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Hepatocellular carcinoma in Hepatitis B and Human Immunodeficiency Virus coinfection in Africa:a focus on surveillance

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Hepatoma Research 2022年第1期8卷 445-457页

作者： Qian Wan Chimaobi Anugwom hailemichael desalegn Jose D.Debes Department of Medicine Division of Infectious Disease and International Medicine&Division of GastroenterologyHepatology and NutritionUniversity of MinnesotaMinneapolisMN 55455USA Health Partners Digestive Care Saint PaulMN 55130USA Millennium Hospital Addis Ababa 1000Ethiopia Arusha Lutheran Medical Centre ArushaTanzania

Human immunodeficiency virus(HIV)and hepatitis-B virus(HBV)infections are weighty public health challenges,especially in the African *** direct carcinogenic effect of HBV means that it remains a potent cause of early-onset hepatocellular carcinoma(HCC)in Sub-Saharan Africa(SSA),where it causes significant morbidity and *** presence of HIV infection in HBV-infected patients poses a complicating factor,as coinfection has been shown to hasten the progression of liver disease to cirrhosis and HCC,and often resulting in early-age hepatocarcinogenesis with consequent late diagnosis and lower *** this review,we discuss this unique conundrum,the epidemiology of HIV-HBV coinfection in SSA,its effect on liver disease and development of HCC,as well as practices and barriers to HCC surveillance in this distinct *** propose a way forward to curb this considerable health burden focusing on reduction of disease stigma,the need for easy-to-measure biomarkers,and implementation of large prospective studies in this population.

关键词： HBV HIV coinfection hepatocellular carcinoma surveillance Sub-Saharan Africa

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

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World Journal of Hepatology 2024年第7期16卷 995-1008页

作者： Nejib Y Ismael Semir A Usmael Nega B Belay hailemichael desalegn Mekonen Asgeir Johannessen Stian MS Orlien Haramaya University College of Health and Medical SciencesHarar 252Ethiopia Aklilu Lemma Institute of Pathobiology Addis Ababa UniversityAddis Ababa 1000Ethiopia Regional Centre for Imported and Tropical Diseases Oslo University HospitalOslo 0450UllevålNorway Internal Medicine Gastroenterology and Hepatology UnitSaint Paul’s Hospital Millennium Medical CollegeAddis Ababa 1000Ethiopia Department of Infectious Disease Vestfold Hospital TrustTønsberg 3103Norway Institute of Clinical Medicine Oslo UniversityOslo 0318Norway Department of PediatricsOslo UniversityOslo 0450UllevålNorway

BACKGROUND 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 *** To investigate the characteristics of CHB in Eastern Ethiopia and assess the efficacy and safety of antiviral *** This cohort study included 193 adults who were human immunodeficiency virus-negative with CHB between June 2016 and December *** assessments included chemistry,serologic,and viral markers.χ^(2) tests,Mann-Whitney U tests,and logistic regression analyses were used to identify the determinants of *** disoproxil fumarate(TDF)was initiated using treatment criteria from the Ethiopian CHB pilot *** 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 *** use,hepatitis B envelope antigen positivity,and a high viral load were independently associated with ***,66 patients(33.4%)fulfilled the treatment criteria and 59(30.6%)started *** 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)(P=0.002),and viral suppression was achieved in 80.9%and 100%of patients after 12 months and 24 months of treatment,*** the treated patients,12(20.3%)died within the first 6 months of treatment,of whom 8 had decompensated *** This study highlights the high prevalence of cirrhosis,initial mortality,and the efficacy of TDF *** up measures to prevent and control CHB infections in Ethiopia is crucial.

关键词： Chronic hepatitis B Cirrhosis Cohort study Resource-limited settings Sub-Saharan Africa

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