Little data exist on patients treated with tenofovir in Sub-Saharan Africa. Objective: To describe the clinical and laboratory characteristics of patients with viral hepatitis B treated with tenofovir. Material and me...Little data exist on patients treated with tenofovir in Sub-Saharan Africa. Objective: To describe the clinical and laboratory characteristics of patients with viral hepatitis B treated with tenofovir. Material and methods: A descriptive single-center retrospective study, on chronic viral hepatitis B mono-infected, followed in the hepatogastroenterology department of the University Hospital of Yopougon and treated with tenofovir from February 2012 to February 2015. The studied parameters were demographic, clinical, biochemical, serological, virological, abdominal ultrasound. Liver fibrosis was assessed either by liver biopsy or non-invasive tests. Results: 110 patients were treated with tenofovir disoproxil fumarate with a mean age of 40.4 years and a male predominance. Clinical examination revealed jaundice in 9% of cases, hepatomegaly in 7.3% of cases, splenomegaly in 9.1% of cases and ascites in 15.5% of cases. The AST averaged 77.3 IU/l, the ALT 76.8 IU/l, prothrombin rate at 76.6% , albumin level at 32.3 g/l, total bilirubin at 29.9 g/l, alpha fetoprotein rate at 15.3 ng/ml. HBe antigen was negative in 76.2% of cases. The average rate of DNA at baseline was 7.4 log10 IU/l. 27.5% was cirrhotic. The average time of starting treatment was 23.7 months. Conclusion: TDF is the first-line treatment for chronic hepatitis B in our country, because it is a well-tolerated, potent therapy with a high threshold for resistance development. Our study population had an average age of 40.4 years. Virological profile was dominated by HBe antigen negative patients and high viral load of HVB DNA. One third of patients were at the stage of cirrhosis. This treatment must be delivered free of charge in all the country hospitals, which is going to improve significantly the natural evolution of the disease and to decrease the incidence of the HCC.展开更多
Aims of the Study: 1) Determine the Prevalence of Hepatitis B virus (HBV) infection in children (contact subjects) of chronic Hepatitis B surface antigen (HBsAg) carrier subjects (index subjects);2) Search for factors...Aims of the Study: 1) Determine the Prevalence of Hepatitis B virus (HBV) infection in children (contact subjects) of chronic Hepatitis B surface antigen (HBsAg) carrier subjects (index subjects);2) Search for factors associated with HBV infection in these children. Patients and Methods: Retrospective-crosssectional study (January 5th, 2006 through December 31st, 2012). Studied parameters: biological and clinical characteristics of index subjects;Prevalence of HBsAg and Hepatitis B core antibody (HBcAb) in their children. Search for the HBV infection associated factors in the children (univariate analyses through Chi-square or Fisher’s exact test;multivariate analysis through a backward logistic regression). Results: Our 44 subjects’ median age was 43.1 ± 7.49 years and 88.6% of them lived with a spouse. Average number of children per index subjects was 2.3 ± 1.1. Our 92 children’s median age was 9.3 ± 4.55 (ranging from 1 to 15 years), and 43 (44.8%) were vaccinated against HBV. HBV infection prevalence was 24% (23/96 of which, 4 were HBsAg positive and 19 HBcAb positive subjects without HBsAg). Independent factors associated with HBV infection in children of index subjects were HBV DNA for index subjects >2000 IU/ml (OR = 11.5;p = 0.001), existence of HBV in two parents (OR = 7.9;p = 0.03) and absence of HBV vaccination in the children (OR = 30.9;p = 0.003). Conclusion: Immunization coverage for children of index subjects was insufficient, especially before the introduction of HBV vaccine into the enlarged vaccination program. Outside vertical transmission, those children were more exposed to HBV intrafamilial transmission risk when they were not immunized against HBV, when both parents were infected and when HBV viremia in index subjects was higher than 2000 IU/ml.展开更多
Aims: 1) Describe virological profile of patients followed-up for chronic Hepatitis B virus (HBV);2) Search for a correlation between cirrhosis and virological profile of patients. Patients and Methods: Retrospective ...Aims: 1) Describe virological profile of patients followed-up for chronic Hepatitis B virus (HBV);2) Search for a correlation between cirrhosis and virological profile of patients. Patients and Methods: Retrospective study about 75 HBsAg positive patients followed-up for at least one year in two medical structures of Abidjan. Studied parameters: clinical signs, biological check-up (serum transaminases every 3 months for at least one year, platelets count and prothrombin rate), abdominal echography, virological check-up (HBsAg, HBeAg, anti-HBe, total anti-HBc, anti-VHC and anti- HIV Ab, HBV DNA biannual quantification during at least one year). Histological or biochemical evaluation of hepatic activity and fibrosis were realized in case of transaminases elevation or HBV DNA > 2000 IU/ml. Results: The mean age of our 75 patients (54 men) was 42.1 ± 11.54 years. HBV was fortuitously discovered in most of our patients (74.7% of the cases). The HBV inactive chronic carriage was 50.7%;HBeAg-positive and HBeAg-negative chronic hepatitis represented respectively 9.3% and 40% of the cases. Mean B viral load was 327.5 IU/ml in HBV inactive chronic carriers, 44,047,663 IU/ml in HBeAg-positive chronic HBV and 20,231,822 IU/ml in HBeAg-negative chronic HBV. Cirrhosis prevalence was significantly high- er in positive or negative HBeAg chronic HBV than in HBV inactive chronic carriers (32.4% vs. 5.3%, p = 0.008;OR = 8.6). Conclusion: Our patients’ virological profile was dominated by HBeAg-negative chronic HBV and HBV inactive chronic carriage. The risk of having cirrhosis was multiplied by 8.6 in case of active chronic hepatitis compared with HBV inactive chronic carriage.展开更多
文摘Little data exist on patients treated with tenofovir in Sub-Saharan Africa. Objective: To describe the clinical and laboratory characteristics of patients with viral hepatitis B treated with tenofovir. Material and methods: A descriptive single-center retrospective study, on chronic viral hepatitis B mono-infected, followed in the hepatogastroenterology department of the University Hospital of Yopougon and treated with tenofovir from February 2012 to February 2015. The studied parameters were demographic, clinical, biochemical, serological, virological, abdominal ultrasound. Liver fibrosis was assessed either by liver biopsy or non-invasive tests. Results: 110 patients were treated with tenofovir disoproxil fumarate with a mean age of 40.4 years and a male predominance. Clinical examination revealed jaundice in 9% of cases, hepatomegaly in 7.3% of cases, splenomegaly in 9.1% of cases and ascites in 15.5% of cases. The AST averaged 77.3 IU/l, the ALT 76.8 IU/l, prothrombin rate at 76.6% , albumin level at 32.3 g/l, total bilirubin at 29.9 g/l, alpha fetoprotein rate at 15.3 ng/ml. HBe antigen was negative in 76.2% of cases. The average rate of DNA at baseline was 7.4 log10 IU/l. 27.5% was cirrhotic. The average time of starting treatment was 23.7 months. Conclusion: TDF is the first-line treatment for chronic hepatitis B in our country, because it is a well-tolerated, potent therapy with a high threshold for resistance development. Our study population had an average age of 40.4 years. Virological profile was dominated by HBe antigen negative patients and high viral load of HVB DNA. One third of patients were at the stage of cirrhosis. This treatment must be delivered free of charge in all the country hospitals, which is going to improve significantly the natural evolution of the disease and to decrease the incidence of the HCC.
文摘Aims of the Study: 1) Determine the Prevalence of Hepatitis B virus (HBV) infection in children (contact subjects) of chronic Hepatitis B surface antigen (HBsAg) carrier subjects (index subjects);2) Search for factors associated with HBV infection in these children. Patients and Methods: Retrospective-crosssectional study (January 5th, 2006 through December 31st, 2012). Studied parameters: biological and clinical characteristics of index subjects;Prevalence of HBsAg and Hepatitis B core antibody (HBcAb) in their children. Search for the HBV infection associated factors in the children (univariate analyses through Chi-square or Fisher’s exact test;multivariate analysis through a backward logistic regression). Results: Our 44 subjects’ median age was 43.1 ± 7.49 years and 88.6% of them lived with a spouse. Average number of children per index subjects was 2.3 ± 1.1. Our 92 children’s median age was 9.3 ± 4.55 (ranging from 1 to 15 years), and 43 (44.8%) were vaccinated against HBV. HBV infection prevalence was 24% (23/96 of which, 4 were HBsAg positive and 19 HBcAb positive subjects without HBsAg). Independent factors associated with HBV infection in children of index subjects were HBV DNA for index subjects >2000 IU/ml (OR = 11.5;p = 0.001), existence of HBV in two parents (OR = 7.9;p = 0.03) and absence of HBV vaccination in the children (OR = 30.9;p = 0.003). Conclusion: Immunization coverage for children of index subjects was insufficient, especially before the introduction of HBV vaccine into the enlarged vaccination program. Outside vertical transmission, those children were more exposed to HBV intrafamilial transmission risk when they were not immunized against HBV, when both parents were infected and when HBV viremia in index subjects was higher than 2000 IU/ml.
文摘Aims: 1) Describe virological profile of patients followed-up for chronic Hepatitis B virus (HBV);2) Search for a correlation between cirrhosis and virological profile of patients. Patients and Methods: Retrospective study about 75 HBsAg positive patients followed-up for at least one year in two medical structures of Abidjan. Studied parameters: clinical signs, biological check-up (serum transaminases every 3 months for at least one year, platelets count and prothrombin rate), abdominal echography, virological check-up (HBsAg, HBeAg, anti-HBe, total anti-HBc, anti-VHC and anti- HIV Ab, HBV DNA biannual quantification during at least one year). Histological or biochemical evaluation of hepatic activity and fibrosis were realized in case of transaminases elevation or HBV DNA > 2000 IU/ml. Results: The mean age of our 75 patients (54 men) was 42.1 ± 11.54 years. HBV was fortuitously discovered in most of our patients (74.7% of the cases). The HBV inactive chronic carriage was 50.7%;HBeAg-positive and HBeAg-negative chronic hepatitis represented respectively 9.3% and 40% of the cases. Mean B viral load was 327.5 IU/ml in HBV inactive chronic carriers, 44,047,663 IU/ml in HBeAg-positive chronic HBV and 20,231,822 IU/ml in HBeAg-negative chronic HBV. Cirrhosis prevalence was significantly high- er in positive or negative HBeAg chronic HBV than in HBV inactive chronic carriers (32.4% vs. 5.3%, p = 0.008;OR = 8.6). Conclusion: Our patients’ virological profile was dominated by HBeAg-negative chronic HBV and HBV inactive chronic carriage. The risk of having cirrhosis was multiplied by 8.6 in case of active chronic hepatitis compared with HBV inactive chronic carriage.