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      Diagnosis and treatment of hepatitis B. What contributions can prisons make? Translated title: Diagnóstico y tratamiento de la hepatitis B. ¿Qué pueden aportar las instituciones penitenciarias?

      research-article
      Revista Española de Sanidad Penitenciaria
      Sociedad Española de Sanidad Penitenciaria
      prisons, hepatitis B, vaccination, prevention and control, prisiones, hepatitis B, vacunacion, prevencion y control

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          Abstract

          Hepatitis B is a parenterally and sexually transmitted infection. Vaccination for the disease is highly effective, and its inclusion in Spain as part of a systematic and universal schedule for newborns has led to a significant decrease of incidence in the national population. However, the number of inmates born in other countries some from endemic areas of HBV infection -, the mechanisms of transmission and lack of vaccination in third world countries mean that its prevalence in the prison population is higher than in the general population. These institutions therefore play an essential role in detecting and managing hepatitis B. In this paper, the situation of hepatitis B in prisons is reviewed and recommendations are proposed to optimize its control.

          Resumen

          La hepatitis B es una infeccion de transmision parenteral y sexual. La vacunacion es altamente efectiva, y en Espana, esta incluida en el programa vacunal sistematico y universal en los recien nacidos, lo que ha comportado una importante disminucion de la incidencia en la poblacion autoctona. Sin embargo, el numero de ingresados en prision nacidos en otros paises (algunos procedentes de areas endemicas de la infeccion por el virus de la hepatitis B [VHB]), el mecanismo de transmision y la falta de vacunacion en los paises del tercer mundo, hace que su prevalencia en la poblacion penitenciaria sea mas alta que en la poblacion general. Estas instituciones tienen, por consiguiente, un papel fundamental en la deteccion y manejo de la hepatitis B. En este trabajo, se revisa la situacion de la hepatitis B en las prisiones y se proponen recomendaciones para optimizar su control.

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          Most cited references46

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

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              EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection.

              Hepatitis B virus (HBV) infection remains a global public health problem with changing epidemiology due to several factors including vaccination policies and migration. This Clinical Practice Guideline presents updated recommendations for the optimal management of HBV infection. Chronic HBV infection can be classified into five phases: (I) HBeAg-positive chronic infection, (II) HBeAg-positive chronic hepatitis, (III) HBeAg-negative chronic infection, (IV) HBeAg-negative chronic hepatitis and (V) HBsAg-negative phase. All patients with chronic HBV infection are at increased risk of progression to cirrhosis and hepatocellular carcinoma (HCC), depending on host and viral factors. The main goal of therapy is to improve survival and quality of life by preventing disease progression, and consequently HCC development. The induction of long-term suppression of HBV replication represents the main endpoint of current treatment strategies, while HBsAg loss is an optimal endpoint. The typical indication for treatment requires HBV DNA >2,000IU/ml, elevated ALT and/or at least moderate histological lesions, while all cirrhotic patients with detectable HBV DNA should be treated. Additional indications include the prevention of mother to child transmission in pregnant women with high viremia and prevention of HBV reactivation in patients requiring immunosuppression or chemotherapy. The long-term administration of a potent nucleos(t)ide analogue with high barrier to resistance, i.e., entecavir, tenofovir disoproxil or tenofovir alafenamide, represents the treatment of choice. Pegylated interferon-alfa treatment can also be considered in mild to moderate chronic hepatitis B patients. Combination therapies are not generally recommended. All treated and untreated patients should be monitored for treatment response and adherence, and the risk of progression and development of complications. HCC remains the major concern for treated chronic hepatitis B patients. Several subgroups of patients with HBV infection require specific focus. Future treatment strategies to achieve 'cure' of disease and new biomarkers are discussed.
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                Author and article information

                Journal
                Rev Esp Sanid Penit
                Rev Esp Sanid Penit
                sanipe
                Revista Española de Sanidad Penitenciaria
                Sociedad Española de Sanidad Penitenciaria
                1575-0620
                2013-6463
                Oct-Dec 2021
                19 December 2021
                : 23
                : 3
                : 119-127
                Affiliations
                [1 ] originalHepatology Unit. Digestive Disease Service. Parc Taulí Hospital Universitari. Institut d’Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona. Sabadell. Barcelona. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). Instituto Carlos III. Madrid. Spain normalizedUniversidad Carlos III de Madrid orgdiv2Hepatology Unit. Digestive Disease Service. Parc Taulí Hospital Universitari orgdiv1Institut d’Investigació i Innovació Parc Taulí I3PT orgnameUniversitat Autònoma de Barcelona Sabadell, Barcelona,
                [2 ] orgdiv1Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) orgnameInstituto Carlos III Madrid, Spain
                Author notes
                [Correspondence: ] Mercedes Vergara. Parc Taulí, Sabadell. Parc Taulí, 1. 08208, Sabadell. Barcelona. E-mail: mvergara@ 123456tauli.cat
                Article
                10.18176/resp.00041
                8802821
                f8e4dba3-d8a5-47c9-85f3-196f22b094dc

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 30 May 2021
                : 23 June 2021
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 44, Pages: 09
                Categories
                Special Article

                prisons,hepatitis b,vaccination,prevention and control,prisiones,vacunacion,prevencion y control

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