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Hepatology International

, Volume 3, Issue 2, pp 343–355 | Cite as

A low steady HBsAg seroprevalence is associated with a low incidence of HBV-related liver cirrhosis and hepatocellular carcinoma in Mexico: a systematic review

  • Sonia Roman
  • Arturo PanduroEmail author
  • Yadira Aguilar-Gutierrez
  • Montserrat Maldonado
  • Maclovia Vazquez-VanDyck
  • Erika Martinez-Lopez
  • Bertha Ruiz-Madrigal
  • Zamira Hernandez-Nazara
REVIEW ARTICLE

Abstract

To address the relationship between hepatitis B virus (HBV) endemicity and HBV-related liver diseases in Mexico. Research literature reporting on HBsAg and antibody to hepatitis B core antigen (anti-HBc) prevalence in Mexican study groups were searched in NLM Gateway, PubMed, IMBIOMED, and others. Weighted mean prevalence (WMP) was calculated from the results of each study group. A total of 50 studies were analyzed. Three nationwide surveys revealed an HBsAg seroprevalence of less than 0.3%. Horizontal transmission of HBV infection occurred mainly by sexual activity and exposure to both contaminated surgical equipment and body fluids. High-risk groups exposed to these factors included healthcare workers, pregnant women, female sex workers, hemodialysis patients, and emergency department attendees with an HBsAg WMP ranging from 1.05% (95% confidence interval [CI], 0.68–1.43) to 14.3% (95% CI, 9.5–19.1). A higher prevalence of anti-HBc in adults than those younger than 20 years was associated with the main risk factors. Anti-HBc WMP ranged from 3.13% (95% CI, 3.01–3.24) in blood donors to 27.7% (95% CI, 21.6–33.9) in hemodialysis patients. A heterogeneous distribution of HBV infection was detected, mainly in native Mexican groups with a high anti-HBc WMP of 42.0% (95% CI, 39.5–44.3) but with a low HBsAg WMP of 2.9% (95% CI 2.08–3.75). Estimations of the Mexican population growth rate and main risk factors suggest that HBsAg seroprevalence has remained steady since 1974. A low HBsAg prevalence is related to the low incidence of HBV-related liver cirrhosis and hepatocellular carcinoma (HCC) previously reported in Mexico.

Keywords

HBsAg Anti-HBc Low HBsAg seroprevalence areas Mexico HBV genotype H Epidemiology of HBV Hepatocellular carcinoma 

Abbreviations

anti-HBc

Antibody to hepatitis B core antigen

CEP

Counterelectrophoresis

HBsAg

Hepatitis B virus surface antigen

HBV

Hepatitis B virus

HCC

Hepatocellular carcinoma

HCV

Hepatitis C virus

HIV

Human immunodeficiency virus

MP

Mean prevalence

NAT

Nucleic acid testing

PP

Pooled prevalence

WMP

Weighted mean prevalence

Notes

Acknowledgment

This work was supported by a grant (Salud-Conacyt-2004-01-025) to A.P. from the National Council of Science and Technology (CONACYT, Mexico).

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Copyright information

© Asian Pacific Association for the Study of the Liver 2008

Authors and Affiliations

  • Sonia Roman
    • 1
  • Arturo Panduro
    • 1
    Email author
  • Yadira Aguilar-Gutierrez
    • 1
  • Montserrat Maldonado
    • 1
  • Maclovia Vazquez-VanDyck
    • 1
  • Erika Martinez-Lopez
    • 1
  • Bertha Ruiz-Madrigal
    • 1
  • Zamira Hernandez-Nazara
    • 1
  1. 1.Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara“Fray Antonio Alcalde” and Health Sciences University Center, University of GuadalajaraGuadalajaraMexico

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