[Epidemiologic and situational panorama of hepatitis C in Mexico].
OBJECTIVE
To determine the epidemiological situation of Chronic Hepatitis C (CHC) in our country.


BACKGROUND
Chronic Hepatitis C affects 170 million people worldwide, and about 0.7% of Mexican population. There is no enough epidemiological information about CHC in our country, and it is very probable that some cases are not even detected.


METHODS
An investigation poll was performed. Age, gender, birthday, weight, race, residence and birth place, routes of transmission, ALT levels, histological, serological and molecular diagnosis, evidence of complications and previous treatments were recorded. A data recollection sheet was dispatched to different country provinces; they had 6 months to answer it, in order to recollect all information.


RESULTS
831 patients were analized (58.6% female and 41.4% male) with the following distribution in our country provinces: Aguascalientes 15, Chihuahua 12, Distrito Federal 495, Durango 10, Jalisco 89, Guanajuato 78, Yucatán 8, Querétaro 11, Sonora 40, Tabasco 15, Baja California 5, Veracruz 13, Tamaulipas 2 and 38 patients of Nuevo León. The highest incidence of CHC was found at fifth and sixth decade of life (28.5% y 26.7% respectively. The weight distribution was 36.2% < 65kg, 34.6% 65-75 kg and 29.2% > 75 kg. 86.5% had chronic hepatitis and 13.2% cirrhosis. The risk factors for HCV infection analysis showed that the main route of transmission was via contaminated blood (64.2%); when we excluded the patients that were exposed before 1995, the incidence was lowered to 4.5%. The higher incidence was showed between 1970 and 1990 (68%). The intravenous drug users were predominantly male and on those patients in the provinces near the north border line of our country. The predominant genotype was gen- 1 no matter the province (72.2%), in the intravenous drug users genotype 3 was found in 25%. The viral load was similar in all the provinces. 75% of the patients had have treatment and 22.5% had have two cycles, 50% of cirrhotic patients had have treatment whereas only 28% of the patients with late complications had have it. The most common treatment was pegylated alpha-2a interferon plus ribavirine.


CONCLUSIONS
1. The main route of transmission was blood transfusion. There is a marked decrease in the incidence of post-transfusional hepatitis since the introduction of anti-VHC antibody screening of blood donors (4.5%). 2. The time between the infection and diagnosis was 23 years for chronic hepatitis and 26 years for cirrhosis. 3. Intravenous drugs use was an important route of transmission in the north of our country. 4. The predominant genotype was gen-1. 5. Almost all the patients with chronic hepatitis received treatment, the most common used was pegylated interferon alpha-2a and ribavirin. 6.50% of the patients with CHC have late complications.
Vera de León
Lizeth
L
Servicio de Gastroenterología, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), México. lizvera@prodigy.net.mx
Juárez Navarro
Jesús Alberto
JA
Díaz Gómez
Marcelino
M
Méndez Navarro
Jorge
J
Chirino Sprung
Ruby Ann
RA
Dehesa Violante
Margarita
M
Casillas Davila
Leticia
L
Rizo Robles
María Teresa
MT
Torres Ibarra
Rocio
R
Cano Domínguez
Carlos
C
Nava Estrada
Jesús
J
Ramos Gómez
Mayra
M
Hernández
María Elena
ME
Wong González
Samuel
S
Félix Tamayo
Monica
M
Corona Lechuga
M Del Carmen
Mdel C
Zárate Negrete
Alma Rosa
AR
Rangel Jiménez
Magdalena
M
Rodríguez Hernández
Heriberto
H
González Ortiz
Valentin
V
Tirado Estrella
Martha Patricia
MP
Villanueva Carreto
María Los de Angeles
ML
Orta Flores
Raymundo
R
Manteca Argumedo
José Luis
JL
Vázquez Avila
Isidro
I
González Macias
Juan
J
Razcón Hernández
Omar
O
Torres López
Pastora
P
Bazán Pérez
Carlos
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies