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Page 4 of 18 Galicia-Moreno et al. Hepatoma Res 2020;6:20 I http://dx.doi.org/10.20517/2394-5079.2019.36

Table 2. Estimated number of viremic people in Latin America and the Caribbean in 2016
Region Estimated number of viremic (HCV-RNA) people, 2016
Latin America 3.8 million (2.6-4.2 million)
Caribbean 240,000 (180,000-350,000)
Latin America and the Caribbean 4.1 million (2.8-4.6 million)
HCV: hepatitis C virus

A B C

Figure 2. Choropleth maps related to HCV related to disease and death in Latin America. A: HCV prevalence in 2015; B: estimated
population with cirrhosis related to HCV in 2015; C: HCC mortality rate caused by HCV by 100,000 inhabitants, 2013. HCV: hepatitis C
virus; HCC: hepatocellular carcinoma

Globally, the estimated annual percentage change in liver cancer due to age-standardized HCV incidence
rate has increased 0.57 (95%CI: 0.48-0.66) between 1990 and 2016. This pattern is heterogeneous across
regions and countries. This rate was also higher in low- and middle-income countries than in high-income
[13]
countries .
In 2016, the percentage contribution of HCV to absolute liver cancer incidence (in both sexes) in Tropical,
[13]
Southern, Central and Andean Latin America were 37.4%, 47.9%, 34.2% and 13.6%, respectively . Deaths
due to HCC related to HCV infection (in 2013) had the highest incidence in the Dominican Republic at
3.27 per 100, 000 people, followed by Chile with 3.22, Cuba with 2.96, Argentina with 2.84, and Mexico with
2.68 [9,10] [Figure 2 and Table 3].

DISTRIBUTION OF HCV GENOTYPES IN LATIN AMERICA
Studies on HCV genotypes related to different stages of liver disease have been reported even though the
results are controversial. Nevertheless, cofactors such as age, sex, obesity, diabetes and alcohol consumption
[14]
must be taken into consideration since they have an impact on the progress of chronic liver disease .
Worldwide, genotype 1 is the most prevalent, causing 44% of all infections, followed by genotype 3 with 25%
and then genotype 4 with 15%. HCV genotype 1 is also the most prevalent in Latin America [Figure 3] and
[15]
genotype 1b is predominant in the LAC .
[16]
According to Maucort-Boulch et al. , HCV was the cause of HCC in 58.7% of cases in Mexico, 50.0% in
Brazil and 35%-38.8% in the rest of the LAC countries that were analyzed [3,10,16] [Figure 3].