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

作者：Jaquet Antoine^*; Nouaman Marcellin; Tine Judicael; Tanon Aristophane; Anoma Camille; Inwoley Andre; Attia Alain; Ekouevi Didier K; Seydi Moussa; Dabis Francois; Wandeler Gilles

来源：Liver International, 2017, 37(8): 1116-1121.

DOI：10.1111/liv.13484

• Africa
• antiviral treatment
• hepatitis B virus

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.

• 出版日期2017-8