable disease, requires the most urgent attention at this time. HB infection endemicity in the Region varies from low (temperate North and South America) to moderate (Tropical Central and South America), but high HBV endemicity occurs throughout the Amazon Basin, in Hispaniola, and in certain population of several other tropical countries. Factors such as race, socioeconomic status, and urban-rural status as well as lifestyle (homosexuality, prostitution) and occupational (health care) factors increase HB prevalence in segments of populations, and it is likely that the number of persons at high risk of HB infection is currently underestimated. Chronic consequences of HB infection are likely proportional to disease endemicity and, in high endemicity areas, comparable to those in Africa and Southeast Asia. In addition, delta infection causes high mortality due to fulminant and chronic hepatitis throughout the high HBV endemicity areas in northern South America. Hepatitis A is a disease of childhood throughout the Region, and causes significant morbidity in older children