Experts warn of hepatitis C outbreak among dialysis patients in Venezuela

Although the world has set a goal of eliminating hepatitis as a public health problem by 2030, Venezuela has reached world hepatitis dayOn July 28 this year, there was an underdiagnosis of hepatitis A and an outbreak of hepatitis C in different dialysis centers in the country.

The world slogan for 2023 is “one life, one livercalling for expanded access to diagnosis and treatment to save lives. However, in Venezuela, where public hospitals cannot detect certain viruses, hepatitis C has spread among dialysis patients.

according to Rosalia PerazzoHepatitis C is an invisible disease in Venezuela: It is estimated that about 1% of the population may be infected with the virus, but Most people are unaware of its condition.

“Venezuela has no census and the Ministry of Health does not report on the disease. It is an invisible disease. In some blood banks that report its incidence, they tell us about 1.2%”On July 27, at a meeting organized by the Institute of Tropical Medicine of the Central University of Venezuela (IMT-UCV) and the Venezuelan Society of Infectious Diseases (SVI).

The hepatitis C virus is spread through blood. The most common reasons are unsafe use of syringes or needles during medical procedures; transfusion of unanalyzed blood and blood products; injecting drugs; sharing injecting equipment.

According to experts, hepatitis C has become a public health problem in Venezuela in recent years, Outbreak in dialysis room Belonging to the Institute of Social Security (Ivss) of the Venezuelan states.

In 2021, the Venezuelan Institute of Science (Ivic), the Ministry of Science and Technology (Mincyt) and several hospitals across the country started a study. To date, they have diagnosed at least 84 hepatitis C patients across three entities.

At the Acarigua Dialysis Center in Portugal, 37 patients tested positive. Ivss donated the treatment to them. In Trujillo state, 11 patients were diagnosed with hepatitis C, most of them in Bocono state, and Mincyt also donated the treatment.

exist Caracascurrently detected 36 patients Dialysis was positive for hepatitis C virus, but the overall incidence in the city remains unclear. These patients also received treatment donated by Mincyt.

From January 2022 to January 2023, a total of 5,736 donors went to the blood bank of Dr. Miguel Pérez Carreño Hospital to donate blood. Among them, 51 cases were positive for hepatitis C virus, with an incidence rate of 0.88%.

“This is the fact that I want to draw attention to the fact that this is an invisible disease because of these patients, no one is sent to the ward (hepatology consultation). They don’t look for results, because they are not responsible for calling patients Tell him he tested positive,” Perazzo said.

During the same period, the Pérez Carreño Liver Clinic received 60 positive patients. Twenty-six of these patients were from different dialysis units in Caracas.

“We are evaluating all dialysis units in Caracas with reported cases. Also in Zulia and Falcon. A state of emergency has been declared nationwide,” he added.

no public treatment

There are also non-dialysis patients with hepatitis C, such as patients with cancer or chronic diseases, who also need treatment but cannot get it, Perazzo said. Outside of the project, there is no public level treatment.

Of the total number of people infected in the country, only an estimated 0.07% were treated.

In 2016, the Ministry of Health approved drugs such as interferon, ribavirin and sofosbuvir. Then, the direct-acting antivirals (sofosbuvir and others) that have been shown to have the highest efficacy are approved, but these drugs have yet to deliver.

In 2016, a donation from soccer player Dani Alves brought us treatment, benefiting 350 patients.

“at the moment In Venezuela, social security does not cover treatment for hepatitis C, So it has to be sought in a specific way,” says the hepatologist. In the private sector, treatment can cost as much as $900.

Hepatitis C infection is often undetected in the acute phase, but if left untreated, 20 to 30 years later it may manifest as chronic liver disease, cirrhosis, or cancer (hepatocellular carcinoma).

It affects an estimated 58 million people worldwide, at least 3.2 million of whom are children and adolescents, with approximately 1.5 million new infections each year. There is no effective hepatitis C vaccine.

Hepatitis A is underdiagnosed

IMT-UCV professor Julio Castro, an infectious disease doctor, said the changing economic conditions in the country and the deterioration of water quality and its supply were already having health consequences.

According to experts, one of these effects is an increase in the prevalence of Hepatitis A

In 2018, the situation in Venezuela maintained a history of stability, except in specific cases such as river overflows, troughs, or incidents related to water management.

The hepatitis A virus is mainly spread through ingestion of contaminated food or water or direct contact with an infected person. According to the World Health Organization (WHO), their infections are closely linked to consumption of unhealthy food and water.

In World Hepatitis Day IMT-UCV speech, Castro reflects on the alarm in Venezuela in 2018: In a short time, a prominent politician is infected, a pioneering doctor dies of fulminant hepatitis, players of two football teams are professional people are infected.

More and more patients are coming to clinics in the country’s capital. In the case of the Caracas metropolitan area, there is clear evidence of an increase in hepatitis cases for several years in a row.

“Disease rates are starting to rise again because of the deteriorating sanitation in the country. Our water quality has deteriorated. People who don’t have water dig wells or wait for cisterns to come. How do you find water? In natural resources where you can’t see the quality of water, said Castro.

The patient profile was young adults between the ages of 30 and 50. Castro said this suggested that there were more susceptible people who did not have the disease as children due to good water quality in previous years.

For Castro, changing population health and economic conditions, a lack of epidemiological information, a possible increase in susceptible populations, and a lack of hepatitis A vaccination policies have combined to contribute to the gradual increase in cases.

Currently, the hepatitis A situation in Venezuela is unclear, as there have been no official epidemiological notifications since 2016.

Despite humanitarian investments to improve water quality in some areas, options for accessing water are increasingly limited. Hepatitis A was also not diagnosed in the public sector.

“There isn’t a single hospital in Venezuela that can test for hepatitis A. None,” he said. “Because we were not equipped to make a diagnosis, the disease was subdiagnosed.”

Preventing Hepatitis in Venezuela

🟡If you have hepatitis, homemade recipes are not recommended: do not use annatto roots, do not drink coffee suppositories, do not eat foods rich in sugar. Dr. Giulio Castro emphasized that annatto is toxic to the liver.

🟡 this is important boiling water for human consumption and handle food properly. Make sure you cook your food properly to prevent hepatitis A. If you cannot boil water, you can chlorinate it.

Avoid eating in places with poor sanitation. Wash your hands regularly before meals and after going to the bathroom.

🟡 Use protection (condoms) when having sex because the hepatitis B virus is transmitted sexually. HCV can also be spread during sexual contact with blood.

HBV can also be transmitted from mother to child through injections during childbirth or exposure to sharp instruments in healthcare or community settings.

🟡 Get Hepatitis B Vaccinea vaccine included in the Ministry of Health’s Expanded Program on Immunization (PAI).

“It is very important that the hepatitis B vaccine is kept up to date. It is suitable for everyone from newborns to the elderly. This is important because it is the first vaccine to limit liver cancer,” says vaccine expert and infectious disease scientist María Viki Zabaleta explain.

🟡 Get Hepatitis A Vaccine (for all ages 1+). This vaccine is only available in the private sector. There are two doses. See the Medical Society’s Vaccination Consensus here.

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