Chronic hepatitis B virus infection in Eastern Ethiopia: Clinical characteristics and determinants of cirrhosis

• Published in: World journal of hepatology Vol. 16; no. 7; pp. 995 - 1008
• Main Authors: Ismael, Nejib Y, Usmael, Semir A, Belay, Nega B, Mekonen, Hailemichael Desalegn, Johannessen, Asgeir, Orlien, Stian Ms
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 27.07.2024
• Subjects: Retrospective Cohort Study; Resource-limited settings; Cirrhosis; Chronic hepatitis B; Cohort study; Sub-Saharan Africa
• ISSN: 1948-5182; 1948-5182
• DOI: 10.4254/wjh.v16.i7.995

Chronic hepatitis B (CHB) virus infection is a major cause of liver-associated morbidity and mortality, particularly in low-income countries. A better understanding of the epidemiological, clinical, and virological characteristics of CHB will guide appropriate treatment strategies and improve the control and management of CHB in Ethiopia. To investigate the characteristics of CHB in Eastern Ethiopia and assess the efficacy and safety of antiviral treatment. This cohort study included 193 adults who were human immunodeficiency virus-negative with CHB between June 2016 and December 2019. Baseline assessments included chemistry, serologic, and viral markers. tests, Mann-Whitney tests, and logistic regression analyses were used to identify the determinants of cirrhosis. Tenofovir disoproxil fumarate (TDF) was initiated using treatment criteria from the Ethiopian CHB pilot program. A total of 132 patients (68.4%) were men, with a median age of 30 years [interquartile range (IQR): 24-38]. At enrollment, 60 (31.1%) patients had cirrhosis, of whom 35 (58.3%) had decompensated cirrhosis. Khat use, hepatitis B envelope antigen positivity, and a high viral load were independently associated with cirrhosis. Additionally, 66 patients (33.4%) fulfilled the treatment criteria and 59 (30.6%) started TDF. Among 29 patients who completed 24 months of treatment, the median aspartate aminotransferase to platelet ratio index declined from 1.54 (IQR: 0.66-2.91) to 1.10 (IQR: 0.75-2.53) ( = 0.002), and viral suppression was achieved in 80.9% and 100% of patients after 12 months and 24 months of treatment, respectively. Among the treated patients, 12 (20.3%) died within the first 6 months of treatment, of whom 8 had decompensated cirrhosis. This study highlights the high prevalence of cirrhosis, initial mortality, and the efficacy of TDF treatment. Scaling up measures to prevent and control CHB infections in Ethiopia is crucial.