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Prevalence of hepatitis B infection and factors associated in children of Ivorian HBsAg carrier subjects

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Open Journal of Gastroenterology 2013年第4期3卷 237-240页

作者： koffi alain Attia Ya Henriette Kissi Stanislas Doffou Demba Bangoura Roseline Flora Wilson Georges Bougha Fulgence Yao Bathaix Kouame Alassan Mahassadi Mohamed Sayegh Therese N’dri-Yoman Department of General Medicine and Hepato-Gastroenterology Teaching Hospital of Yopougon Abidjan Cote d’Ivoire Medical Private hospital of Danga Cocody Abidjan Cote d’Ivoire

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.

关键词： Hepatitis B Infection Intrafamilial Transmission Screening

Risks of Viral Hepatitis B Transmission in Mother-to-Infant of Pregnant Women Carriers of Chronic Viral Hepatitis B in Cote d’Ivoire

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Open Journal of Gastroenterology 2017年第7期7卷 206-215页

作者： Stanislas Adjéka Doffou Fulgence Bathaix Yao Aboubakar Demba Bangoura Dimitri Kouamé Henriette Kissi Anzouan-Kacou Aristide Tchimou Karidiatou Diallo Mahassadi Kouamé Alassan alain koffi Attia Thérèse Ndri Yoman Department of Hepatology and Gastroenterology of the Centre Hospitalier Universitaire de Yopougon(CHU-Y) AbidjanCote d’Ivoire

The aim of this study was to identify the risk factors of mother-to-child transmission of HBV in positive Ag Hbs pregnant women in Cote d’Ivoire. Methods: This was a transversal prospective study that took place over a period of 7 months (from February 2016 to August 2016) in 2 university hospital and 2 private clinics. We consecutively recruited 91 pregnant women who were positive for HBs Ag in prenatal consultations. For each pregnant woman record included in the study, we provided Socio-demographic (Age, marital status, education level, social rank, gravidity, parity) and biological data (HBs Ag, Anti-HBc Total Ac, Hbe Ag, Ac anti-Hbe Ac, DNA-VHB, Ac anti-HCV Ac, retroviral serology, transaminases). All of these data were collected using a survey sheet developed for the study. Results: The age of our pregnant women HBs positive ranged from 18 years to 44 years with a mean age of 30.10 years. The age group from 20 to 39 years was the most represented with a frequency of 92.31%. Almost of all positive HBs Ag pregnant women was HBe Ag negative, only 3.3% was HBe Ag positive. The viral load above 2000 IU/ml was found in 21 (23.03%) patients. There were 4 co-infected patients, which 3 HBV-HIV and 1 HBV-HCV. Only 19 (20.88%) pregnant HBs Ag positive women were able to bring back the supplementary virological assessment within a period less than one month. Conclusion: According to our work the virologic profile of positive HBs Ag in pregnant women in Cote d’Ivoire is characterized by an important viral replication objectified by a high viral load in about 23% pregnant women, a negativity of HBe antigen in 96.6% of them.

关键词： Cote d’Ivoire Hepatitis B Virus Surface Antigen Positive Risk Factors-Mother-to-Child Transmission

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

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

Treatment of Chronic Viral Hepatitis with Pegylated Interferon in Ivory Coast

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Open Journal of Gastroenterology 2016年第3期6卷 65-74页

作者： Henriette Ya Kissi Anzouan-Kacou Aboubacar Demba Bangoura Djenabou Diallo Yacouba Adéhouni Adjeka Stanislas Doffou Hartrydt Dimitri Kouamé Alassan Kouamé Mahassadi Mamert Fulgence Yao Bathaix alain koffi Attia Aya Thérèse Ndri-Yoman Hepatogastroenterology Unit Yopougon Teaching Hospital Yopougon Ivory Coast Pharmacy Unit Yopougon Teaching Hospital Yopougon Ivory Coast

Background: In the Ivory Coast, chronic infection by hepatitis B and C virus is the leading cause of cirrhosis and hepatocellular carcinoma. The absence of universal health coverage makes the treatment inaccessible to all. Objectives: To assess the efficacy of Pegylated Interferon in clinical practice in patients with chronic viral hepatitis B and C and determine the hematologic side effects. Patients and Methods: A descriptive retrospective study from January 2012 to November 2013 on a cohort of patients chronic carriers of hepatitis B virus (n = 11) treated with Pegylated Interferon to 180 mcg per week and hepatitis C virus (n = 30) treated with a combination therapy associating pegylated Interferon to 180 mcg per week and Ribavirin assayed according to the genotype. Results: Out of 1860 patients seen in hepatogastroenterology consultation 422 had viral hepatitis B or C that is a prevalence of 22.7% and 41 patients were treated (9.7%) by Pegylated Interferon. Among these 41 patients mentioned earlier, 30 had HCV (73.17%) with a case of HIV + HVC co-infection, 11 patients had HBV (26.83%) including 3 cases of HBV + HDV co-infection. Patients’ age ranged from 24 - 69 years with an average of 49.2 ± 12.2 years including 46.5 years for HBV and 51.9 years for HCV. The sex ratio was 1.56. The original transaminases were on average 93.37 IU/l for AST and 110.47 for ALT. The average RNA HCV was 1,685,331 IU/ml and the DNA HBV 33,312,767 IU/ml. Patients with HCV were of genotype 1 in 56.66%, genotype 2 in 40% and one case of genotype 4 (3.34%) from Central Africa. Fibrosis score at institution of treatment was significant (≥A2 and/or ≥F2) in 86.9% of cases of Fibrotest®, 100% of cases of Fibrometer®. We observed 48.8% of neutropenia < 750/mm3, 33.3% of anemia and 29.3% of thrombocytopenia < 100,000/mm3. There was no dose reduction of Pegylated Interferon and Ribavirin. For HBV there were 3 partial responses, 3 responders including 1 HBV + HDV co-infected non responder to H

关键词： HBV HCV Pegylated Interferon Ribavirine Africa

Hepatitis B Surface Antigen Serum Level Is Correlated with Fibrosis Severity in Treatment-Naïve, Chronic Hepatitis B Patients in Côte d’Ivoire (West Africa)?

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Open Journal of Gastroenterology 2015年第11期5卷 164-172页

作者： Mamert Fulgence Yao Bathaix Dramane Soro Aboubacar Demba Bangoura Adjéka Stanislas Doffou Siaka Koné Ya Henriette Kissy Dimitri Hartrydt Kouamé Aoudi Ousmane Dé Mahassadi Kouamé Alassane Attia koffi alain Aya Thérèse N’dri Yoman Department of Hepatology and Gastroenterology of the Centre Hospitalier Universitaire de Yopougon (CHU-Y) Abidjan Cote d’Ivoire Department of Hepatology and Gastroenterology of the Centre Hospitalier Universitaire de Cocody (CHU-C) Abidjan Cote d’Ivoire

HBsAg serum level (quantification) may be useful for managing hepatitis B virus (HBV) infection patients. However few studies especially in Africa have evaluated the association between HBsAg serum level and liver fibrosis severity. The objective of this study was to estimate the correlation between HBsAg serum level and liver fibrosis severity with treatment naive chronic hepatitis B patients in Cote d’Ivoire. Methodology: It is a prospective study covering from February 1st, 2014 to April 30st, 2015 at Centre Hospitalier et Universitaire de Yopougon and a private medical office in Abidjan, Cote d’Ivoire. Inclusion criteria for patients were: HBsAg positive, known HBeAg status, serum HBsAg levels, serum HBV DNA levels, complex serum markers and absence of HCV, HDV, or HIV co-infection, drinking more than 30 g/day for men and 20 g/day in women over 10 years, metabolic disease and/or hepatic overload. Pearson’s Chi-square test (r2), Anova, Spearman, T-Student, Pearson’s (r) correlations and Mann Withney’s Test were carried out as appropriate. A p value < 0.05 was taken as significant. Results: We recruited, 105 patients (77 men) of whom the medium age was 39.01 ± 9.72 years. Predominant hepatitis B viral genotype was E (93%). Less than 10% patients had an inactive HBV in HBeAg-negative. Patients had an average high HBsAg serum level (mean 12111.2 ± 10617.4 IU/ml) as well as the one viral load (mean 4.4 e7 ± 7.5 e7). Serum ALAT levels averaged at the upper limit of normal value. The average liver fibrosis score was 0.34 ± 0.22 and the degree of viral activity was 0.19 ± 0.20. Half of our patients had no fibrosis (35.24%) or had mild fibrosis (20.95%). No significant association was observed between HBsAg serum level and patient age (p = 0.3994), genre (p = 0.8075) or serum ALT levels (p = 0, 0787). In multivariate analysis, there’s a significant correlation (r = 0.239, p = 0.014) between HBV DNA levels and HBsAg serum level. There’s a significant correlation (r = 0.92

关键词： Hepatitis B Surface Antigen Serum Level Liver Fibrosis Chronic Hepatitis B Viral Africa

The <i>Helicobacter pylori</i>Eradication Rate in a High Prevalence Area (West Africa): Three Triple Therapy Comparative Study

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Open Journal of Gastroenterology 2015年第12期5卷 200-206页

作者： Adjéka Stanislas Doffou koffi alain Attia Mamert Fulgence Yao Bathaix Aboubacar Demba Bangoura Ya Henriette Kissy-Anzouan Hartrydt Dimitri Kouamé Kouamé Alassan Mahassadi Kouamé Justin N’Da Mohamed Kouyaté Constant Assi Aya Thérèse N’dri-Yoman Department of Hepatology and Gastroenterology Centre Hospitalier Universitaire de Yopougon (CHU-Y) Abidjan Cote d’Ivoire Anatomopathology Laboratory of the Centre Hospitalier Universitaire de Cocody (CHU-C) Abidjan Cote d’Ivoire Department of Hepatology and Gastroenterology Centre Hospitalier Universitaire de Cocody (CHU-C) Abidjan Cote d’Ivoire

In Western countries, the current trend is to use sequential quadruple therapy or bismuth-based instead of triple therapy for the eradication of Helicobacter pylori (H. pylori). In sub-Saharan Africa, high prevalence area of the H. pylori infection, the effectiveness of these triple therapies widely used in routine has been little evaluated. The purpose of this study was to evaluate and compare the effectiveness of three patterns of first-line triple therapy based on combining a proton pump inhibitors (PPI), and 3 types of antibiotics: omeprazole (O), amoxicillin (A), clarythromycin (C) and metronidazole (M). Patients and Methods: This is a randomized clinical trial opened on 3 parallel arms: OAM (group 1 or G1), OAC (group 2 or G2) or OCM (group 3 or G3). The primary endpoint was H. pylori eradication rate after seven days triple therapy. H. pylori diagnosis infection was based on bacterium detection on the histological examination of the gastric biopsies. Histological control was performed 4 weeks after the end of treatment to assess H. pylori eradication rate. Results: The average age of our 153 patients included in the study (86 men) was 44.33 ± 11.72 years. The main reason of the endoscopy was the dyspeptic syndrome (75.16%). The gastroscopy was normal in 28.76%. A Gastric or duodenal peptic ulcer was found in 17% of cases and gastropathy in 45.75%. Histologically, the GC was active in 90.9% of cases, follicular in 35.3% of cases, atrophic in 22.5% of cases and was associated with intestinal metaplasia (IM) in 5.2% of cases. Patients of these three groups (n = 64 for G1, n = 56 for G2 and n = 33 for G3) were comparable for age, gender, endoscopy indications, alcohol consumption history or smoking, and anti-inflammatory drugs taking. Approximately 23% of patients experienced adverse reactions. The overall H. pylori eradication rate was 22.3%. There was no significant difference H. pylori eradication rate depending on the treatment used (28.1%, 21.4% and 15.1% fo

关键词： Helicobacter pylori Triple Therapy Eradication West Africa

Differential colour-ring loss among Dalmatian Pelican(Pelecanus crispus) colonies and its consequence on survival estimates

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Avian Research 2024年第1期15卷 66-71页

作者： Anastasios Bounas Giorgos Catsadorakis Dionyssia Hatzilacou Theodoros Naziridis Jocelyn Champagnon alain J.Crivelli Department of Biological Applications and Technology University of IoanninaIoanninaGreece Society for the Protection of Prespa Agios GermanosGreece Natural Environment and Climate Change Agency 207 Mesogeion Ave.11525AthensGreece Natural Environment and Climate Change Agency Kerkini BranchKerkiniGR-62055Kato PoroiaGreece Tour du Valat Research Institute for Conservation of Mediterranean Wetlands13200ArlesFrance

The analysis of bird ringing data often comes with some potential sources of error and bias,as ring wear and/or loss could affect mark-recapture analyses and produce erroneous estimates of ***,ring wear and loss rates may differ between and within species based on the habitat they use or the species’ life-history traits and behaviour as well as the type of the *** this study we use resighting data from a long-term double marking experiment to directly estimate the rate of colour-ring loss among different Dalmatian Pelican colonies over time,evaluate any possible factors that could contribute to differential ring loss and assess how it may bias the results of mark-resighting *** on 14,849 resightings from 1275 individuals and using multi-state continuous-time hidden Markov models(HMMs) we showed that probability of ring loss was markedly different among colonies,ranging from 0.10 to 0.42 within the first year of marking,whereas the cumulative probability of losing a ring after ten years ranged 0.64 to *** rates are among the highest estimated when compared to previous studies in *** approach assessing the intra-specific variance in ring loss provided several factors potentially involved,such as the use of glue and the fledgling age accuracy and we could further hypothesise the effect of environmental ***,our results showed that ring loss can be a significant challenge for the assessment of the species’ population dynamics using mark-recapture methods as survival was consistently underestimated when not accounting for ring loss and varied significantly among different colonies.

关键词： Bias Capture-mark-recapture Colour-ring Double-marking Hidden Markov models

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