Treatment of chronic hepatitis B in sub-Saharan Africa: 1-year results of a pilot program in Ethiopia

The World Health Organization has set an ambitious goal of eliminating viral hepatitis as a major public health threat by 2030. However, in sub-Saharan Africa, antiviral treatment of chronic hepatitis B (CHB) is virtually unavailable. Herein, we present the 1-year results of a pilot CHB treatment pr...

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Bibliographic Details
Published in:BMC medicine 2018-12, Vol.16 (1), p.234-234, Article 234
Main Authors: Desalegn, Hailemichael, Aberra, Hanna, Berhe, Nega, Mekasha, Bitsatab, Stene-Johansen, Kathrine, Krarup, Henrik, Pereira, Andre Puntervold, Gundersen, Svein Gunnar, Johannessen, Asgeir
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antigens
Antiretroviral agents
Antiretroviral drugs
Antiviral agents
Antiviral Agents - therapeutic use
Antiviral drugs
Antiviral therapy
Biomarkers
Cirrhosis
Clinical medicine
Complications
Dosage and administration
Drug therapy
Drugstores
Epidemiology
Ethiopia
Female
Follow-Up Studies
Health risks
Hepatitis
Hepatitis B
Hepatitis B virus
Hepatitis B, Chronic - complications
Hepatitis B, Chronic - drug therapy
HIV
Hospitals
Human immunodeficiency virus
Humans
Infections
Interferon
Liver
Liver cirrhosis
Liver Cirrhosis - mortality
Liver Cirrhosis - virology
Liver function tests
Low income groups
Male
Markers
Middle Aged
Mortality
Patients
Pharmacy
Pilot Projects
Planning
Public health
Rank tests
Resource-limited settings
Risk factors
Tablets
Tenofovir
Tenofovir - therapeutic use
Therapy
Treatment Adherence and Compliance
Treatment Outcome
Viral hepatitis
Viral Load - drug effects
Viremia
Viruses
Wellness programs
Young Adult
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Summary:The World Health Organization has set an ambitious goal of eliminating viral hepatitis as a major public health threat by 2030. However, in sub-Saharan Africa, antiviral treatment of chronic hepatitis B (CHB) is virtually unavailable. Herein, we present the 1-year results of a pilot CHB treatment program in Ethiopia. At a public hospital in Addis Ababa, CHB patients were treated with tenofovir disoproxil fumarate based on simplified eligibility criteria. Baseline assessment included liver function tests, viral markers, and transient elastography (Fibroscan). Changes in laboratory markers were analyzed using Wilcoxon signed-rank tests. Adherence to therapy was measured by pharmacy refill data. Out of 1303 patients, 328 (25.2%) fulfilled the treatment criteria and 254 (19.5%) had started tenofovir disoproxil fumarate therapy prior to September 1, 2016. Of the patients who started therapy, 30 (11.8%) died within the first year of follow-up (28 of whom had decompensated cirrhosis), 9 (3.5%) self-stopped treatment, 7 (2.8%) were lost to follow-up, and 4 (1.6%) were transferred out. In patients who completed 12 months of treatment, the median Fibroscan value declined from 12.8 to 10.4 kPa (p  1,000,000 IU/mL; adjusted OR 2.41; 95% CI 1.04-5.55) and suboptimal adherence (
ISSN:1741-7015
1741-7015
DOI:10.1186/s12916-018-1229-x