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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

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

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

Diagnostic accuracy of biochemical markers of fibrosis in black African patients with chronic hepatitis B

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Health 2010年第12期2卷 1413-1420页

作者： alassan kouamé mahassadi Alain Koffi Attia Fulgence M. Yao Bathaix Narcisse Baudouin Agbé Stanislas Doffou Henriette Ya Kissi Isidore Mouhenou Diomandé Paul Cales Thérese Ndri-Yoman 不详

Contradictory results of the accuracy of bio-chemical markers to predict the stage of fibrosis in black African patients with chronic hepatitis B (CHB) were previously published. We con-ducted a prospective cohort study to determine the diagnostic accuracy of aspartate ami-notransferase to platelet ratio (APRI), aspartate aminotransferase to alanine aminotransferase ratio (AAR), platelet count, age-platelet (AP) in-dex, and FIB-4 index for the prediction of sig-nificant fibrosis or cirrhosis in 117 black African patients (median age: 38 years, males: 73 %) with CHB not previously treated. Among them, 45 had significant fibrosis and 18 had cirrhosis using the METAVIR score system. Factors as-sociated either with significant fibrosis or cir-rhosis were determined in logistic multivariate analysis. Areas under receiver operating curve were assessed and compared for APRI, AAR, AP index, FIB-4 index and platelet count. Sensitivity, specificity, positive and negative predictive values were determined for each biochemical markers. Multivariate analysis showed that as-partate aminotransferase (p 1.1) and FIB-4 index (cut-off > 2.1) ruled out significant fibrosis with high specific-ity of 84.7 % and 86.1 % respectively and nega-tive predictive values of 78.2 % and 72.9 % re-spectively. More accurately, APRI (cut-off > 0.63) or FIB-4 index (cut-off > 1.26) ruled out cirrhosis with high sensitivity of 94.4% and 88.9% and high negative predictive values of 98.1% and 96.3% respectively. In conclusion, APRI and FIB-4 index are simple readily available markers to exclude significant fibrosis or more accu-rately cirrhosis in black African patients with CHB.

关键词： Non Invasive Models Fibrosis Cirrhsis Hepatitis B Sub-Saharan Africa

Diagnostic accuracy of biochemical markers of fibrosis in black African patients with chronic hepatitis B

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

Health（健康） 2010年第12期

作者： alassan kouamé mahassadi Alain Koffi Attia Fulgence M. Yao Bathaix Narcisse Baudouin Agbé Stanislas Doffou Henriette Ya Kissi Isidore Mouhenou Diomandé Paul Cales Thérese Ndri-Yoman

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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

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

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

Barcelona Clinic Liver Cancer Classification and Treatment of Hepatocellular Carcinoma in a Côte d’Ivoire University Hospital

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Open Journal of Gastroenterology 2023年第10期13卷 319-327页

作者： Kissi Anzouan-Kacou Henriette Ya Bangoura Aboubacar Demba kouame Dimitri 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: Hepatocellular carcinoma occurs mainly and increasingly in developing countries, where the prognosis is particularly poor. The Barcelona Clinic Liver Cancer classification is used to guide the treatment of hepatocellular carcinoma. The aim of this retrospective study was to describe the Barcelona Clinic Liver Cancer classification and the treatment of hepatocellular carcinoma in a University Hospital in Côte d’Ivoire. Methods: Patients with hepatocellular carcinoma hospitalized in the hepato-gastroenterology unit of the University Hospital of Yopougon from 01 January 2012 to 30 June 2017 were included. The diagnosis of hepatocellular carcinoma was based on the presence of hepatic nodules on the abdominal ultrasound scan, typical images with the helical scanner associated or not with an increase of the α-fetoprotein higher than 200 ng/ml or with histology. Demographic, clinical, biological and radiological data were determined at the time of diagnosis. Patients were classified according to the Barcelona Clinic Liver Cancer classification. Their treatment was specified. Results: There were 258 patients whose median age was 48.1 years. Viral hepatitis B virus was the primary cause of hepatocellular carcinoma in 64.7% of cases. The severity of the underlying cirrhosis was Child-Pugh A in 12.1%, B in 63.6% and C in 24.3% of cases. The median size of the tumor was 63 mm. The α-fetoprotein level was higher than 200 mg/ml in 56.03% of cases. The Eastern Cooperative Oncology Group (ECOG)/World Health Organization (WHO) system was ≥2 in 82.9%. The Barcelona Clinic Liver Cancer classification was A in 1.3%, B in 0%, C in 55.2% and D in 43.5% of patients. There was no transplantation or hepatic resection. Very few patients (1.9%) received radio-frequency curative therapy. The treatment was predominantly symptomatic in 97.8% of patients. During hospitalization 43.7% of patients died. Conclusion: Hepatocellular carcinoma occurs on a liver with severe cirrhosis

关键词： Hepatocellular Carcinoma Barcelona Clinic Liver Cancer Classification Viral Hepatitis B Africa