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Hepatitis B virus infection and hepatocellular carcinoma in sub- Saharan Africa: Implications for elimination of viral hepatitis by 2030?

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World Journal of Gastroenterology 2021年第36期27卷 6025-6038页

作者： edina amponsah-dacosta Vaccines for Africa Initiative School of Public Health and Family MedicineUniversity of Cape TownCape Town 7925Western CapeSouth Africa

Elimination of viral hepatitis in sub-Saharan Africa by 2030 is an ambitious ***,as stated by the World Health Organization,there are unprecedented opportunities to act and make significant contributions to the elimination *** 60 million people chronically infected with hepatitis B virus(HBV)of whom 38800 are at risk of developing highly fatal hepatocellular carcinoma(HCC)every year,sub-Saharan Africa faces one of the greatest battles towards elimination of viral *** is a need to examine progress in controlling the disproportionate burden of HBV-associated HCC in sub-Saharan Africa within the context of this elimination *** scaling-up coverage of hepatitis B birth dose and early childhood vaccination,we can significantly reduce new cases of HCC by as much as 50%within the next three to five *** the substantial reservoir of chronic HBV carriers however,projections show that HCC incidence and mortality rates in sub-Saharan Africa will double by *** warrants urgent public health *** trends in the burden of HCC over the next two decades,will be determined to a large extent by progress in achieving early diagnosis and appropriate linkage to care for high-risk chronic HBV infected persons.

关键词： Hepatitis B virus Viral hepatitis,Hepatocellular Carcinoma Elimination Human Immunodeficiency Virus Sub-Saharan Africa

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Chronic hepatitis B-associated liver disease in the context of human immunodeficiency virus co-infection and underlying metabolic syndrome

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World Journal of Virology 2020年第5期9卷 54-66页

作者： edina amponsah-dacosta Cynthia Tamandjou Tchuem Motswedi Anderson Vaccines for Africa Initiative School of Public Health and Family MedicineUniversity of Cape TownCape Town 7925Western CapeSouth Africa Health Economics Unit School of Public Health and Family MedicineUniversity of Cape TownCape Town 7925Western CapeSouth Africa Botswana Harvard AIDS Institute Partnership GaboroneBotswana

Globally,a shift in the epidemiology of chronic liver disease has been *** has been mainly driven by a marked decline in the prevalence of chronic hepatitis B virus infection(CHB),with the greatest burden restricted to the Western Pacific and sub-Saharan African *** this is a growing burden of metabolic syndrome(MetS)worldwide.A disproportionate co-burden of human immunodeficiency virus(HIV)infection is also reported in sub-Saharan Africa,which poses a further risk of liver-related morbidity and mortality in the *** reviewed the existing evidence base to improve current understanding of the effect of underlying MetS on the development and progression of chronic liver disease during CHB and HIV *** the mechanistic association between CHB and MetS remains poorly resolved,the evidence suggests that MetS may have an additive effect on the liver damage caused by *** HIV infected individuals,MetS-associated liver disease is emerging as an important cause of non-AIDS related morbidity and mortality despite antiretroviral therapy(ART).It is plausible that underlying MetS may lead to adverse outcomes among those with concomitant CHB and HIV ***,this remains to be explored through rigorous longitudinal studies,especially in sub-Saharan ***,there is a need for a comprehensive package of care that integrates ART programs with routine screening for MetS and promotion of lifestyle modification to ensure an improved quality of life among CHB and HIV coinfected individuals.

关键词： Hepatitis B virus Human immunodeficiency virus Metabolic syndrome Fatty liver disease Chronic liver disease Sub-Sharan Africa

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