Hepatitis B in Latin America presents unique challenges including high HCC rates in endemic areas (Amazon basin, Central Andes), predominance of horizontal transmission, and a treatment gap where only 1 in 5 diagnosed patients receive therapy despite effective antivirals.
- The speaker reported that HBV prevalence in Latin America is about 5%, with endemic areas in the Amazon basin and Central Andes of Peru where geographic isolation limits healthcare access and HBV is a leading cause of HCC
- In South American endemic areas, the speaker stated that HBV accounts for 31% of HCC without cirrhosis, occurring at younger ages (even below 30 years old) and with low viral loads (less than 2000), possibly related to genotype F oncogenic potential
- The speaker reported that HDV co-infection prevalence in the Amazon basin was almost 34% in the 1990s but has dropped to less than 7% with universal vaccination, though the combination of HDV genotype 3 and HBV genotype F was associated with more severe disease
- MASLD prevalence reaches almost 40% in South America and the speaker stated it increases HCC risk fourfold even under antiviral treatment, while Latin America is the second highest region for alcohol-related mortality with 20% of adolescents aged 15-19 as binge drinkers
- The speaker reported that monitoring costs almost $800 per year compared to $100 for treatment in one Latin American country, and advocated for treatment simplification and broader treatment access, especially where regular monitoring is not feasible
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