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Inicio Annals of Hepatology OP-4 IMPLEMENTATION OF A RE-LINKAGE TO CARE STRATEGY IN PATIENTS WITH CHRONIC HE...
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Vol. 28. Issue S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(March 2023)
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Vol. 28. Issue S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(March 2023)
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OP-4 IMPLEMENTATION OF A RE-LINKAGE TO CARE STRATEGY IN PATIENTS WITH CHRONIC HEPATITIS C WHO WERE LOST TO FOLLOW-UP IN LATIN AMERICA
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Manuel Mendizabal1, Marcos Thompson1, Esteban Gonzalez-Ballerga2, Margarita Anders3, Graciela E Castro-Narro4, Mario G Pessoa5, Hugo Cheinquer6, Gabriel Mezzano7, Ana Palazzo8, Ezequiel Ridruejo9, Valeria Descalzi10, Jose A Velarde-Ruiz Velasco11, Sebastian Marciano12, Linda Muñoz13, Maria I Schinoni14, Jaime Poniachik15, Rosalía Perazzo16, Eira Cerda17, Francisco Fuster18, Adriana Varon19..., Sandro Ruiz García20, Alejandro Soza21, Cecilia Cabrera22, Andres J Gomez-Aldana23, Flor de María Beltrán24, Solange Gerona25, Daniel Cocozzella26, Fernando Bessone27, Nelia Hernández28, Cristina Alonso1, Melina Ferreiro2, Florencia Antinucci3, Aldo Torre4, Bruna D Moutinho5, Silvia Coelho Borges29, Fernando Gomez7, Maria Dolores Murga8, Federico Piñero1, Gisela F Sotera2, Jhonier A Ocampo3, Valeria A Cortés Mollinedo4, Marcos Girala30, Pedro Montes31, Natalia Ratusnu32, Claudia A Zuñagua33, Lida Castillo34, Mauricio Castillo Barradas35, Rocío Chávez36, Cláudia Ivantes37, Julia Brutti38, Laura Tenorio38, Jorge Garavito39, Katherine Zevallos40, Fernando Contreras41, Mirtha Infante42, Emilia Vera-Pozo43, Martín Tagle44, Luis G Toro45, Carlos A De La Rocha46, Daniela Simian15, Marcelo O Silva1Ver más
1 Liver Unit and Liver Transplant Unit, Austral University Hospital, Pilar, Argentina
2 Hepatology Section, Clinic Hospital “José de San Martín”, University of Buenos Aires, Argentina
3 Hepatology and Liver Transplant Unit, German Hospital, Argentina
4 Gastroenterology Departmet, National Institute of Medical Sciences and Nutrition “Salvador Zubirán”, México
5 Gastroenterology and Hepatology Division, Clinic Hospital of University School of Medicine of São Paulo, São Paulo, Brazil
6 Full Professor of Gastroenterology and Hepatology at the Federal University of Rio Grande do Sul and of Porto Alegre Clinic Hospital, Brazil
7 Gastroenterology Section, El Salvador Hospital, Santiago Chile
8 Gastroenterology Service, Hepatology Section, Padilla Hospital, Tucumán, Argentina
9 Hepatology Section, Department of Medicine. Center for Medical Education and Clinical Research Norberto Quirno “CEMIC”. Buenos Aires, Argentina
10 Liver and Hepatic Transplant Unit, Universitary Hospital Favaloro Foundation, Buenos Aires, Argentina
11 Fray Antonio Alcalde Civil Hospital of Guadalajara. Guadalajara, Jalisco, México
12 Hepatology Section. Buenos Aires Italian Hospital, Buenos Aires, Argentina
13 Universitary Hospital “Dr. José E. González,”, Monterrey, México
14 Hepatology Core, Prof. Edgard Santos Universitary Hospital, Federal University of Bahia, Salvador, Brazil
15 Gastroenterology Section, Medicine Department, Clinical Hospital of University of Chile, Santiago, Chile
16 Gastroenterology Unit, Miguel Perez Carreño Hospital, Venezuela
17 Hospital Central Militar, Military School of Health Graduates, México
18 Hepatology Unit, Gustavo Fricke Hospital, Viña del Mar, Chile
19 Cardioinfantil Foundation, Cardiology Institute, Bogotá, Colombia
20 Victor Lazarte Echegaray Hospital, Trujillo, Perú
21 Department of Gastroenterology, Pontifical Catholic University of Chile, Santiago, Chile
22 Gastroenterology Unit, Daniel A. Carrión National Hospital, Callao, Perú
23 Gastroenterology and Transplantation Unit Foundation Santa Fe of Bogotá, Bogotá, Colombia
24 Gastroenterology Service, PNP Luis N. Sáenz National Hospital, Perú
25 Liver Unit, Armed Forces Hospital, Montevideo, Uruguay
26 Hepatology, La Plata Italian Hospital, La Plata, Argentina
27 Gastroenterology Department, Medical School, Centenario Provincial Hospital, University of Rosario School of Medicine, Rosario, Chile
28 Gastroenterology Clinic, Clinic Hospital, School of Medicine, UdelaR, Montevideo, Uruguay
29 Moinhos de Vento Hospital of Porto Alegre, Porto Alegre, Brasil
30 Gastroenterology Department. Clinic Hospital. Faculty of Medical Sciences. Asunción National University, San Lorenzo, Paraguay
31 Daniel A. Carrión National Hospital, Lima, Perú
32 Hepatology Unit, Regional Hospital of Ushuaia, Ushuaia Argentina
33 Liver Club, La Paz, Bolivia
34 High Complexity Hospital "Virgen de la Puerta", Lima, Perú
35 Hospital de Especialidades Centro Médico Nacional La Raza of the Mexican Social Security Institute, México City, México
36 Adolfo Guevara Velasco National Hospital- EsSalud, Cusco, México
37 Center for Surgery, Gastroenterology and Hepatology - Nossa Senhora das Graças Hospital, Curitiba, Brazil
38 Liver and Liver Transplant Unit, German Hospital, Buenos Aires, Argentina
39 Gastroenterology Service, Arzobispo Loayza National Hospital, Lima, Perú
40 Carlos Alberto Seguín Escobedo Hospital Essalud, Arequipa, Perú
41 Center for Advanced Gastroenterology, Santo Domingo, República Dominicana
42 Gastroenterology Institute of Cuba
43 Dr. Teodoro Maldonado Carbo Regional Hospital of IESS, Guayaquil, Ecuador
44 Anglo American Clinic, Lima, Perú
45 San Vicente Foundation Hospitals of Medellín and Rionegro, Colombia
46 Responsible for the National Infectious Diseases Program Component: STIs/HIV/AIDS/ Viral Hepatitis, Bolivia
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Vol. 28. Issue S1

Abstracts of the 2022 Annual Meeting of the ALEH

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Introduction and Objectives

To achieve WHO's goal of eliminating HCV, innovative strategies must be designed to diagnose and treat more patients. This study aimed to describe an implementation strategy to identify patients with HCV who were lost to follow-up (LTFU) and offer them re-linkage to Figure 1. Analysis of global DNA methylation. A) Representative dot blot using anti-5mC which recognizes global methylated DNA, anti-IgG as negative control and methylene blue staining as total DNA loading control. B) Graphs shows mean ± standard deviation of 5mC densitometry brand intensity of study groups. C) Graph that represents the percentage of global methylation of the DNA analyzed with ELISA.A one-way ANOVA statistical test and a Tukey post hoc test were performed. Group NT: only received vehicle; Group HCC: damage group induced by weekly administration of DEN and 2-AAF for 12 weeks; and Group HCC/PFD: which received the same treatment as Group HCC, plus PFD (300 mg/kg) (**p<0.005)Figure 1. Analysis of global DNA methylation. A) Representative dot blot using anti-5mC which recognizes global methylated DNA, anti-IgG as negative control and methylene blue staining as total DNA loading control. B) Graphs shows mean ± standard deviation of 5mC densitometry brand intensity of study groups. C) Graph that represents the percentage of global methylation of the DNA analyzed with ELISA.A one-way ANOVA statistical test and a Tukey post hoc test were performed. Group NT: only received vehicle; Group HCC: damage group induced by weekly administration of DEN and 2-AAF for 12 weeks; and Group HCC/PFD: which received the same treatment as Group HCC, plus PFD (300 mg/kg) (**p<0.005)Figure 1. Analysis of global DNA methylation. A) Representative dot blot using anti-5mC which recognizes global methylated DNA, anti-IgG as negative control and methylene blue staining as total DNA loading control. B) Graphs shows mean ± standard deviation of 5mC densitometry brand intensity of study groups. C) Graph that represents the percentage of global methylation of the DNA analyzed with ELISA.A one-way ANOVA statistical test and a Tukey post hoc test were performed. Group NT: only received vehicle; Group HCC: damage group induced by weekly administration of DEN and 2-AAF for 12 weeks; and Group HCC/PFD: which received the same treatment as Group HCC, plus PFD (300 mg/kg) (**p<0.005)

Materials and Methods

We conducted an implementation study utilizing a strategy to contact patients with HCV who were not under regular follow-up in 45 centers from 13 Latin American countries. Patients with HCV were identified by the international classification of diseases (ICD-9/10) or equivalent. Medical records were then reviewed to confirm the diagnosis of chronic HCV infection defined by anti-HCV+ and detectable HCV-RNA. Identified patients who were not under follow-up by a liver specialist were contacted by telephone or email and offered a medical reevaluation.

Results

A total of 10364 patients were classified to have HCV. After reviewing their medical charts, 1349 (13%) had undetectable HCV-RNA or were wrongly coded (figure). Overall, 9015 (86.9%) individuals were identified with chronic HCV infection. A total of 5096 (56.5%) patients were under routine HCV care and 3919 (43.5%) had been LTFU. We were able to contact 1617 (41.3%) of the 3919 patients who were LTFU at the primary medical institution, of which 427 (26.4%) were cured at different institutions or were dead. Of the remaining patients, 906 (76.1%) were candidates for retrieval. Overall, patients who were LTFU were younger (58.7 vs. 61.1 years; p<0.001), were more likely to be men (57.4% vs. 49.5%; p<0.001), and to have a concomitant infection of HIV (13.8% vs. 7.3%; p<0.001) and HBV (3.1% vs. 1.7%; p<0.001).

Conclusions

In our cohort, about 1 out of 4 patients with chronic HCV who were LTFU were candidates to receive treatment. This strategy has the potential to be effective and accessible and significantly impacts the HCV care cascade. (NCT04470271)

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