Viral hepatitis constitutes a critical public health concern in Brazil, responsible for significant morbidity and mortality rates globally. Annual mortality from these infections is approximately 1.34 million, predominantly due to hepatitis B virus (HBV) and hepatitis C virus (HCV). While Brazil has made progress, particularly through the enhancement of public health policies, notable gaps still exist in prevention, diagnosis, and treatment, especially in marginalized populations.
Brazil is known to bear a substantial burden of viral hepatitis, evidenced by regional disparities and insufficient prevalence data. Over the years, efforts like expanding hepatitis B vaccination and incorporating direct-acting antivirals for hepatitis C have contributed to declining incidence rates. However, challenges remain regarding diagnostic coverage and treatment accessibility, especially in underserved areas influenced by socio-economic determinants.
The country is pivotal in achieving regional elimination goals for viral hepatitis, with its national strategies aligned with the Sustainable Development Agenda and the WHO Global Health Sector Strategy on Viral Hepatitis. In this context, a scoping review aims to consolidate knowledge on the epidemiology of viral hepatitis types A, B, C, D, and E in Brazil from the last decade, identifying patterns, regional disparities, and vulnerable populations, while uncovering critical knowledge gaps for public health policy.
This scoping review utilized the PRISMA guidelines to systematically assess literature from seven databases, focusing on Portuguese/Spanish/English observational studies from 2013 to 2024 that presented epidemiological data. The study developed guiding questions framed around the epidemiological profiles of viral hepatitis in Brazil, focusing on both the general population and vulnerable groups. The systematic review process involved rigorous screening and data extraction methods, classifying studies based on target populations and disease types.
Inclusion criteria emphasized original articles with relevant epidemiological findings from recognized sources. From a total of 7,649 references identified, 200 studies were finally included based on strict eligibility criteria and a comprehensive multi-step selection process.
The review synthesized a diverse array of research focusing predominantly on hepatitis B and C, with 200 studies encompassing data from over 14.5 million participants. Key findings indicate:
These patterns reveal significant regional variations and a vital need for improved comprehensive studies that incorporate both epidemiological data and socio-economic factors.
The heterogeneity in the epidemiological patterns of viral hepatitis in Brazil underscores the unequal research output and highlights the urgent necessity for targeted public health interventions. The preponderance of cross-sectional studies that focus narrowly on prevalence, without integrating social determinants or broader epidemiological findings, indicates a crucial gap in the data landscape. Future studies need to shift towards incorporating comprehensive methodologies that reflect the diverse contexts of the populations impacted by viral hepatitis.
The scoping review serves as a foundational tool aligning with Brazil's national elimination goals and informing strategies to address endemic challenges posed by viral hepatitis. Recommendations include enhanced surveillance systems, strategic operational research, and intersectoral collaborations to mitigate health disparities in marginalized populations.
Viral hepatitis in Brazil presents complex epidemiological challenges marked by substantial regional disparities and significant gaps in knowledge. This review highlights critical findings from existing literature, emphasizing the need for comprehensive, multi-faceted research approaches that can inform targeted public health policies and interventions aimed at achieving national and regional goals for viral hepatitis elimination.