HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa.

Jaquet, Antoine; Wandeler, Gilles; Tine, Judicaël; Dagnra, Claver A; Attia, Alain; Patassi, Akouda; Ndiaye, Abdoulaye; de Ledinghen, Victor; Ekouevi, Didier K; Seydi, Moussa; Dabis, François (2016). HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa. BMC infectious diseases, 16(1), p. 249. BioMed Central 10.1186/s12879-016-1601-4

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BACKGROUND Prisoners represent a vulnerable population for blood-borne and sexually transmitted infections which can potentially lead to liver fibrosis and ultimately cirrhosis. However, little is known about the prevalence of liver fibrosis and associated risk factors among inmates in sub-Saharan Africa. METHODS Screening of liver fibrosis was undertaken in a randomly selected sample of male inmates incarcerated in Lome, Togo and in Dakar, Senegal using transient elastography. A liver stiffness measurement ≥9.5 KPa was retained to define the presence of a severe liver fibrosis. All included inmates were also screened for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Substances abuse including alcohol, tobacco and cannabis use were assessed during face-to-face interviews. Odds Ratio (OR) estimates were computed with their 95 % Confidence Interval (CI) to identify factors associated with severe liver fibrosis. RESULTS Overall, 680 inmates were included with a median age of 30 years [interquartile range: 24-35]. The prevalence of severe fibrosis was 3.1 % (4.9 % in Lome and 1.2 % in Dakar). Infections with HIV, HBV and HCV were identified in 2.6 %, 12.5 % and 0.5 % of inmates, respectively. Factors associated with a severe liver fibrosis were HIV infection (OR = 7.6; CI 1.8-32.1), HBV infection (OR = 4.8; CI 1.8-12.8), HCV infection (OR = 52.6; CI 4.1-673.8), use of traditional medicines (OR = 3.7; CI 1.4-10.1) and being incarcerated in Lome (OR = 3.3; CI 1.1-9.8) compared to Dakar. CONCLUSIONS HIV infection and viral hepatitis infections were identified as important and independent determinants of severe liver fibrosis. While access to active antiviral therapies against HIV and viral hepatitis expands in Africa, adapted strategies for the monitoring of liver disease need to be explored, especially in vulnerable populations such as inmates.

Item Type:

Journal Article (Original 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:

Wandeler, Gilles

Subjects:

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

ISSN:

1471-2334

Publisher:

BioMed Central

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

05 Jul 2016 09:44

Last Modified:

16 Feb 2017 15:54

Publisher DOI:

10.1186/s12879-016-1601-4

PubMed ID:

27267370

Uncontrolled Keywords:

Africa; HIV; Hepatitis B; Hepatitis C; Liver fibrosis

BORIS DOI:

10.7892/boris.83785

URI:

https://boris.unibe.ch/id/eprint/83785

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