The current situation and challenges of screening for and treating hepatitis B in sub-Saharan Africa.

Béguelin, Charles Antoine; Fall, Fatou; Seydi, Moussa; Wandeler, Gilles (2018). The current situation and challenges of screening for and treating hepatitis B in sub-Saharan Africa. Expert review of gastroenterology & hepatology, 12(6), pp. 537-546. 10.1080/17474124.2018.1474097

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INTRODUCTION Hepatitis B virus (HBV) infection is the most important cause of hepatocellular carcinoma in sub-Saharan Africa (SSA). Although the tools to curb the epidemic are known, only a minority of HBV-infected persons are currently diagnosed and treated. Areas covered: We discuss HBV epidemiological trends in SSA, describe important determinants of its natural history, and summarize current knowledge on the continuum of HBV care. Using the results of a systematic review of the literature, we describe the proportion of patients with liver fibrosis at presentation for care. Throughout the manuscript, we highlight major research gaps and explore potential ways to improve uptake of HBV testing, evaluation of liver disease, access to antiviral therapy and monitoring of complications. Expert commentary: Less than 1% of HBV-infected individuals are diagnosed in SSA, despite the availability of rapid tests with good diagnostic accuracy. Up to 15% of individuals enter care with liver cirrhosis, a clear indication for antiviral therapy. Although the proportion of patients eligible for immediate antiviral treatment is generally below 20%, there are few published data from prospective cohort studies. The incidence of hepatocellular carcinoma could be reduced with improved access to antiviral therapy.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Béguelin, Charles Antoine and Wandeler, Gilles

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

1747-4132

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

16 May 2018 15:11

Last Modified:

29 May 2019 09:36

Publisher DOI:

10.1080/17474124.2018.1474097

PubMed ID:

29737218

Uncontrolled Keywords:

antiviral therapy hepatitis B virus hepatocellular carcinoma liver cirrhosis sub-Saharan Africa

BORIS DOI:

10.7892/boris.116526

URI:

https://boris.unibe.ch/id/eprint/116526

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