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Prevalence and Factors Associated with Intestinal Metaplasia in Chronic Helicobacter pylori Gastritis in a Country with High Endemicity: Ivory Coast Case

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Open Journal of Gastroenterology 2023年第12期13卷 401-410页

作者： hatrydt guillaume dimitri kouamé Lisiane Mewetieh Kouassi Olivier Claver Koffi Bathaix Fulgence Mamert Yao Medical Sciences Training and Research Unit of Abidjan Félix Houphou&#235t-Boigny University Abidjan Ivory Coast Hepatology and Gastroenterology Unit Yopougon University Hospital Abidjan Ivory Coast

Context/Objective: Few studies have been carried out in a country with high endemicity for Helicobacter pylori (H. pylori) infection in Sub-Saharan Africa looking for the association of intestinal metaplasia (IM) with chronic gastritis. We hypothesize that IM is correlated with the intensity of H. pylori infection in a country with high endemicity, Ivory Coast. The objective of this study was to determine the prevalence of intestinal metaplasia in chronic H. pylori gastritis in Ivory Coast. Methods: This was a prospective, cross-sectional, multicenter study, carried out over a period of 5 months, in the reference hospital centers of Abidjan, specialized in Gastroenterology. All patients who had undergone Gastroscopy with biopsies according to the criteria of the Sydney System for the anatomopathological study, those with chronic gastritis and/or H. pylori intestinal metaplasia on histology and in whom all the parameters of the Sydney system classification had been well informed. The quantitative variables were expressed by their means accompanied by their standard deviations and the qualitative variables by their numbers and percentages. Chi-square and Fischer tests were used to look for associations between variables. The significance level was set at 5%. Results: 152 patients were retained. The mean age was 44.9 ± 12.9 years. The prevalence of intestinal metaplasia was 11.8%. In univariate analysis, no significant association was found between clinical and pathological sociodemographic factors (age, sex, ethnicity, educational level, profession) and intestinal metaplasia in chronic Helicobacter pylori gastric cases. In multivariate analysis we found that prolonged use of Proton Pump Inhibitors (PPIs) and a history of Gastroesophageal Reflux Disease (GERD) were significantly associated with the absence of IM. Conclusion: Chronic H. pylori gastritis is the main risk factor for intestinal metaplasia. Prolonged use of PPIs and a history of GERD were significantly iden

关键词： Helicobacter Pylori Chronic Gastritis Intestinal Metaplasia Ivory Coast

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Factors Associated with Hepatic Steatosis in Black African Subjects with Chronic Viral Hepatitis B in Côte d’Ivoire

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Open Journal of Gastroenterology 2023年第10期13卷 328-337页

作者： kouamé hatrydt guillaume dimitri Kissi Anzouan-Kacou Henriette Ya Gogan Patricia Bangoura Aboubacar Demba Doffou Stanislas Adjeka Mahassadi kouame Alassan Yao Bathaix Fulgence Mamert Attia Alain Koffi Medical Sciences Training and Research Unit of Abidjan Félix Houphou&eumlt-Boigny University Abidjan C&ocircte d’Ivoire Hepatology and Gastroenterology Unit Yopougon University Hospital Abidjan C&ocircte d’Ivoire

Context/Objectives: With the progression of the global epidemic of obesity and metabolic syndrome, the coexistence of hepatic steatosis in patients with chronic viral hepatitis B (VHB) is becoming significant. The aim of this work was to determine the factors associated with hepatic steatosis assessed by a Fibroscan with Controlled Attenuation Parameter (CAP) in patients with chronic viral hepatitis B in Côte d’Ivoire. Methods: This was a cross-sectional and analytical study. Data was collected from February 15 to July 31, 2020 in a private hospital structure in the city of Abidjan in Côte d’Ivoire. We included 83 patients with chronic viral hepatitis B. These were black patients, having performed a Fibroscan/CAP during the recruitment period and consenting to participate in the study. Patients with significant alcohol consumption, a secondary cause of hepatic steatosis, or other liver disease regardless of the etiology associated with hepatitis B were not included. Results: The frequency of hepatic steatosis in chronic VHB carriers assessed by the CAP in our study population was 48.19% including 24.10% severe steatosis. Obesity and high LDL cholesterol were statistically correlated with the presence of steatosis in our patients. Patients who had steatosis on ultrasound were 5 times more likely to have steatosis on CAP. Significant fibrosis was not significantly associated with steatosis. Conclusion: Obesity and LDL hypercholesterolemia are the main factors associated with hepatic steatosis detected by Fibroscan/CAP in patients with chronic viral hepatitis B.

关键词： Non-Alcoholic Fatty Liver Disease Chronic Viral Hepatitis B Obesity Metabolic Syndrome Fibroscan/CAP Africa

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Predictors of Direct-Acting Antivirals Failure in Patients with Chronic Hepatitis C Virus in Ivory Coast: About 5 Cases

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Open Journal of Gastroenterology 2019年第10期9卷 193-201页

作者： dimitri hatrydt kouamé Stanislas Adjéka Doffou Henriette Kissi Anzouan-Kacou Yannick Mfupa Tchana Aboubakar Demba Bangoura Mahassadi kouamé Alassan Fulgence Bathaix Yao Alain Koffi Attia Thérè se Ndri Yoman Hepatogastroenterology Unit Yopougon Teaching Hospital Yopougon C&ocirc te d’Ivoire

Context and Aim: Direct-acting antivirals are the therapeutic revolution in the management of viral hepatitis C, but often with a few cases of failure. The aim of this study was to identify factors that may be implicated in the failure of direct-acting antiviral therapy in patients with hepatitis C virus in Ivory Coast. Methodology: This was a cross-sectional and descriptive study with a retrospective compendium of data from the year 2016 to the year 2018. This study included all patients with chronic viral hepatitis C, patients naive to antiviral treatment, or pre-treated patients in whom a failure to treatment with direct-acting antiviral has been diagnosed. Results: During the study period, 5 patients out of 14 cases of therapeutic failure were included, i.e. 35.71%. Most of the patients were over 50 years (4 out of 5) and predominantly female (3 out of 5). High blood pressure was the most common comorbidity (3 out of 5 patients). Genotype 1 was found in 4 patients versus 1 case of genotype 2. None of the patients had hepatitis B or HIV coinfection. A viral load > 6log was found in 4 patients at baseline. All our patients had hepatic cytolysis. Two of them were cirrhotic. All 4 cases of genotype 1 benefited from the combination sofosbuvir + ledipasvir for 12 weeks and the case of genotype 2 from the combination sofosbuvir + ribavirin for 24 weeks. The resistance mutations were observed mainly on the sequencing of NS5A at the Y93H, L31M, 28L, 30T, 31V, 58S and 93H genes and a case of mutation on the N3 gene sequencing. Conclusion: Age > 50 years, comorbidities (high blood pressure), polymedication, female gender, genotype 1b, viremia > 6log, and cytolysis were the profile of patients with treatment of HCV by direct-acting antiviral failure.

关键词： HVC Direct-Acting Antivirals Failure Ivory Coast

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Treatment of Chronic Hepatitis B with Tenofovir Disoproxil Fumarate in Ivory Coast

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Open Journal of Gastroenterology 2016年第2期6卷 39-45页

作者： Ya Henriette Kissi Anzouan-Kacou Adjeka Stanislas Doffou Djeinabou Diallo Demba Aboubacar Bangoura Yacouba Adéhouni hatrydt dimitri kouamé Alassan kouamé Mahassadi Fulgence Yao Bathaix Koffi Alain Attia Aya Thérèse Ndri-Yoman Department of Medicine and Hepatogastroenterology University Hospital of Yopougon Abidjan Cote d’Ivoire Department of Pharmacy University Hospital of Yopougon Abidjan Cote d’Ivoire

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.

关键词： Chronic Hepatitis B Virus Tenofovir Disoproxil Fumarate Treatment Ivory Coast Sub-Saharan Africa

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Prognostic Factors for Cirrhosis Hospital in Abidjan (Cote d’Ivoire)

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Open Journal of Gastroenterology 2015年第7期5卷 103-109页

作者： Mamert Fulgence Yao Bathaix Akelesso Bagny kouamé Alassane Mahassadi Anassé Jean-Baptiste Okon Ya Henriette Kissi-Anzouan Stanislas Doffou Aboubacar Demba Bangoura hatrydt dimitri kouamé Kadiatou Diallo Antonin N’Dam Aoudi Ousman De Koffi Alain Attia Aya Thérèse N’dri Yoman Department of Hepatology and Gastroenterology of the Centre Hospitalier Universitaire de Yopougon (CHU-Y) Abidjan Cote d’Ivoire

Cirrhosis is the cause of a high rate of death in hospitals. The aim of this research was to estimate the incidence of mortality and identify the risk factors associated with cirrhosis patients in hospital in Cote d’Ivoire. Methodology: It is a retrospective study covering from January 1st, 2002 to December 31st, 2011 at Centre Hospitalier et Universitaire de Yopougon in Abidjan. We concerned the cirrhosis patients that have been followed at the hepatology and gastroenterology department. Survival was estimated by the Kaplan-Meier curve and comparison of survival curves by the log-rank test. The multi-varied analysis of the survivals has been achieved with the Cox proportional Hazard regression. A p value < 0.05 was taken as significant. Results: We recruited, 221 patients (135 men) of whom the medium age was 59 ± 15.12 years. Among those patients, 34.5% were classified as Child Pugh C and 52.94% Child Pugh B, 19.45% suffered from digestive hemorrhage, 26.5% suffered from renal deficiency, 47% suffered from hepatic encephalopathy and 10.7% from hyponatremia. The median overall survival of patients was 0.50 person-months. The variables that were significantly associated to a reduction of survival were hepatic encephalopathy (p = 0.0029), spontaneous ascitesfluid infection (p = 0.0208), hyponatremia (p = 0.0434) and stage Cof Child- Pugh score (p = 0.046). Conclusion: The incidence of mortality in cirrhotic patients hospitalized in Abidjan is high. Pejorative prognostic factors were essentially hepatic encephalopathy, spontaneous ascites fluid infection, hyponatremia and stage C of Child-Pugh score.

关键词： Cirrhosis Portal Hypertension Child-Pugh Encephalopathy Prognostic Cote d’Ivoire

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