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Title: Monitoring hepatitis B and C infections among HIV patients: a proposed model for a cascade of care in viral hepatitis in the Dominican Republic [poster]
Autores: Tapia-Barredo, Leandro
Peña, Paola
Matos, Y.
Valerio, K.
Muñoz, M.
Ledesma, J.
Jiménez, M.
Paulino-Ramírez, Robert
Researchers (UNIBE): Tapia-Barredo, Leandro 
Peña, Paola 
Paulino-Ramírez, Robert 
Affiliations: Instituto de Medicina Tropical y Salud Global (IMTSAG) 
Instituto de Medicina Tropical y Salud Global (IMTSAG) 
Instituto de Medicina Tropical y Salud Global (IMTSAG) 
Research area: Ciencias de la Salud
Issue Date: 2018
Source: Journal of the International AIDS Society, 21 (S3), e25093
metadata.dc.identifier.artno: e25093
Volume: 21
Issue: S3
Start page: e25093
Conference: HIV & Hepatitis in the Americas 19‐21 April 2018, Mexico City, Mexico
Although the hepatitis B vaccine began widely used in high-income countries in the 1980s, almost 20 years later it was still rarely used in low- and middle-income countries. The main reasons behind these gaps included limited money for immunization, a lack of the infrastructure needed to carry out effective immunization programs, and a lack of political interest in immunization [1]. It is estimated a HBV prevalence of 2 to 4% in the Caribbean, and for HCV it is around 1.2% in the Latin-American region [2]. In the DR prevalence of both HIV and/or HBV/HCV are higher among GMT persons [3].

Materials and methods:
Patients enrolled in care in a community-based clinic in Santo Domingo were evaluated for clinical indicators of HBV/HCV/Syphilis and HIV infections. A proposed model of cascade of care was proposed with the indicators found (Figures 1, 2)

A total of 2435 cases of HIV (+) patients were evaluated. Serological tests demonstrating HBsAg detection was 91% (n = 2238), and co-infection HIV/HBV was 63% (n = 29), and Tenofovir-based ARV regimens among HBsAg (+) was 49% (n = 14) The mean age in the HIV/HBV/HCV cohort was 44 years old, 71.8% were male, and of those 12% was MSM. HCV/HIV co-infection was 41%(n = 19), and the frequency of HIV/HBV/HCV was only 4.3%. In all cases there were no HBV or HCV viral loads available, and none of them with treatment for HCV infection. Among those with HBV infection and HIV 48% was on ARV Tenofovir-based treatment.

This study reveals that it is needed more investment on early detection and intensive screening for both HBV and HCV in the context of non-HIV positive patients. The proposed cascade of care to monitor interventions requires a scale-up in case reporting and early treatment in each scenario.
DOI: 10.1002/jia2.25093
Appears in Collections:Publicaciones del IMTSAG-UNIBE

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