Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019
Both hepatitis B virus (HBV) and hepatitis C virus (HCV) are major sources of morbidity and mortality worldwide; however, their prevalence in key groups in Colombia is not yet known. We aimed to analyse the prevalence of HBV and HCV and its associated factors in key groups who were treated at an ins...
- Autores:
-
Cardona Arias, Jaiberth Antonio
Cataño Correa, Juan Carlos
Higuita Gutiérrez, Luis Felipe
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2020
- Institución:
- Universidad Cooperativa de Colombia
- Repositorio:
- Repositorio UCC
- Idioma:
- OAI Identifier:
- oai:repository.ucc.edu.co:20.500.12494/28271
- Acceso en línea:
- https://doi.org/10.1371/journal.pone.0238655
https://hdl.handle.net/20.500.12494/28271
- Palabra clave:
- Hepatitis B virus (HBV)
Hepatitis C virus (HCV)
Prevalence
Hepatitis B virus (HBV)
Hepatitis C virus (HCV)
Prevalence
- Rights
- openAccess
- License
- Atribución
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| dc.title.spa.fl_str_mv |
Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| title |
Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| spellingShingle |
Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 Hepatitis B virus (HBV) Hepatitis C virus (HCV) Prevalence Hepatitis B virus (HBV) Hepatitis C virus (HCV) Prevalence |
| title_short |
Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| title_full |
Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| title_fullStr |
Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| title_full_unstemmed |
Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| title_sort |
Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| dc.creator.fl_str_mv |
Cardona Arias, Jaiberth Antonio Cataño Correa, Juan Carlos Higuita Gutiérrez, Luis Felipe |
| dc.contributor.author.none.fl_str_mv |
Cardona Arias, Jaiberth Antonio Cataño Correa, Juan Carlos Higuita Gutiérrez, Luis Felipe |
| dc.subject.spa.fl_str_mv |
Hepatitis B virus (HBV) Hepatitis C virus (HCV) Prevalence |
| topic |
Hepatitis B virus (HBV) Hepatitis C virus (HCV) Prevalence Hepatitis B virus (HBV) Hepatitis C virus (HCV) Prevalence |
| dc.subject.other.spa.fl_str_mv |
Hepatitis B virus (HBV) Hepatitis C virus (HCV) Prevalence |
| description |
Both hepatitis B virus (HBV) and hepatitis C virus (HCV) are major sources of morbidity and mortality worldwide; however, their prevalence in key groups in Colombia is not yet known. We aimed to analyse the prevalence of HBV and HCV and its associated factors in key groups who were treated at an institution providing health services in Colombia during 2019. This was a multiple-group ecological study that included 2,624 subjects from the general population, 1,100 men who have had sex with men (MSM), 1,061 homeless individuals, 380 sex workers, 260 vulnerable young people, 202 drug users, 41 inmates and 103 people from the lesbian, gay, bisexual and transgender community. Prevalence of infection with a 95% confidence interval and its associated factors was calculated for each group. Confounding variables were assessed using logistical regression and SPSS 25.0 software. Prevalence of HBV and HCV in the general population was 0.15% and 0.27%, respectively; 0.27% and 2.09% in MSM; 0.37% and 2.17% amongst homeless individuals; 0.26% and 0.0% amongst sex workers; 0.39% and 0.0% amongst vulnerable youth; and 5.94% and 45.54 amongst injecting drug users. In the multivariate HBV model, the explanatory variables included the study group, city of origin and the type of health affiliation; for HCV they were group, origin, sex, age group, health affiliation, use of drugs and hallucinogen use during sexual intercourse. A high prevalence of HBV and HCV were evidenced for both viral infections, which was, consequently, much higher within the key groups. The main associated factors that were identified related to origin and type of health affiliation and demonstrated a double vulnerability, that is, belonging to groups that are discriminated and excluded from many health policies and living under unfavourable socioeconomic conditions that prevent proper affiliation and health care. |
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2020 |
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2020-11-25T18:33:19Z |
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2020-11-25T18:33:19Z |
| dc.date.issued.none.fl_str_mv |
2020-09-22 |
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Artículo |
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http://purl.org/coar/resource_type/c_2df8fbb1 |
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http://purl.org/coar/version/c_970fb48d4fbd8a85 |
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19326203 |
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https://doi.org/10.1371/journal.pone.0238655 |
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https://hdl.handle.net/20.500.12494/28271 |
| dc.identifier.bibliographicCitation.spa.fl_str_mv |
Cardona-Arias, J.A., Cataño Correa, J.C, Higuita Gutiérrez, L.F. (2019) Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| identifier_str_mv |
19326203 Cardona-Arias, J.A., Cataño Correa, J.C, Higuita Gutiérrez, L.F. (2019) Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019 |
| url |
https://doi.org/10.1371/journal.pone.0238655 https://hdl.handle.net/20.500.12494/28271 |
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https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238655 |
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Plos One |
| dc.relation.references.spa.fl_str_mv |
Organización Mundial de la Salud (OMS). Los datos más recientes ponen de relieve la necesidad de actuar urgentemente a nivel mundial contra las hepatitis. 2019. Available from: https://www.who.int/es/news-room/detail/21-04-201-new-hepatitis-data-highlight-need-forurgent-global-response. Accessed April 2020. World Health Organization. Global Hepatitis Report 2017. 2017. Available from: https://apps.who.int/iris/bitstream/handle/10665/255016/9789241565455-eng. Accessed April 2020. Rustgi VK. The epidemiology of hepatitis C infection in the United States. J Gastroenterol. 2007;42(7): 513–521. 10.1007/s00535-007-2064-6 Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61(Suppl 1): S58–S68. 10.1016/j.jhep.2014.07.012 Organización Mundial de la Salud (OMS). Los datos más recientes ponen de relieve la necesidad de actuar urgentemente a nivel mundial contra las hepatitis. 2017. Available from: https://www.who.int/es/news-room/detail/21-04-2017-new-hepatitis-data-highlight-need-for-urgent-global-response. Accessed April 2020. Farooq A, Waheed U, Zaheer HA, Aldakheel F, Alduraywish S, Arshad M. Detection of HBsAg mutants in the blood donor population of Pakistan. PLoS ONE. 2017;12(11): 1–11. 10.1371/journal.pone.0188066 El-Ghitany EM, Farghaly AG. Evaluation of commercialized rapid diagnostic testing for some Hepatitis B biomarkers in an area of intermediate endemicity. J Virol Methods. 2013;194(1–2): 190–193. 10.1016/j.jviromet.2013.08.026 Randrianirina F, Carod J-F, Ratsima E, Chrétien J-B, Richard V, Talarmin A. Evaluation of the performance of four rapid tests for detection of hepatitis B surface antigen in Antananarivo, Madagascar. J Virol Methods. 2008;151(2): 294–297. 10.1016/j.jviromet.2008.03.019 Dogbe EE, Arthur F. Diagnostic accuracy of blood centers in the screening of blood donors for viral markers. Pan Afr Med J. 2015;20: 119 10.11604/pamj.2015.20.119.5263 Alvarado-Mora MV, Fernandez MF, Gomes-Gouvêa MS, de Azevedo Neto RS, Carrilho FJ, Pinho JR. Hepatitis B (HBV), hepatitis C (HCV) and hepatitis delta (HDV) viruses in the Colombian population—how is the epidemiological situation? PLoS One. 2011;6(4): e18888 10.1371/journal.pone.0018888 Callejas-Rojo F, Serna-Quintana G, Cardona-Arias J. Frecuencia de reactividad a la prueba VDRL y de positividad para Chlamydia spp, VIH y virus de la hepatitis B y C en una institución prestadora de servicios de la salud de Medellín, 2015. CES Med. 2017;31(1): 27–37. Bedoya J, Cortés M, Cardona-Arias J. Seroprevalencia de marcadores de infecciones transmisibles por vía transfusional en banco de sangre de Colombia. Rev Saúde Pública. 2012;46(6): 950–959 Ruiz Mendoza L, Villegas Gracia R, Cardona-Arias J. Prevalencia de agentes transmisibles por transfusión y factores asociados en un banco de sangre de Córdoba-Colombia 2014–2016. Rev. UDCA. 2018;21(2): 297–308. Rios W, Cortes F, Olarte J, Soto A, Navas M. Occult Hepatitis B Virus infection among blood donors in Colombia. Virol J. 2014;11:206 10.1186/s12985-014-0206-z Jaramillo C, de La Hoz F, Porras A, di Filippo D, Choconta L, Payares E, et al. Characterization of Hepatitis B Virus in Amerindian children and mothers from Amazonas State, Colombia. PLoS One. 2017;12(10):e0181643 10.1371/journal.pone.0181643 Mateu P, Guarino H, Quinn K, Meylakhs P, Campos S, Meylakhs A, et al. Young Drug Users: A Vulnerable Population and an Underutilized Resource in HIV/HCV Prevention. Curr HIV/AIDS Rep. 2018;15(4):324–335. 10.1007/s11904-018-0406-z Toro D, Berbesi D, Mateu P, Segura A, Montoya L. Prevalence of Hepatitis C Virus in Young People Who Inject Drugs in Four Colombian Cities: A Cross-Sectional Study Using Respondent Driven Sampling. Int J Drug Policy. 2018;60:56–64. 10.1016/j.drugpo.2018.07.002 Abad S, Vega A, Rincón D, Hernández E, Mérida E, Macías N, et al. Eficacia de los antivirales de acción directa en la infección por el virus de la hepatitis C en pacientes en hemodiálisis. Nefrología. 2017;37(2): 158–163. 10.1016/j.nefro.2016.10.003 Hyams KC, Phillips IA, Moran AY, Tejada A, Wignall FS, Escamilla J. Seroprevalence of hepatitis C antibody in Peru. J Med Virol. 1992;37(2): 127–131. 10.1002/jmv.1890370210 Fairley CK, Leslie DE, Nicholson S, Gust ID. Epidemiology and hepatitis C virus in Victoria. Med J Aust. 1990;153(5): 271–273. 10.5694/j.1326-5377.1990.tb136899.x Gorgos L. Sexual transmission of viral hepatitis. Infect Dis Clin N Am. 2013;27(4): 811–836. 10.1016/j.idc.2013.08.002 Bradshaw D, Matthews G, Danta M. Sexually transmitted hepatitis C infection: the new epidemic in MSM? Curr Opin Infect Dis. 2013;26(1): 66–72. 10.1097/QCO.0b013e32835c2120 Matos MA, França DDDS, Carneiro MADS, Martins RMB, Kerr LRFS, Caetano KAA, et al. Viral hepatitis in female sex workers using the Respondent-Driven Sampling. Rev Saude Publica. 2017;51: 65 10.1590/S1518-8787.2017051006540 Alonso M, Gutzman A, Mazin R, Pinzon CE, Reveiz L, Ghidinelli M. Hepatitis C in key populations in Latin America and the Caribbean: systematic review and meta-analysis. Int J Public Health. 2015;60(7): 789–798. 10.1007/s00038-015-0708-5 Le LN, O'Connor S, Tran TH, Maher L, Kaldor J, Sabin K, et al. High hepatitis C virus infection among female sex workers in Viet Nam: strong correlation with HIV and IV drug use. Western Pac Surveill Response J. 2019;10(3): 9–18. Baden R, Rockstroh JK, Buti M. Natural history and management of hepatitis C: Does sex play a role? J Infect Dis. 2014; 209(Suppl 3): S81–S85. 10.1093/infdis/jiu057 Pando MA, Berini C, Bibini M, Fernández M, Reinaga E, Maulen S, et al. Prevalence of HIV and other sexually transmitted infections among female commercial sex workers in Argentina. Am J Trop Med Hyg. 2006;74(2): 233–238 León P, Venegas E, Bengoechea L, Rojas E, López JA, Elola C, et al. Prevalence of infections by hepatitis B, C, D and E viruses in Bolivia. Rev Panam Salud Publica. 1999;5(3): 144–151. 10.1590/s1020-49891999000300002 Camejo MI, Mata G, Díaz M. Prevalence of hepatitis B, hepatitis C and syphilis in female sex workers in Venezuela. Rev Saude Publica. 2003;37(3): 339–244. 10.1590/s0034-89102003000300012 Cheung RC, Hanson AK, Maganti K, Keeffe EB, Matsui SM. Viral hepatitis and other infectious diseases in a homeless population. J Clin Gastroenterol. 2002;34(4): 476–480. 10.1097/00004836-200204000-00021 Beijer U, Wolf A, Fazel S. Prevalence of tuberculosis, hepatitis C virus, and HIV in homeless people: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(11): 859–870. 10.1016/S1473-3099(12)70177-9 Hakobyan S, Sepehry AA, Nikoo N, Khachatryan D, Nikoo M, Song MJ, et al. An update of Hepatitis C prevalence rates in homeless adults after Hepatitis C treatment paradigm change: A systematic review and meta-analysis. Med Res Arch. 2018;6(1): 1–15. 10.18103/mra.v6i1.1596 Indolfi G, Easterbrook P, Dusheiko G, Siberry G, Chang MH, Thorne C, et al. Hepatitis B virus infection in children and adolescents. Lancet Gastroenterol Hepatol. 2019;4(6): 466–476. 10.1016/S2468-1253(19)30042-1 Silva MB, Andrade TM, Silva LK, Rodart IF, Lopes GB, Carmo TM, et al. Prevalence and genotypes of hepatitis C virus among Injecting drug users from Salvador-BA, Brazil. Mem Inst Oswaldo Cruz. 2010;105(3): 299–303. 10.1590/s0074-02762010000300009 European Centre for Disease Prevention and Control. Systematic review on hepatitis B and C prevalence in the EU/EEA. Stockholm: ECDC; 2016. Available from: https://www.ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/systematic-review-hepatitis-B-C-prevalence.pdf. Accessed April 2020. Behzadifar M, Behzadifar M, Bragazzi NL. A systematic review and meta-analysis of the prevalence of hepatitis C virus infection in people who inject drugs in Iran. BMC Public Health. 2020;20(1): 62 10.1186/s12889-020-8175-1 Edmunds WJ, Medley GF, Nokes DJ, Hall AJ, Whittle HC. The influence of age on the development of the hepatitis B carrier state. Proc Biol Sci. 1993; 253:197–201. 10.1098/rspb.1993.0102 Cooke GS, Andrieux-Meyer I, Applegate TL, Atun R, Burry JR, Cheinquer H, et al. Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol. 2019;4(2): 135–184. 10.1016/S2468-1253(18)30270-X |
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Cardona Arias, Jaiberth AntonioCataño Correa, Juan CarlosHiguita Gutiérrez, Luis Felipe15(9)2020-11-25T18:33:19Z2020-11-25T18:33:19Z2020-09-2219326203https://doi.org/10.1371/journal.pone.0238655https://hdl.handle.net/20.500.12494/28271Cardona-Arias, J.A., Cataño Correa, J.C, Higuita Gutiérrez, L.F. (2019) Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019Both hepatitis B virus (HBV) and hepatitis C virus (HCV) are major sources of morbidity and mortality worldwide; however, their prevalence in key groups in Colombia is not yet known. We aimed to analyse the prevalence of HBV and HCV and its associated factors in key groups who were treated at an institution providing health services in Colombia during 2019. This was a multiple-group ecological study that included 2,624 subjects from the general population, 1,100 men who have had sex with men (MSM), 1,061 homeless individuals, 380 sex workers, 260 vulnerable young people, 202 drug users, 41 inmates and 103 people from the lesbian, gay, bisexual and transgender community. Prevalence of infection with a 95% confidence interval and its associated factors was calculated for each group. Confounding variables were assessed using logistical regression and SPSS 25.0 software. Prevalence of HBV and HCV in the general population was 0.15% and 0.27%, respectively; 0.27% and 2.09% in MSM; 0.37% and 2.17% amongst homeless individuals; 0.26% and 0.0% amongst sex workers; 0.39% and 0.0% amongst vulnerable youth; and 5.94% and 45.54 amongst injecting drug users. In the multivariate HBV model, the explanatory variables included the study group, city of origin and the type of health affiliation; for HCV they were group, origin, sex, age group, health affiliation, use of drugs and hallucinogen use during sexual intercourse. A high prevalence of HBV and HCV were evidenced for both viral infections, which was, consequently, much higher within the key groups. The main associated factors that were identified related to origin and type of health affiliation and demonstrated a double vulnerability, that is, belonging to groups that are discriminated and excluded from many health policies and living under unfavourable socioeconomic conditions that prevent proper affiliation and health care.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001501791https://orcid.org/0000-0003-1361-3124https://scienti.minciencias.gov.co/gruplac/jsp/visualiza/visualizagr.jsp?nro=00000000011355jaiberthcardona@gmail.comkataju@hotmail.comluis.higuita@campusucc.edu.co1-14PloSUniversidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Medicina, Medellín y EnvigadoMedicinaMedellínhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238655Plos OneOrganización Mundial de la Salud (OMS). Los datos más recientes ponen de relieve la necesidad de actuar urgentemente a nivel mundial contra las hepatitis. 2019. Available from: https://www.who.int/es/news-room/detail/21-04-201-new-hepatitis-data-highlight-need-forurgent-global-response. Accessed April 2020.World Health Organization. Global Hepatitis Report 2017. 2017. Available from: https://apps.who.int/iris/bitstream/handle/10665/255016/9789241565455-eng. Accessed April 2020.Rustgi VK. The epidemiology of hepatitis C infection in the United States. J Gastroenterol. 2007;42(7): 513–521. 10.1007/s00535-007-2064-6Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61(Suppl 1): S58–S68. 10.1016/j.jhep.2014.07.012Organización Mundial de la Salud (OMS). Los datos más recientes ponen de relieve la necesidad de actuar urgentemente a nivel mundial contra las hepatitis. 2017. Available from: https://www.who.int/es/news-room/detail/21-04-2017-new-hepatitis-data-highlight-need-for-urgent-global-response. Accessed April 2020.Farooq A, Waheed U, Zaheer HA, Aldakheel F, Alduraywish S, Arshad M. Detection of HBsAg mutants in the blood donor population of Pakistan. PLoS ONE. 2017;12(11): 1–11. 10.1371/journal.pone.0188066El-Ghitany EM, Farghaly AG. Evaluation of commercialized rapid diagnostic testing for some Hepatitis B biomarkers in an area of intermediate endemicity. J Virol Methods. 2013;194(1–2): 190–193. 10.1016/j.jviromet.2013.08.026Randrianirina F, Carod J-F, Ratsima E, Chrétien J-B, Richard V, Talarmin A. Evaluation of the performance of four rapid tests for detection of hepatitis B surface antigen in Antananarivo, Madagascar. J Virol Methods. 2008;151(2): 294–297. 10.1016/j.jviromet.2008.03.019Dogbe EE, Arthur F. Diagnostic accuracy of blood centers in the screening of blood donors for viral markers. Pan Afr Med J. 2015;20: 119 10.11604/pamj.2015.20.119.5263Alvarado-Mora MV, Fernandez MF, Gomes-Gouvêa MS, de Azevedo Neto RS, Carrilho FJ, Pinho JR. Hepatitis B (HBV), hepatitis C (HCV) and hepatitis delta (HDV) viruses in the Colombian population—how is the epidemiological situation? PLoS One. 2011;6(4): e18888 10.1371/journal.pone.0018888Callejas-Rojo F, Serna-Quintana G, Cardona-Arias J. Frecuencia de reactividad a la prueba VDRL y de positividad para Chlamydia spp, VIH y virus de la hepatitis B y C en una institución prestadora de servicios de la salud de Medellín, 2015. CES Med. 2017;31(1): 27–37.Bedoya J, Cortés M, Cardona-Arias J. Seroprevalencia de marcadores de infecciones transmisibles por vía transfusional en banco de sangre de Colombia. Rev Saúde Pública. 2012;46(6): 950–959Ruiz Mendoza L, Villegas Gracia R, Cardona-Arias J. Prevalencia de agentes transmisibles por transfusión y factores asociados en un banco de sangre de Córdoba-Colombia 2014–2016. Rev. UDCA. 2018;21(2): 297–308.Rios W, Cortes F, Olarte J, Soto A, Navas M. Occult Hepatitis B Virus infection among blood donors in Colombia. Virol J. 2014;11:206 10.1186/s12985-014-0206-zJaramillo C, de La Hoz F, Porras A, di Filippo D, Choconta L, Payares E, et al. Characterization of Hepatitis B Virus in Amerindian children and mothers from Amazonas State, Colombia. PLoS One. 2017;12(10):e0181643 10.1371/journal.pone.0181643Mateu P, Guarino H, Quinn K, Meylakhs P, Campos S, Meylakhs A, et al. Young Drug Users: A Vulnerable Population and an Underutilized Resource in HIV/HCV Prevention. Curr HIV/AIDS Rep. 2018;15(4):324–335. 10.1007/s11904-018-0406-zToro D, Berbesi D, Mateu P, Segura A, Montoya L. Prevalence of Hepatitis C Virus in Young People Who Inject Drugs in Four Colombian Cities: A Cross-Sectional Study Using Respondent Driven Sampling. Int J Drug Policy. 2018;60:56–64. 10.1016/j.drugpo.2018.07.002Abad S, Vega A, Rincón D, Hernández E, Mérida E, Macías N, et al. Eficacia de los antivirales de acción directa en la infección por el virus de la hepatitis C en pacientes en hemodiálisis. Nefrología. 2017;37(2): 158–163. 10.1016/j.nefro.2016.10.003Hyams KC, Phillips IA, Moran AY, Tejada A, Wignall FS, Escamilla J. Seroprevalence of hepatitis C antibody in Peru. J Med Virol. 1992;37(2): 127–131. 10.1002/jmv.1890370210Fairley CK, Leslie DE, Nicholson S, Gust ID. Epidemiology and hepatitis C virus in Victoria. Med J Aust. 1990;153(5): 271–273. 10.5694/j.1326-5377.1990.tb136899.xGorgos L. Sexual transmission of viral hepatitis. Infect Dis Clin N Am. 2013;27(4): 811–836. 10.1016/j.idc.2013.08.002Bradshaw D, Matthews G, Danta M. Sexually transmitted hepatitis C infection: the new epidemic in MSM? Curr Opin Infect Dis. 2013;26(1): 66–72. 10.1097/QCO.0b013e32835c2120Matos MA, França DDDS, Carneiro MADS, Martins RMB, Kerr LRFS, Caetano KAA, et al. Viral hepatitis in female sex workers using the Respondent-Driven Sampling. Rev Saude Publica. 2017;51: 65 10.1590/S1518-8787.2017051006540Alonso M, Gutzman A, Mazin R, Pinzon CE, Reveiz L, Ghidinelli M. 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BMC Public Health. 2020;20(1): 62 10.1186/s12889-020-8175-1Edmunds WJ, Medley GF, Nokes DJ, Hall AJ, Whittle HC. The influence of age on the development of the hepatitis B carrier state. Proc Biol Sci. 1993; 253:197–201. 10.1098/rspb.1993.0102Cooke GS, Andrieux-Meyer I, Applegate TL, Atun R, Burry JR, Cheinquer H, et al. Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission. 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