ESTRATEGIAS PARA LA ERRADICACIÓN MUNDIAL DE LA HEPATITIS VIRAL CRÓNICA PARA EL 2030
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Abstract
Los virus de hepatitis B (VHB), C (VHC) y D (VHD); producen hepatitis viral crónica (HVC) responsable de 1.4 millones de muertes por cirrosis hepática y carcinoma hepatocelular. La Organización Mundial de la Salud, adoptó estrategias para la eliminación del VHC para el año 2030. La vacunación contra el VHB reduce el 80% de muertes, previene la HVC por VHB, VHD y el carcinoma hepatocelular. La prevención de la transmisión vertical es una estrategia 90% útil para detener la HVC en hijos de madres infectadas con el VHB. El uso apropiado de inyecciones, pesquisaje adecuado de la sangre de dotantes y la selección restrictiva de donantes disminuye el riesgo de VHC. Las medidas de reducción de daño de HVC consisten en proporcionar jeringas estériles a adictos, prevención de accidentes por pinchazos en personal de salud, introducción de dispositivos de seguridad para la prevención de lesiones punzantes, vacunación de todos los trabajadores de la salud y profilaxis posterior a accidentes laborales. El diagnóstico correcto de VHB permitirá instaurar el tratamiento disponible no curativo, mientras que la terapia antiviral de acción directa cura la hepatitis C. El uso de preservativos y nuevos métodos diagnósticos podrían ser estrategias útiles de prevención de HVC.
Palabras claves: hepatitis B, hepatitis C, hepatitis D, hepatitis viral crónica, cirrosis hepática, erradicación.
ABSTRACT
Chronic viral hepatitis (CVH) associated with Hepatitis B (HBV), C (HCV) and D (HDV) viruses are responsible for 1.4 million deaths from liver cirrhosis and hepatocellular carcinoma. The World Health Organization has implemented strategies for the elimination of HCV by 2030. Vaccination against HBV reduces 80% of deaths and prevents CVH associated with HBV, HDV, and hepatocellular carcinoma. The prevention of perinatal vertical transmission is the most appropriate strategy to avoid CVH by 90% in children of HBV infected mothers. The use of injections appropriately, the screening of blood from donors, and restrictive donor selection decrease the risk of HCV. CVH harm reduction consist of providing sterile syringes to people who inject drugs (PWID), prevention of accidental puncture in health personnel, introduction of safety devices for the prevention of puncture injuries, vaccination against HBV of all health workers and post-exposure prophylaxis after work related accidents. The correct diagnosis of HBV, will allow the introduction of available non-curative treatment, while direct-acting antiviral therapy cures hepatitis C. The use of condoms and new diagnostic methods could be useful strategies for preventing HCV.
Keywords: hepatitis B, hepatitis C, hepatitis D, chronic viral hepatitis, liver cirrhosis, eradication.
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