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


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.


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



Antibody to hepatitis B core antigen




Hepatitis B virus surface antigen


Hepatitis B virus


Hepatocellular carcinoma


Hepatitis C virus


Human immunodeficiency virus


Mean prevalence


Nucleic acid testing


Pooled prevalence


Weighted mean prevalence



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).


  1. 1.
    Mast EE, Alter MJ, Margolis HS. Strategies to prevent and control hepatitis B and C virus infections: a global perspective. Vaccine 1999;17:1730–1733. doi: 10.1016/S0264-410X(98)00415-0 PubMedCrossRefGoogle Scholar
  2. 2.
    World Health Organization. Department of Communicable Disease Surveillance and Response 2002, Hepatitis B [cited December 2007]. Available from:
  3. 3.
    Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004;11:97–107. doi: 10.1046/j.1365-2893.2003.00487.x PubMedCrossRefGoogle Scholar
  4. 4.
    Hou J, Liu Z, Gu F. Epidemiology and prevention of hepatitis B virus infection. Int J Med Sci 2005;2(1):50–57PubMedGoogle Scholar
  5. 5.
    Gish RG, Gadano AC. Chronic hepatitis B: current epidemiology in the Americas and implications for management. J Viral Hepat 2006;13(12):787–798. doi: 10.1111/j.1365-2893.2006.00787.x PubMedCrossRefGoogle Scholar
  6. 6.
    Fay OH. Hepatitis B in Latin America: epidemiological patterns and eradication strategy. The Latin American Regional Study Group. Vaccine 1990;8(Suppl):S100–S106Google Scholar
  7. 7.
    Silveira TR, da Fonseca JC, Rivera L, Fay OH, Tapia R, Santos JI, et al. Hepatitis B seroprevalence in Latin America. Rev Panam Salud Pública/Pan. Am J Public Health 1999;6(6):378–383Google Scholar
  8. 8.
    Ramiro Cruz J, Perez-Rosales MD. Availability, safety, and quality of blood for transfusion in the Americas. Rev Panam Salud Pública 2003;13(2–3):103–110Google Scholar
  9. 9.
    Campos RH, Mbayed VA, Pineiro Y, Leone FG. Molecular epidemiology of hepatitis B virus in Latin America. J Clin Virol 2005;34(Suppl 2):S8–S13. doi: 10.1016/S1386-6532(05)80028-9 PubMedCrossRefGoogle Scholar
  10. 10.
    Ponce JG, Cadenas LF, Garcia F, Leon G, Blitz-Dorfman L, Monsalve F, et al. Alta prevalencia de marcadores de hepatitis B y C en una comunidad de indigentes en Caracas Venezuela. Invest Clin 1994;35(3):123–129PubMedGoogle Scholar
  11. 11.
    Echevarria JM, Leon P. Epidemiology of viruses causing chronic hepatitis among populations from the Amazon Basin and related ecosystems. Cad Saude Publica 2003;19(6):1583–1591. doi: 10.1590/S0102-311X2003000600003 PubMedCrossRefGoogle Scholar
  12. 12.
    Miyakawa Y, Mizokami M. Classifying hepatitis B virus genotypes. Intervirology 2003;46(6):329–338. doi: 10.1159/000074988 PubMedCrossRefGoogle Scholar
  13. 13.
    Norder H, Louroucé AM, Coursaget P, Echevarria JM, Lee SD, Mushahwar JK, et al. Genetic diversity of hepatitis B virus strains derived worldwide: genotypes, subgenotypes and HBsAg subtypes. Intervirology 2004;47(6):289–309. doi: 10.1159/000080872 PubMedCrossRefGoogle Scholar
  14. 14.
    Sanchez LV, Maldonado M, Bastidas-Ramirez BE, Norder H, Panduro A. Genotypes and S-gene variability of Mexican hepatitis B virus strains. J Med Virol 2002;68(1):24–32. doi: 10.1002/jmv.10166 PubMedCrossRefGoogle Scholar
  15. 15.
    Sanchez LV, Tanaka Y, Maldonado M, Mizokami M, Panduro A. Difference of hepatitis B virus genotype distribution in two groups of Mexican patients with different risk factors. Intervirology 2007;50(1):9–15. doi: 10.1159/000096307 PubMedCrossRefGoogle Scholar
  16. 16.
    Arauz-Ruiz P, Norder H, Robertson BH, Magnius LO. Genotype H: a new Amerindian genotype of hepatitis B virus revealed in Central America. J Gen Virol 2002;83:2059–2073PubMedGoogle Scholar
  17. 17.
    Nakajima A, Usui M, Huy TT, Hlaing NKT, Masaki N, Sata T, et al. Full-length sequence of hepatitis B virus belonging to genotype H identified in a Japanese patient with chronic hepatitis. Jpn J Infect Dis 2005;58:244–246PubMedGoogle Scholar
  18. 18.
    Mbayed VA, Barbini L, Lopez JL, Campos RH. Phylogenetic analysis of the hepatitis B virus (HBV) genotype F including Argentine isolates. Arch Virol 2001;146(9):1803–1810. doi: 10.1007/s007050170066 PubMedCrossRefGoogle Scholar
  19. 19.
    Norder H, Arauz-Ruiz P, Blitz L, Pujol FH, Echevarria JM, Magnius LO. The T (1858) variant predisposing to the precore stop mutation correlates with one or two major genotype F hepatitis B virus clades. J Gen Virol 2003;84(Pt 8):2083–2087. doi: 10.1099/vir.0.19034-0 PubMedCrossRefGoogle Scholar
  20. 20.
    Huy TT, Ushijima H, Sata T, Abe K. Genomic characterization of HBV genotype F in Bolivia: genotype F subgenotypes correlate with geographic distribution and T (1858) variant. Arch Virol 2006;151(3):589–597. doi: 10.1007/s00705-005-0671-1 PubMedCrossRefGoogle Scholar
  21. 21.
    Khan A, Tanaka Y, Saito H, Ebinuma H, Sekiguchi H, Iwama H, et al. Transmission of hepatitis B virus (HBV) genotypes among Japanese immigrants and natives in Bolivia. Virus Res 2008;132(1–2):174–180PubMedCrossRefGoogle Scholar
  22. 22.
    Kao JH, Chen PJ, Lai MY, Chen DJ. Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B. Gastroenterology 2000;118:554–559. doi: 10.1016/S0016-5085(00)70261-7 PubMedCrossRefGoogle Scholar
  23. 23.
    Kao JM. Hepatitis B viral genotypes: clinical relevance and molecular characteristics. J Gastroenterol Hepatol 2002;17(6):643–650. doi: 10.1046/j.1440-1746.2002.02737.x PubMedCrossRefGoogle Scholar
  24. 24.
    Tanaka Y, Mizokami M. Genetic diversity of hepatitis B virus as an important factor associated with differences in clinical outcomes. J Infect Dis 2007;195(1):1–4. doi: 10.1086/509898 PubMedCrossRefGoogle Scholar
  25. 25.
    Ganem D, Prince AM. Hepatitis B virus infection—natural history and clinical consequences. N Engl J Med 2004;350(11):1118–1129. doi: 10.1056/NEJMra031087 PubMedCrossRefGoogle Scholar
  26. 26.
    Pan CQ, Zhang JX. Natural history and clinical consequences of hepatitis B virus infection. Int J Med Sci 2005;2(1):36–40PubMedGoogle Scholar
  27. 27.
    Cortes-Espinoza T, Mondragón-Sanchez R, Hurtado-Andrade H, Sanchez-Cisneros R. Hepatocellular carcinoma and hepatic cirrhosis in Mexico: a 25 year necroscopy review. Hepatogastroenterology 1997;44(17):1401–1403Google Scholar
  28. 28.
    Vivas Arceo C, Bastidas Ramírez BE, Panduro A. Hepatocellular carcinoma is rarely present in Western Mexico. Hepatol Res 1999;16(1):26–35. doi: 10.1016/S1386-6346(99)00035-2 CrossRefGoogle Scholar
  29. 29.
    Méndez-Sánchez N, Aguilar-Ramírez JR, Reyes A, Dehesa M, Juárez A, Castañeda B, et al. Etiology of liver cirrhosis in Mexico. Ann Hepatol 2004;3(1):30–33PubMedGoogle Scholar
  30. 30.
    Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernandez S, Hernández-Avila M, et al. Encuesta Nacional de Salud y Nutricion 2006. Cuernavaca Morelos (Mexico): Instituto Nacional de Salud Pública; 2006. p. 1–132 [cited December 2007]. Available from:
  31. 31.
    Green S. Systematic reviews and meta-analysis. Singapore Med J 2005;46(6):270–274PubMedGoogle Scholar
  32. 32.
    Clarke M. Systematic reviews and the Cochrane Collaboration [cited November 2007]. Available from:
  33. 33.
    Landa L. Seroepidemiología de la hepatitis B. Gac Med Mex 1976;111(2):108–114Google Scholar
  34. 34.
    Chiquete E, Panduro A. Low prevalence of anti-hepatitis C virus antibodies in Mexico: a systematic review. Intervirology 2007;50:1–8. doi: 10.1159/000096306 PubMedCrossRefGoogle Scholar
  35. 35.
    Valdespino JL, Conde-González CJ, Olaiz-Fernandez G, Palma O, Sepúlveda J. Prevalence of hepatitis B infection and carrier status among adults in Mexico. Salud Publica Mex 2007;49(Suppl 3):S404–S411Google Scholar
  36. 36.
    Marín LA, Luis LA, Ortega RM, López PS, Montiel MG. Marcadores serológicos indirectos (ALAT y anti-HBc) para hepatitis noA noB en donadores de sangre de la ciudad de Puebla. In Mem XXXI Jornada Agrup Mex Estudio Hematol; Oct 1990; Monterrey, Nuevo León, MexicoGoogle Scholar
  37. 37.
    Álvarez Muñoz MT, Bustamante Calvillo ME, Guiscafre Gallardo JP, Muñoz O. Hepatitis B y Delta: prevalencia de marcadores seroepidemiológicos en donadores de sangre voluntarios y su grupo familiar. Gac Med Mex 1991;127(5):399–404PubMedGoogle Scholar
  38. 38.
    Rivas Velazco R, Palomares BR, Gómez E, Moreno G, Martínez I, Badillo H. Enfermedades transmisibles en donadores de sangre en la zona oriente de la ciudad de México. In Mem XXXII Jornada Agrup Mex Estudio Hematol Oct 1991; Xalapa, Veracruz, MexicoGoogle Scholar
  39. 39.
    Rivas R, Gómez Martínez E, Martínez Pérez I, López Flores H, Fernández Jiménez A, Palomares B. Comportamiento de la seroprevalencia de enfermedades transmisibles en donadores de la zona oriente del Valle de México. In Mem XXXIV Jornada Agrup Mex Estudio Hematol Junio 1993; Guadalajara, Jalisco, MexicoGoogle Scholar
  40. 40.
    Souto Meiriño CA, Simón Domínguez J, Pulido Priego MA, Hernández Pérez A, García Hernández IC, Río Chiriboga CA. Prevalencia de marcadores para hepatitis A, B y C en un hospital de México. Salud Publica Mex 1994;36(3):257–262PubMedGoogle Scholar
  41. 41.
    Rivas Llamas R. Seroprevalencia y tendencia de la infección por VIH, VHB, VHC en donadores de sangre en la ciudad de Culiacán. Rev Med IMSS Mex 1996;34(6):487–493Google Scholar
  42. 42.
    Romero D, Villanueva M, Guzmán E, Bravo A. Prevalencia de anticuerpos contra hepatitis C en una población de disponentes familiares en la ciudad de México. In Mem XXXVIII Jornada Agrup Mex Estudio Hematol Mayo, 1997, León, Guanajuato, MexicoGoogle Scholar
  43. 43.
    Ayala Gaytan JJ, Guerra Avalos FJ, Mora Brondo P, Casillas Romo A. Prevalencia de marcadores virales para hepatitis B, C y Virus de la Inmunodeficiencia Humana en donadores de sangre voluntarios en el Noroeste de México. Rev Gastroenterol Mex 1997;62(4):250–253PubMedGoogle Scholar
  44. 44.
    Pita-Ramírez L, Torres-Ortiz GE. Prevalencia de anticuerpos virales y reaginas luéticas en donadores de sangre de un hospital. Rev Invest Clin 1997;49:475–480PubMedGoogle Scholar
  45. 45.
    Romero Martínez E. Selección de donadores sanguíneos: identificación de anti-HBc para evitar hepatitis postransfusional. Rev Med IMSS Mex 1998;36(4):327–332Google Scholar
  46. 46.
    Ramírez-Barragan J, Muñoz-Valle JF, Navarro-Hernández RE. Frecuencia de anticuerpos contra el HIV, HCV y HBsAg en donadores familiares en el Hospital del Carmen de la ciudad de Guadalajara, Jalisco. Rev Mex Patol Clin 1999;46(4):243–248Google Scholar
  47. 47.
    Méndez-Sánchez N, Baptista González H, Sánchez Gómez RH, Bordes Aznar J, Uribe Esquivel M. Prevalencia de hepatitis B y C en donadores de sangre en un hospital de tercer nivel de la ciudad de México. Salud Publica Mex 1999;41:475–478PubMedGoogle Scholar
  48. 48.
    Tristan Rojas CM, Nájera Tobias E, Cázares Taméz R, Flores Aréchiga A. Estudio comparativo de la seroprevalencia observada en diferentes bancos de sangre de la Republica Mexicana. XXVIII Congreso de Patología Clínica. Rev Mex Patol Clin 1999;46(1):34–35Google Scholar
  49. 49.
    Carreto-Velez MA, Carrada-Bravo T, Martínez-Magdaleno A. Seroprevalencia de VHB, VHC y VIH de donadores de sangre en Irapuato, México. Salud Publica Mex 2002;45(Suppl 5):S690–S693Google Scholar
  50. 50.
    Flores-Padilla L, Trejo-Franco J, Becerril-Brito J. Prevalencia de seromarcadores de hepatitis B y C en donadores del IMSS, Cd. Juarez, Chihuahua. XXVII Congreso Anual de la Asociación Mexicana de Infectologia y Microbiologia Clínica, A.C. 2002;22(3):106Google Scholar
  51. 51.
    Monteon VM, Reyes-Lopez PA, Sosa-Palacio A, Leon-Tello G, Martinez-Murguia J, Sosa-Jurado F. Heterogeneous distribution of the prevalence of anti-Trypsanosoma cruzi antibodies among blood donors in the State of Puebla, Mexico. Salud Publica Mex 2005;47(2):116–125. doi: 10.1590/S0036-36342005000200005 PubMedGoogle Scholar
  52. 52.
    Rivera-Lopez MRF, Zavala-Méndez C, Arenas-Esqueda A. Prevalencia de seropositividad para VIH, hepatitis B y C en donadores de sangre. Gac Med Mex 2004;140(6):657–660PubMedGoogle Scholar
  53. 53.
    Chiquete E, Sanchez LV, Becerra G, Quintero A, Maldonado M, Panduro A. Performance of the serologic and molecular screening of blood donations for the hepatitis B and C viruses in a Mexican Transfusion Center. Ann Hepatol 2005;4(4):275–278PubMedGoogle Scholar
  54. 54.
    García-Montalvo BM. Seropositividad de VIH, VHB, VHC y Treponema pallidum en donadores de sangre en el Sureste de Mexico. Rev Invest Clin 2006;58(6):567–572PubMedGoogle Scholar
  55. 55.
    Pita-Ramírez L, Rodríguez-Mejorada M. Comparación de dos poblaciones de sangre de la ciudad de Morelia. XLVII Congreso Nacional de Hematologia: Medicina Transfusional. Revista de Hematología 2006;7 (Suppl 1):S73Google Scholar
  56. 56.
    Cacique-Almazán J, Pérez-Martínez E, Gómez-Bravo A, Ángeles-Chimal JS. XLVII Congreso Nacional de Hematología: Medicina Transfusional. Rev Hematol 2006;7(Suppl 1):S71Google Scholar
  57. 57.
    Vázquez-Flores JA, Valiente-Banuet L, Marín y López RA, Sanchez-Guerrero SA. La seguridad de las reservas sanguíneas en la Republica Mexicana durante los años 1999 a 2003. Rev Invest Clin 2006;58(2):101–108PubMedGoogle Scholar
  58. 58.
    Álvarez Muñoz MT, Vázquez Rosales JG, Bustamante Calvillo ME, del Rey Pineda G, Arredondo García JL. Prevalencia de marcadores serológicos para los virus B y C de la hepatitis en una cohorte de mujeres embarazadas del Valle de México. Bol Med Hosp Infant Mex 1995;52(3):143–147Google Scholar
  59. 59.
    Ortiz Ibarra F, Figueroa Damian R, Lara Sánchez J, Arredondo García JL, Ahued Ahued JR. Prevalencia de marcadores serológicos de los virus de la hepatitis A, B, C y D en embarazadas. Salud Publica Mex 1996;38:317–322PubMedGoogle Scholar
  60. 60.
    Hernández Arriaga JL, Ramírez Crespo A, a Gómez M, Castellanos Martínez J. Marcadores serológicos de hepatitis B en la etapa perinatal. Bol Med Hosp Infant Mex 2000;57(12):682–685Google Scholar
  61. 61.
    Vazquez Martínez JL, Coreño Juárez MO, Montaño Estrada LF, Attlan M, Gómez Dantés H. Seroprevalencia de hepatitis B en mujeres embarazadas en México. Salud Publica Mex 2003;45(3):165–170PubMedGoogle Scholar
  62. 62.
    Kerschenobich D, Hurtado R, Collawin C, Bobadilla J, Cabrera G, Borovoy J, et al. Seroprevalencia de marcadores virales de hepatitis B en profesionales de la salud. Estudio multicéntrico en México. Rev Invest Clin 1990;42(4):251–256Google Scholar
  63. 63.
    Navarrete-Navarro S, Alvarez-Muñoz MA, Bustamante C, Vallejo Aguilar OJ, Muñoz O, Santos-Preciado JI, et al. Protección contra hepatitis B en trabajadores de salud con vacuna de DNA recombinante. Bol Med Hosp Infant Mex 1992;49(11):739–742PubMedGoogle Scholar
  64. 64.
    Flores Calderón J, Álvarez Muñoz MT, Bustamante Calvillo ME, Vázquez Rosales G, Reyes Morales H. Prevalencia de marcadores serológicos para el virus de la hepatitis B en personal de un hospital pediátrico. Bol Med Hosp Infant Mex 1994;51:99–104Google Scholar
  65. 65.
    Villasis-Keever MA, Peña LA, Miranda Novales G, Alvarez Muñoz MT, Damasio Santana RA, López Fuentes G, et al. Prevalence of serological markers against measles, varicella, hepatitis B, hepatitis C, and human immunodeficiency virus among medical residents in Mexico. Prev Med 2001;32(5):424–428. doi: 10.1006/pmed.2001.0825 PubMedCrossRefGoogle Scholar
  66. 66.
    Méndez-Sánchez N, Motola-Kuba D, Zamora-Valdés D, Sánchez-Lara K, Ponciano-Rodríguez G, Uribe-Ramos MH, et al. Risk factors and prevalence of hepatitis virus B and C serum markers among nurses at a tertiary-care hospital in Mexico City, Mexico: a descriptive study. Ann Hepatol 2006;5(4):276–280PubMedGoogle Scholar
  67. 67.
    Flores Castañeda MS, García Méndez BL, Tijerina Menchaca R. Seropositividad de la infección por HCV y VHB en estudiantes universitarios del Estado de Nuevo León, México. Rev Gastroenterol Mex 1996;61(4):327–331PubMedGoogle Scholar
  68. 68.
    Hyams KC, Escamilla J, Lozada Romero R, Macareno Alvarado E, Bonilla Giraldo N, Papadimos TJ, et al. Hepatitis B infection in a non-drug abusing prostitute population in Mexico. Scand J Infect Dis 1990;22(5):527–531. doi: 10.3109/00365549009027091 PubMedCrossRefGoogle Scholar
  69. 69.
    Valdespino Gómez JL, García García ML, del Río Chiriboga C, Loo Méndez E, López Sotelo A. Las enfermedades de transmisión sexual y la epidemia de VIH/SIDA. Salud Publica Mex 1995;37(6):549–555PubMedGoogle Scholar
  70. 70.
    Uribe-Salas F, Hernández-Giron C, Conde-González C, Cruz-Valdez A, Juárez-Figueroa L, Hernández-Avila M. Characteristics related to STD/HIV in men working in bars with prostitutes in Mexico City. Salud Publica Mex 1995;37:385–393PubMedGoogle Scholar
  71. 71.
    Juárez-Figueroa LA, Uribe-Salas FJ, Conde-González CJ, Hernández-Avila M, Hernández-Nevarez P, Uribe-Zúñiga P, et al. Hepatitis B markers in men seeking human immunodeficiency virus antibody testing in Mexico City. Sex Transm Dis 1997;24(4):211–217PubMedCrossRefGoogle Scholar
  72. 72.
    Hernández-Girón C, Uribe-Salas F, Conde-González C, Cruz-Valdez A, Juárez-Figueroa L, Uribe-Zúñiga P, et al. Seroprevalencias a diversos virus y características sociodemográficas en mujeres que buscan detectarse VIH. Rev Invest Clin 1997;49:5–13PubMedGoogle Scholar
  73. 73.
    Juárez-Figueroa L, Uribe-Salas F, Conde-González C, Hernández-Ávila M, Olamendi-Portugal M, Uribe-Zúñiga P, et al. Low prevalence of hepatitis B among Mexican female sex workers. Sex Transm Infect 1998;74:448–450PubMedCrossRefGoogle Scholar
  74. 74.
    Uribe-Salas F, Hernández-Avila , Juárez-Figueroa L, Conde-González CJ, Uribe-Zuñiga P. Risk factors for herpes simplex virus type 2 infection among female commercial sex workers in Mexico City. Int J STD AIDS 1999;10(2):105–111. doi: 10.1258/0956462991913727 PubMedCrossRefGoogle Scholar
  75. 75.
    Uribe-Salas F, Conde-González CJ, Juárez-Figueroa L, Hernández-Castellanos A. Sociodemographic dynamics and sexually transmitted infections in female sex workers at the Mexican-Guatemalan border. Sex Transm Dis 2003;30(3):266–271. doi: 10.1097/00007435-200303000-00018 PubMedCrossRefGoogle Scholar
  76. 76.
    Tamez Treviño E, Tijerina Menchaca R, Bosques Padilla F, Rangel Orozco R, Isibasi A, Flores Castañeda MS. Frecuencia de la infección con VHC, VHB o VIH no diagnosticada en pacientes hepatópatas. Med Universitaria 2002;4(16):148–152Google Scholar
  77. 77.
    Campollo O, Valencia-Salinas JJ, Berumen-Arellano A, Pérez-Aranda MA, Panduro-Cerda A, Segura-Ortega J. Características epidemiológicas de la cirrosis hepática en el Hospital Civil de Guadalajara. Salud Publica Mex 1997;39:195–200. doi: 10.1590/S0036-36341997000300004 PubMedGoogle Scholar
  78. 78.
    Porras Nuñez LO, Balderas Ávila R, Lejia Guzman M, Mattar Olivo C. Core M marcador útil de hepatitis B en pacientes de hemodiálisis. Rev Mex Patol Clin 2002;49(3):148–152Google Scholar
  79. 79.
    Treviño Hernández R, Pérez Ramírez JL, Cruz Valdez J, Ramírez B, et al. Prevalencia de hepatitis C y B en pacientes con insuficiencia renal crónica en programa de hemodiálisis en el Hospital Universitario y Centro Renal de Monterrey. Med Universitaria 2003;5(21):228–232Google Scholar
  80. 80.
    Kato-Maeda M, Ponce-de-Leon S, Sifuentes-Osoirnio J, Rangel-Frausto MS, Calva-Mercado J, Infante-Surez L, et al. Bloodborne viral infections in patients attending an emergency room in Mexico City: estimate of seroconversion probability in healthcare workers alter an occupational exposure. Infect Control Hosp Epidemiol 2000;21(9):600–602. doi: 10.1086/501811 PubMedCrossRefGoogle Scholar
  81. 81.
    Alvarado-Esquivel C, Arreola-Valenzuela MA, Mercado-Suarez F, Espinoza-Andrade F. Hepatitis B virus infection among inpatients of a psychiatric hospital of Mexico. Clin Pract Epidemol Ment Health 2005;1:10. doi: 10.1186/1745-0179-1-10 PubMedCrossRefGoogle Scholar
  82. 82.
    Alvarez Muñoz MT, Bustamante Calvillo MA, Martínez García MC, Moreno Altamirano L, Guiscafre-Gallardo H, Guiscafre JP, et al. Seroepidemiology of the hepatitis B and delta in the southeast of Chiapas, Mexico. Arch Invest Med (Mex) 1989;20(2):189–195Google Scholar
  83. 83.
    Cisneros-Castolo M, Hernández-Ruiz L, Ibarra-Robles IE, Fernández-Gárate IH, Escobedo-de la Peña J. Prevalence of hepatitis B virus infection and related risk factors in a rural community of Mexico. Am J Trop Med Hyg 2001;65(6):759–763PubMedGoogle Scholar
  84. 84.
    Roman S, Panduro A, Maldonado M, Sanchez C, Quezada D, Martinez E, et al. High prevalence of occult hepatitis B infection among different Mexican ethnic groups. Liver Int 2006;26(Suppl 1):S51Google Scholar
  85. 85.
    Secretaria de Salud. México, Sistema Único de Vigilancia Epidemiológica. Dirección General de Epidemiología. Anuario de Morbilidad 1984–2006 [cited December 2007]. Available from:
  86. 86.
    Secretaria de Salud. México, Sistema Nacional de Información en Salud, Reporte de Mortalidad 2000–2005 [cited December 2007]. Available from:
  87. 87.
    Instituto Nacional de Estadisticas. Geografia e Informatica (INEGI). Censo General de Población y Vivienda 2000 (data on CD-ROM). Aguascalientes (Mexico): INEGI; 2001Google Scholar
  88. 88.
    Celis A, Gaxiola-Robles R, Sevilla-Godinez E, Orozco-Valerio MJ, Armas J. Tendencia de la mortalidad por picaduras de alacran en Mexico, 1979–2003. Rev Panam Salud Publica 2007;21(6):373–380. doi: 10.1590/S1020-49892007000500005 PubMedCrossRefGoogle Scholar
  89. 89.
    Taylor RN, Fulford KM. Results of the Center for Disease Control Proficiency Testing Program for the detection of hepatitis B surface antigen. J Clin Microbiol 1976;4(1):32–39PubMedGoogle Scholar
  90. 90.
    Weber B, Bayer A, Kirch P, Schlüter V, Schlieper D, Melchior W. Improved detection of hepatitis B virus surface antigen by a new rapid automated assay. J Clin Microbiol 1999;37(8):2639–2647PubMedGoogle Scholar
  91. 91.
    Diepersloot RJ, van Zantvliet-van Oostrom Y, Gleaves CA. Comparison of a chemiluminescent immunoassay with two microparticle enzyme immunoassays for detection of hepatitis B virus surface antigen. Clin Diagn Lab Immunol 2000;7(6):865–866. doi: 10.1128/CDLI.7.6.865-866.2000 PubMedCrossRefGoogle Scholar
  92. 92.
    Gerlich WH. Diagnostic problems caused by HBsAg mutants—a consensus report of an expert meeting. Intervirology 2004;47(6):310–313. doi: 10.1159/000080873 PubMedCrossRefGoogle Scholar
  93. 93.
    Ly TD, Servant-Delmas A, Bagot S, Gonzalo S, Férey MP, Ebel A, et al. Sensitivities of four new commercial hepatitis B virus surface antigen (HBsAg) assays in detection of HBsAg mutant forms. J Clin Microbiol 2006;44(7):2321–2326. doi: 10.1128/JCM.00121-06 PubMedCrossRefGoogle Scholar
  94. 94.
    Food and Drug Administration. Test for hepatitis B surface antigen. Fed Regist 1975;40:P29706–P29712Google Scholar
  95. 95.
    Principles in evaluation of HBsAg test kits: appropriate use of 2nd WHO International Standard (IS) and Reference Panel for HBsAg. Geneva: World Health Organization; Nov 2004 [cited September 15, 2008]. Available from:
  96. 96.
    Mizuochi T, Okada Y, Umemori K, Mizusawa S, Sato S, Yamaguchi K. Reactivity of genotypically distinct hepatitis B virus surface antigens in 10 commercial diagnostic kits available in Japan. Jpn J Infect Dis 2005;58(2):83–87PubMedGoogle Scholar
  97. 97.
    van Roosmalen MH, de Jong JJ, Haenen W, Jacobs T, Couwenberg F, Ahlers-de Boer GJ, et al. A new HBsAg screening assay designed for sensitive detection of HBsAg subtypes and variants. Intervirology 2006;49(3):127–132. doi: 10.1159/000089373 PubMedCrossRefGoogle Scholar
  98. 98.
    Togashi H, Hashimoto C, Yokozawa J, Suzuki A, Sugahara K, Saito T, et al. What can be revealed by extending the sensitivity of HBsAg detection to below the present limit? J Hepatol 2008;49(1):17–24. doi: 10.1016/j.jhep.2008.03.019 PubMedCrossRefGoogle Scholar
  99. 99.
    Baptista González HA, Kourchenko Raab H, Rosenfeld Mann F, Rizo Almenara S, Peñuela Olaya MA. Estudio de infecciones virales en el lactante menor transfundido en la etapa neonatal. Bol Med Hosp Infant Mex 1998;55(7):386–392Google Scholar
  100. 100.
    Cervantes Bustamante R, Ramírez Mayans J, Zarate Mondragón F, Mata Rivera N, Munguia Venegas P, Mason Cordero T, et al. Marcadores serológicos para el virus de Hepatitis B en un grupo de niños mexicanos. Acta Pediatr Mex 2002;23(6):352–354Google Scholar
  101. 101.
    Norma Oficial Mexicana NOM. 003/SSA2/1993. Normas y Técnicas para la Disposición de Sangre Humana y sus Componentes con Fines Terapéuticos. Diario Oficial de la Federación del 18 de Julio del 1994 [cited November 2007]. Available from:
  102. 102.
    Norma Oficial Mexicana. NOM-031-SSA2-1999, para la atencion a la salud del niňo. Diario Oficial de Federacion del 9 de junio del 2000 [cited November 2007]. Available from:
  103. 103.
    CONADICT. Statistics on Drug Abuse Patterns, Mexico 2001 [cited January 2008]. Available from:
  104. 104.
    Simonetti RG, Camma C, Fiorello F, Politi F, D’amico G, Pagliaro L. Hepatocellular carcinoma. A worldwide problem and the major risk factors. Dig Dis Sci 1991;36:962–972. doi: 10.1007/BF01297149 PubMedCrossRefGoogle Scholar
  105. 105.
    Tanaka Y, Kurbanov F, Mano S, Orito E, Vargas V, Esteban JI, et al. Molecular tracing of the global hepatitis C virus epidemic predicts regional patterns of hepatocellular carcinoma. Gastroenterology 2006;130(3):703–714. doi: 10.1053/j.gastro.2006.01.032 PubMedCrossRefGoogle Scholar

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

Personalised recommendations