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Viruses
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Viral Hepatitis in Latin America and the Caribbean
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Viral Hepatitis in Latin America and the Caribbean

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 7625

Special Issue Editors

Dr. Lia L. Lewis-Ximenez

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Guest Editor
Viral Hepatitis Ambulatory, Viral Hepatitis Laboratory, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Manguinhos, Rio de Janeiro, Brazil
Interests: acute viral hepatitis; hepatitis A; hepatitis B; hepatitis C; hepatitis E; immune response; occult hepatitis; viral hepatitis during pregnancy; mother-to-infant transmission; vulnerable high-risk populations; rapid diagnostic tests; hemodialysis; indigenous populations
Special Issues, Collections and Topics in MDPI journals
Dr. Livia Melo Villar

E-Mail Website
Guest Editor
Viral Hepatitis Laboratory, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Manguinhos, Rio de Janeiro, Brazil
Interests: viral hepatitis; innovation in the diagnosis of hepatitis; molecular epidemiology; epidemiology; the biology of viral hepatitis; vulnerable high-risk populations; indigenous populations
Special Issues, Collections and Topics in MDPI journals
Dr. Carlos Alberto Espul

E-Mail Website
Guest Editor
Laboratorio de Virología, Hospital Central, Mendoza, Argentina
Interests: gastroenteritis viruses; hepatitis viruses
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Flor Helene Pujol

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Guest Editor
Laboratorio de Virología Molecular, Centro de Microbiología y Biología Celular (CMBC), Instituto Venezolano de Investigaciones Científicas (IVIC), Caracas 1020A, Venezuela
Interests: hepatitis viruses; HIV; SARS-CoV-2; influenza; emerging viruses; viral genomics
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Sonia Roman

E-Mail Website
Guest Editor
Laboratory of Molecular Biology in Medicine, Health Sciences Center, University of Guadalajara, Guadalajara, Mexico
Interests: viral hepatitis; cirrhosis; molecular epidemiology; diagnosis; immunology

Special Issue Information

Dear Colleagues,

Viral hepatitis is a major global concern, as it contributes to the toll of deaths from infectious diseases and cancer worldwide. The five main types of hepatitis (A, B, C, D, and E) vary in terms of their transmission routes, geographic distributions, and clinical outcomes. In the context of Latin America and the Caribbean, these infections have great public health relevance but scarce and limited data. Even with the significant reduction in the number of cases among younger age groups over the decades, especially in light of vaccine availability and improved access to sanitation and drinking water services, hepatitis A (HAV) still exhibits high or intermediate endemicity in certain countries of this region, leading to epidemic outbreaks, especially among susceptible adults (with a higher mortality rate) and vulnerable populations. In the case of hepatitis B (HBV) and C (HCV), it is estimated that approximately 4.7 million individuals are chronically infected, leading to millions of deaths related to liver cancer and cirrhosis. As for hepatitis D (or Delta) (HDV), most Latin American studies have focused mainly on the Amazon Basin region. Few studies have explored regions outside this endemic area, meaning that the infection, which has great importance in the context of co-infection with HBV, is neglected. Hepatitis E (HEV), on the other hand, still has a very limited epidemiology in Latin America and the Caribbean, with rates of prevalence ranging from 1% (in Caribbean countries) to 12% (Nicaragua and Chile). It is likely that these numbers represent a significant underestimation of the true global burden of the disease and its incidence in the region. To shed light on and provide new information about viral hepatitis in the context of Latin America and the Caribbean, new studies are required in order to provide data relevant to this highly diverse region.

With this objective in mind, this Special Issue of Viruses will address the following topics: 1) genetic variations in viral hepatitis, which may aid us in understanding the diverse types of response (clinical outcomes, treatments, immunological factors); 2) general epidemiological studies and those focusing on key populations; and 3) new diagnostic procedures that will aid in the elimination of these viruses.

Dr. Lia L. Lewis-Ximenez
Dr. Livia Melo Villar
Dr. Carlos Alberto Espul
Prof. Dr. Flor H. Pujol
Prof. Dr. Sonia Roman
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • viral hepatitis
  • Latin America
  • key populations
  • epidemiology
  • molecular epidemiology
  • therapy
  • diagnostics
  • new diagnostic technologies
  • immune response
  • clinical outcome
  • genotype

Related Special Issue

Published Papers (6 papers)

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Research

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14 pages, 2302 KiB  
Article
Mixed Infections Unravel Novel HCV Inter-Genotypic Recombinant Forms within the Conserved IRES Region
by Natalia Echeverría, Fabiana Gámbaro, Stéphanie Beaucourt, Martín Soñora, Nelia Hernández, Juan Cristina, Gonzalo Moratorio and Pilar Moreno
Viruses 2024, 16(4), 560; https://doi.org/10.3390/v16040560 - 03 Apr 2024
Viewed by 446
Abstract
Hepatitis C virus (HCV) remains a significant global health challenge, affecting millions of people worldwide, with chronic infection a persistent threat. Despite the advent of direct-acting antivirals (DAAs), challenges in diagnosis and treatment remain, compounded by the lack of an effective vaccine. The [...] Read more.
Hepatitis C virus (HCV) remains a significant global health challenge, affecting millions of people worldwide, with chronic infection a persistent threat. Despite the advent of direct-acting antivirals (DAAs), challenges in diagnosis and treatment remain, compounded by the lack of an effective vaccine. The HCV genome, characterized by high genetic variability, consists of eight distinct genotypes and over ninety subtypes, underscoring the complex dynamics of the virus within infected individuals. This study delves into the intriguing realm of HCV genetic diversity, specifically exploring the phenomenon of mixed infections and the subsequent detection of recombinant forms within the conserved internal ribosome entry site (IRES) region. Previous studies have identified recombination as a rare event in HCV. However, our findings challenge this notion by providing the first evidence of 1a/3a (and vice versa) inter-genotypic recombination within the conserved IRES region. Utilizing advanced sequencing methods, such as deep sequencing and molecular cloning, our study reveals mixed infections involving genotypes 1a and 3a. This comprehensive approach not only confirmed the presence of mixed infections, but also identified the existence of recombinant forms not previously seen in the IRES region. The recombinant sequences, although present as low-frequency variants, open new avenues for understanding HCV evolution and adaptation. Full article
(This article belongs to the Special Issue Viral Hepatitis in Latin America and the Caribbean)
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11 pages, 286 KiB  
Article
Core Promoter and Pre-Core Variants of the Hepatitis B Virus (HBV) Are Frequent in Chronic Hepatitis B HBeAg-Negative Patients Infected by Genotypes A and D
by Tania Reuter, Michele Soares Gomes-Gouvea, Samira Chuffi, Ulisses Horst Duque, Waltesia Perini, Raymundo Soares Azevedo and João Renato Rebello Pinho
Viruses 2023, 15(12), 2339; https://doi.org/10.3390/v15122339 - 29 Nov 2023
Viewed by 709
Abstract
In Brazil, hepatitis B virus endemicity is low, moderate, or high in some areas, such as Espírito Santo State in the southeast region. In this study, we intend to characterize the basal core promoter (BCP) and pre-core region (PC) variants and their association [...] Read more.
In Brazil, hepatitis B virus endemicity is low, moderate, or high in some areas, such as Espírito Santo State in the southeast region. In this study, we intend to characterize the basal core promoter (BCP) and pre-core region (PC) variants and their association with clinical/epidemiological disease patterns in patients infected with genotypes A and D. The study included 116 chronic hepatitis B patients from Espírito Santo State, Southeast Brazil, infected with genotypes A and D. Basal core promoter (BCP) and pre-core mutations were analyzed in these patients. The frequency of BCP and PC mutations was compared with age, HBeAg status, HBV genotype and subgenotype, HBV-DNA level, clinical classification, and transmission route. HBeAg-negative status was found in 101 (87.1%) patients: 87 (75.0%) were infected with genotype A (A1 = 85; A2 = 2) and 29 (25.0%) were infected with genotype D (D3 = 24; D4 = 3; D2 = 2). BCP + PC variants altogether were more frequent (48.1%) in genotype D than in genotype A strains (6.0%) (p < 0.001). When this evaluation was performed considering the cases that presented only the A1762T and/or G1764A (BCP) mutations, it was observed that the frequency was higher in genotype A (67.5%) compared to genotype D (7.4%) (p < 0.001). On the other hand, considering the samples with mutations only in positions G1896A and/or G1899A (PC), the frequency was higher in genotype D (75.8%) than in genotype A (6.9%) (p < 0.001). Interestingly, HBV DNA was lower than 2000 IU/mL especially when both BCP/PC mutations were present (p < 0.001) or when only PC mutations were detected (p = 0.047), reinforcing their role in viral replication. Full article
(This article belongs to the Special Issue Viral Hepatitis in Latin America and the Caribbean)
10 pages, 741 KiB  
Article
Hepatitis C and Human Pegivirus Coinfection in Patients with Chronic Hepatitis C from the Brazilian Amazon Region: Prevalence, Genotypes and Clinical Data
by Patrícia Ferreira Nunes, Evelen da Cruz Coelho, Joseane Rodrigues da Silva, Camila Carla da Silva Costa, Regiane Miranda Arnund Sampaio, Paula Cristina Rodrigues Frade, Nagib Abdon Ponteira, Samara Silveira da Cruz, Aline Damasceno Seabra, Debora Monteiro Carneiro, Rommel Mario Rodriguez Burbano and Luisa Caricio Martins
Viruses 2023, 15(9), 1892; https://doi.org/10.3390/v15091892 - 07 Sep 2023
Cited by 1 | Viewed by 1230
Abstract
Coinfection of HPgV-1 with hepatitis C virus (HCV) is common due to shared modes of transmission, with a prevalence of HPgV-1 viremia of approximately 20% among individuals with chronic HCV infection. The aim of the present study was to estimate the prevalence of [...] Read more.
Coinfection of HPgV-1 with hepatitis C virus (HCV) is common due to shared modes of transmission, with a prevalence of HPgV-1 viremia of approximately 20% among individuals with chronic HCV infection. The aim of the present study was to estimate the prevalence of HPgV-1 RNA and circulating genotypes in patients with hepatitis C from a health service located in the city of Belém, in the state of Pará, Northern Brazil. A total of 147 samples were included in the study from February to December 2019. Among the participants, 72.1% (106/147) were monoinfected with HCV, with detectable HCV viral RNA, and 27.9% (41/147) were coinfected with HCV/HPgV-1. The most frequently found genotypes were HPgV-1 genotypes 1 and 2 (36.6% and 63.4%), respectively. While for HCV there was a predominance of genotypes 1 and 3 (58.5% and 41.5%). No significant differences were found when comparing any risk, sociodemographic, or clinical factors between groups. Also, there was no statistically significant difference when relating the viral genotypes of both agents. This study indicated that the prevalence of infection by HPgV-1 is high in HCV carriers in Belém, Pará, and probably does not change the clinical course of HCV infection, however, further studies are still needed. Full article
(This article belongs to the Special Issue Viral Hepatitis in Latin America and the Caribbean)
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12 pages, 307 KiB  
Article
Donated Blood Screening for HIV, HCV and HBV by ID-NAT and the Residual Risk of Iatrogenic Transmission in a Tertiary Care Hospital Blood Bank in Puebla, Mexico
by Francisca Sosa-Jurado, Roxana Palencia-Lara, Cinthia Xicoténcatl-Grijalva, Maribel Bernal-Soto, Álvaro Montiel-Jarquin, Yolanda Ibarra-Pichardo, Nora Hilda Rosas-Murrieta, Rosalia Lira, Paulina Cortes-Hernandez and Gerardo Santos-López
Viruses 2023, 15(6), 1331; https://doi.org/10.3390/v15061331 - 06 Jun 2023
Cited by 1 | Viewed by 1175
Abstract
Hepatitis C virus (HCV), human immunodeficiency virus (HIV) and hepatitis B virus (HBV) can be transmitted by blood transfusion. Most transmission occurs during the acute viremic phase (AVP), before antibody development. To reduce transmission risk, individual donor nucleic acid testing (ID-NAT) is used. [...] Read more.
Hepatitis C virus (HCV), human immunodeficiency virus (HIV) and hepatitis B virus (HBV) can be transmitted by blood transfusion. Most transmission occurs during the acute viremic phase (AVP), before antibody development. To reduce transmission risk, individual donor nucleic acid testing (ID-NAT) is used. In Puebla, Mexico, serological tests and ID-NAT have been applied to screen blood donors and detect individuals in AVP. In the present study, 106,125 blood donors’ data in two periods (2012–2015 and 2017–2019) were analyzed. The residual risk (RR) values were calculated considering ID-NAT results. The RR for HIV was 14 in 1 million donations or 1 in 71,428, the RR for HVC was 6.8 in 1 million donations or 1 in 147,058 and, for HBV, it was 156 in 1 million donations, or 1 in 6410. Previously, it was predicted that the transmission RR of these viruses would be reduced in Mexico through better screening with NAT. The use of ID-NAT has, indeed, increased the safety of blood reserves for HIV and HCV. However, more research is needed to determine why the residual risk of HBV did not decrease as much over the study period. ID-NAT is an important complementary tool for blood donor screening that should be implemented. Full article
(This article belongs to the Special Issue Viral Hepatitis in Latin America and the Caribbean)

Review

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25 pages, 3287 KiB  
Review
Hepatitis B Virus Genotype H: Epidemiological, Molecular, and Clinical Characteristics in Mexico
by Arturo Panduro, Sonia Roman, Saul Laguna-Meraz and Alexis Jose-Abrego
Viruses 2023, 15(11), 2186; https://doi.org/10.3390/v15112186 - 30 Oct 2023
Cited by 1 | Viewed by 1715
Abstract
The hepatitis B virus (HBV), comprising of ten genotypes (A-J), has been a silent threat against humanity, constituting a public health problem worldwide. In 2016, the World Health Organization set forth an impressive initiative for the global elimination of viral hepatitis by 2030. [...] Read more.
The hepatitis B virus (HBV), comprising of ten genotypes (A-J), has been a silent threat against humanity, constituting a public health problem worldwide. In 2016, the World Health Organization set forth an impressive initiative for the global elimination of viral hepatitis by 2030. As the target date approaches, many nations, particularly in the Latin American region, face challenges in designing and implementing their respective elimination plan. This review aimed to portray the state of knowledge about the epidemiological, molecular, and clinical characteristics of HBV genotype H (HBV/H), endemic to Mexico. PubMed, Scopus, Web of Science, and Google Scholar were searched to compile scientific literature over 50 years (1970–2022). A total of 91 articles were organized into thematic categories, addressing essential aspects such as epidemiological data, risk factors, HBV genotype distribution, HBV mixed infections, clinical characteristics, and vaccination. The prevalence and its associated 95% confidence interval (95% CI) were estimated using the Metafor package in R programming language (version 4.1.2). We provide insights into the strengths and weaknesses in diagnostics and prevention measures that explain the current epidemiological profile of HBV/H. Training, research, and awareness actions are required to control HBV infections in Mexico. These actions should contribute to creating more specific clinical practice guides according to the region’s characteristics. Mexico’s elimination plan for HBV will require teamwork among the government health administration, researchers, physicians, specialists, and civil society advocates to overcome this task jointly. Full article
(This article belongs to the Special Issue Viral Hepatitis in Latin America and the Caribbean)
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16 pages, 4050 KiB  
Review
Tracing the History of Hepatitis E Virus Infection in Mexico: From the Enigmatic Genotype 2 to the Current Disease Situation
by Oliver Viera-Segura, Arturo Calderón-Flores, Julio A. Batún-Alfaro and Nora A. Fierro
Viruses 2023, 15(9), 1911; https://doi.org/10.3390/v15091911 - 12 Sep 2023
Viewed by 1621
Abstract
Hepatitis E virus (HEV) is the major cause of acute viral hepatitis worldwide. This virus is responsible for waterborne outbreaks in low-income countries and zoonosis transmission in industrialized regions. Initially, considered self-limiting, HEV may also lead to chronic disease, and evidence supports that [...] Read more.
Hepatitis E virus (HEV) is the major cause of acute viral hepatitis worldwide. This virus is responsible for waterborne outbreaks in low-income countries and zoonosis transmission in industrialized regions. Initially, considered self-limiting, HEV may also lead to chronic disease, and evidence supports that infection can be considered a systemic disease. In the late 1980s, Mexico became a hot spot in the study of HEV due to one of the first virus outbreaks in Latin America related to enterically transmitted viral non-A, non-B hepatitis. Viral stool particles recovered from Mexican viral hepatitis outbreaks represented the first identification of HEV genotype (Gt) 2 (Gt2) in the world. No new findings of HEV-Gt2 have been reported in the country, whereas this genotype has been found in countries on the African continent. Recent investigations in Mexico have identified other strains (HEV-Gt1 and -Gt3) and a high frequency of anti-HEV antibodies in animal and human populations. Herein, the potential reasons for the disappearance of HEV-Gt2 in Mexico and the advances in the study of HEV in the country are discussed along with challenges in studying this neglected pathogen. These pieces of information are expected to contribute to disease control in the entire Latin American region. Full article
(This article belongs to the Special Issue Viral Hepatitis in Latin America and the Caribbean)
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