Hepatitis B treatment eligibility in West Africa: Uncertainties and need for prospective cohort studies

Background & Aims While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV‐infected persons in need of antiviral therapy in these settings. Methods Prisoners in Senegal and Togo as well as female sex workers and men...

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Published inLiver international Vol. 37; no. 8; pp. 1116 - 1121
Main Authors Jaquet, Antoine, Nouaman, Marcellin, Tine, Judicaël, Tanon, Aristophane, Anoma, Camille, Inwoley, André, Attia, Alain, Ekouevi, Didier K., Seydi, Moussa, Dabis, François, Wandeler, Gilles
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.08.2017
Subjects
Adult
Africa
Africa, Western - epidemiology
Alanine
Alanine transaminase
Antiviral agents
antiviral treatment
Chronic infection
Cirrhosis
Cohort analysis
Cross-Sectional Studies
Female
Fibrosis
Hepatitis
Hepatitis B
Hepatitis B surface antigen
hepatitis B virus
Hepatitis B, Chronic - epidemiology
Humans
Liver
Liver cirrhosis
Male
Prevalence
Prisoners
Prisoners - statistics & numerical data
Prostitution
Replication
Sex Workers - statistics & numerical data
Sexual and Gender Minorities - statistics & numerical data
Therapy
Viruses
Workers
Ivory Coast
Togo
Senegal
West Africa
antiviral treatment
hepatitis B virus
Africa
Online AccessGet full text

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Abstract Background & Aims While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV‐infected persons in need of antiviral therapy in these settings. Methods Prisoners in Senegal and Togo as well as female sex workers and men who have sex with men in Cote d'Ivoire were screened for HBV infection. All HBsAg‐positive participants underwent transient elastography, alanine aminotransferase (ALT) and HBV viral load (VL) quantification. Individuals with cirrhosis or those aged >30 years with an HBV replication ≥20 000 IU/mL and elevated ALT were considered eligible for antiviral therapy. Results Of 1256 participants, 110 (8.8%) were HBsAg positive; their median age was 30 years [interquartile range: 25‐33] and 96 (86.5%) were men. Three individuals (2.7%) had cirrhosis, while 28 (29.5%) of 94 participants with available measurements had an HBV VL ≥20 000 IU/mL. Overall, 11 (10.0%) subjects were considered eligible for immediate antiviral treatment (2.1% of participants in Dakar, 7.7% in Abidjan and 21.6% in Lome, P=.001) and 59 (53.4%) for close monitoring due to the presence of significant liver fibrosis, elevated ALT or significant HBV replication. Conclusions Among vulnerable populations in West Africa, a minority of HBV‐infected individuals were eligible for immediate antiviral therapy. Prospective cohort studies are necessary to evaluate anti‐HBV treatment eligibility facing the significant proportion of individuals with active chronic HBV infection.
AbstractList While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV-infected persons in need of antiviral therapy in these settings.BACKGROUND & AIMSWhile universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV-infected persons in need of antiviral therapy in these settings.Prisoners in Senegal and Togo as well as female sex workers and men who have sex with men in Cote d'Ivoire were screened for HBV infection. All HBsAg-positive participants underwent transient elastography, alanine aminotransferase (ALT) and HBV viral load (VL) quantification. Individuals with cirrhosis or those aged >30 years with an HBV replication ≥20 000 IU/mL and elevated ALT were considered eligible for antiviral therapy.METHODSPrisoners in Senegal and Togo as well as female sex workers and men who have sex with men in Cote d'Ivoire were screened for HBV infection. All HBsAg-positive participants underwent transient elastography, alanine aminotransferase (ALT) and HBV viral load (VL) quantification. Individuals with cirrhosis or those aged >30 years with an HBV replication ≥20 000 IU/mL and elevated ALT were considered eligible for antiviral therapy.Of 1256 participants, 110 (8.8%) were HBsAg positive; their median age was 30 years [interquartile range: 25-33] and 96 (86.5%) were men. Three individuals (2.7%) had cirrhosis, while 28 (29.5%) of 94 participants with available measurements had an HBV VL ≥20 000 IU/mL. Overall, 11 (10.0%) subjects were considered eligible for immediate antiviral treatment (2.1% of participants in Dakar, 7.7% in Abidjan and 21.6% in Lome, P=.001) and 59 (53.4%) for close monitoring due to the presence of significant liver fibrosis, elevated ALT or significant HBV replication.RESULTSOf 1256 participants, 110 (8.8%) were HBsAg positive; their median age was 30 years [interquartile range: 25-33] and 96 (86.5%) were men. Three individuals (2.7%) had cirrhosis, while 28 (29.5%) of 94 participants with available measurements had an HBV VL ≥20 000 IU/mL. Overall, 11 (10.0%) subjects were considered eligible for immediate antiviral treatment (2.1% of participants in Dakar, 7.7% in Abidjan and 21.6% in Lome, P=.001) and 59 (53.4%) for close monitoring due to the presence of significant liver fibrosis, elevated ALT or significant HBV replication.Among vulnerable populations in West Africa, a minority of HBV-infected individuals were eligible for immediate antiviral therapy. Prospective cohort studies are necessary to evaluate anti-HBV treatment eligibility facing the significant proportion of individuals with active chronic HBV infection.CONCLUSIONSAmong vulnerable populations in West Africa, a minority of HBV-infected individuals were eligible for immediate antiviral therapy. Prospective cohort studies are necessary to evaluate anti-HBV treatment eligibility facing the significant proportion of individuals with active chronic HBV infection.
Background & Aims While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV‐infected persons in need of antiviral therapy in these settings. Methods Prisoners in Senegal and Togo as well as female sex workers and men who have sex with men in Cote d'Ivoire were screened for HBV infection. All HBsAg‐positive participants underwent transient elastography, alanine aminotransferase (ALT) and HBV viral load (VL) quantification. Individuals with cirrhosis or those aged >30 years with an HBV replication ≥20 000 IU/mL and elevated ALT were considered eligible for antiviral therapy. Results Of 1256 participants, 110 (8.8%) were HBsAg positive; their median age was 30 years [interquartile range: 25‐33] and 96 (86.5%) were men. Three individuals (2.7%) had cirrhosis, while 28 (29.5%) of 94 participants with available measurements had an HBV VL ≥20 000 IU/mL. Overall, 11 (10.0%) subjects were considered eligible for immediate antiviral treatment (2.1% of participants in Dakar, 7.7% in Abidjan and 21.6% in Lome, P=.001) and 59 (53.4%) for close monitoring due to the presence of significant liver fibrosis, elevated ALT or significant HBV replication. Conclusions Among vulnerable populations in West Africa, a minority of HBV‐infected individuals were eligible for immediate antiviral therapy. Prospective cohort studies are necessary to evaluate anti‐HBV treatment eligibility facing the significant proportion of individuals with active chronic HBV infection.
While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV-infected persons in need of antiviral therapy in these settings. Prisoners in Senegal and Togo as well as female sex workers and men who have sex with men in Cote d'Ivoire were screened for HBV infection. All HBsAg-positive participants underwent transient elastography, alanine aminotransferase (ALT) and HBV viral load (VL) quantification. Individuals with cirrhosis or those aged >30 years with an HBV replication ≥20 000 IU/mL and elevated ALT were considered eligible for antiviral therapy. Of 1256 participants, 110 (8.8%) were HBsAg positive; their median age was 30 years [interquartile range: 25-33] and 96 (86.5%) were men. Three individuals (2.7%) had cirrhosis, while 28 (29.5%) of 94 participants with available measurements had an HBV VL ≥20 000 IU/mL. Overall, 11 (10.0%) subjects were considered eligible for immediate antiviral treatment (2.1% of participants in Dakar, 7.7% in Abidjan and 21.6% in Lome, P=.001) and 59 (53.4%) for close monitoring due to the presence of significant liver fibrosis, elevated ALT or significant HBV replication. Among vulnerable populations in West Africa, a minority of HBV-infected individuals were eligible for immediate antiviral therapy. Prospective cohort studies are necessary to evaluate anti-HBV treatment eligibility facing the significant proportion of individuals with active chronic HBV infection.
Background & Aims While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV-infected persons in need of antiviral therapy in these settings. Methods Prisoners in Senegal and Togo as well as female sex workers and men who have sex with men in Cote d'Ivoire were screened for HBV infection. All HBsAg-positive participants underwent transient elastography, alanine aminotransferase (ALT) and HBV viral load (VL) quantification. Individuals with cirrhosis or those aged >30 years with an HBV replication ≥20 000 IU/mL and elevated ALT were considered eligible for antiviral therapy. Results Of 1256 participants, 110 (8.8%) were HBsAg positive; their median age was 30 years [interquartile range: 25-33] and 96 (86.5%) were men. Three individuals (2.7%) had cirrhosis, while 28 (29.5%) of 94 participants with available measurements had an HBV VL ≥20 000 IU/mL. Overall, 11 (10.0%) subjects were considered eligible for immediate antiviral treatment (2.1% of participants in Dakar, 7.7% in Abidjan and 21.6% in Lome, P=.001) and 59 (53.4%) for close monitoring due to the presence of significant liver fibrosis, elevated ALT or significant HBV replication. Conclusions Among vulnerable populations in West Africa, a minority of HBV-infected individuals were eligible for immediate antiviral therapy. Prospective cohort studies are necessary to evaluate anti-HBV treatment eligibility facing the significant proportion of individuals with active chronic HBV infection.
Author Inwoley, André
Seydi, Moussa
Tine, Judicaël
Attia, Alain
Dabis, François
Anoma, Camille
Nouaman, Marcellin
Wandeler, Gilles
Ekouevi, Didier K.
Jaquet, Antoine
Tanon, Aristophane
AuthorAffiliation 7 CeDReS, CHU de Treichville, Abidjan, Cote d’Ivoire
6 ONG Clinique de Confiance d’Abidjan, Abidjan, Cote d’Ivoire
10 Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland
2 Inserm, ISPED, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
11 Institute of Social and Preventive Medicine, University of Bern, Switzerland
4 Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Senegal
5 Service de maladies infectieuses et tropicales, CHU de Treichville, Abidjan, Cote d’Ivoire
1 Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
9 Département de Santé Publique, Faculté des Sciences de la santé, Université de Lome, Lome, Togo
8 Service de hépato-gastroentérologie, CHU de Yopougon, Abidjan, Cote d’Ivoire
3 Programme PACCI, CHU de Treichville, Abidjan, Cote d’Ivoire
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Keywords antiviral treatment
hepatitis B virus
Africa
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2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Notes The National Cancer Institute (NCI), the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Drug Abuse (NIDA) (grant no. 5U01AI069919). GW was supported by a fellowship from the Swiss National Science Foundation (PZ00P3_154730).
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Snippet Background & Aims While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of...
While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of HBV-infected persons in...
Background & Aims While universal screening of hepatitis B virus (HBV) is recommended in high burden countries, little is known about the proportion of...
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Index Database
Enrichment Source
Publisher
StartPage 1116
SubjectTerms Adult
Africa
Africa, Western - epidemiology
Alanine
Alanine transaminase
Antiviral agents
antiviral treatment
Chronic infection
Cirrhosis
Cohort analysis
Cross-Sectional Studies
Female
Fibrosis
Hepatitis
Hepatitis B
Hepatitis B surface antigen
hepatitis B virus
Hepatitis B, Chronic - epidemiology
Humans
Liver
Liver cirrhosis
Male
Prevalence
Prisoners
Prisoners - statistics & numerical data
Prostitution
Replication
Sex Workers - statistics & numerical data
Sexual and Gender Minorities - statistics & numerical data
Therapy
Viruses
Workers
Title Hepatitis B treatment eligibility in West Africa: Uncertainties and need for prospective cohort studies
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fliv.13484
https://www.ncbi.nlm.nih.gov/pubmed/28561454
https://www.proquest.com/docview/1920515514
https://www.proquest.com/docview/1904228364
https://pubmed.ncbi.nlm.nih.gov/PMC5524454
Volume 37
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