No abstract

Since its discovery by Blumberg in 1965, the hepatitis B surface antigen (HBsAg) is used as the fingerprint of hepatitis B infection. Occult hepatitis B infection (OBI) is defined by a viral replication (DNA detectable) in the absence of HBsAg. Burkina Faso is a high endemic area where the prevalence is higher than 14%. At the National Center for Blood Transfusion (NCBT) of Ouagadougou, HBsAg is the only sought marker used to distinguish donors towards Hepatitis B Virus (HBV). Acceptation of blood donation is based specifically on the absence of HBsAg, which exposes to the risk of HBV transmission during transfusion. The goal of this study is to evaluate this risk by determining the prevalence of OBI in blood donors. Patients and Methods: It was a five-month prospective study on blood donations collected from January to May 2016. The HBc antibody has been sought in the serums of negative HBsAg donors. The measure of B DNA by Real Time PCR (polymerase chain reaction) and that of antibodies anti-HBs have been proposed to anti-HBc positive donors. Abdominal ultrasound, the transaminases, prothrombin level, alphafeto-proteins, hepatic fibrosis have been proposed to donors who were detectable for the DNA. Sociodemographic parameters have been collected. The test costs were borne by donors who were recalled by phone to adhere to the study. Results: Among 1980 negative donors HBsAg, 872 (44%) were positive for anti-HBc. 160 on 872 donors were received for consultation, among which 76 (76/160) were able to realise DNA which was detectable in 25 donors on 76, thus a prevalence of 32.8%. The mean value of DNA was 953 IU/ml. Physical examination and hepatic ultrasounds were normal except a case where hepatic steatosis was found. The biologic standard hepatic results were in normal range. None of the patient was able to realise hepatic fibrosis evaluation. A case of co-infection HIV/OBI was noted. Conclusion: This study shows that in BurHow to cite this paper: Somda, K.S., Sermé, A.K., Coulibaly, A., Cissé, K., Sawadogo, A., Sombié, A.R. and Bougouma, A. 363kina, almost half of blood bags transfused are anti-HBc positive and around one third (32.8%) probably have HBV DNA. This poses a potential risk of contamination for non-immunized recipient. It is thus important that, in addition to HBsAg, AntiHBc should be systematically sought in order to minimize the risk.

No abstract

Background: Prevalence of Peptic Ulcer Disease (PUD) is decreasing in developed countries since the use of the treatments for eradication of Helicobacter pylori. Objectives: To revalue the sociodemographic, clinical and evolutionary aspects of the PUD among hospitalized patients in CHUYO. Methodology: This prospective study is related to 65 files of patients hospitalized in hepato-gastroenterology and general surgical services of the CHUYO between March 1st and August 31st, 2015. Results: Hospital utilization rate was 6.59%. The average age of patients was 40.6 years with extremes of 17 and 80 years. The sex ratio was 9.8. The location of the ulcer was 69.23% in stomach. A notion of taking aggressive gastrointestinal products was found in 62 patients (95.4%). The clinical picture was represented by diffuse abdominal pain (76.92%), peritoneal irritation syndrome (64.61%) and epigastric pain (56.92%), anemia (23.07%). Gastric perforations (64.61%) and gastrointestinal bleeding (12.30%) were the main complications. Consumption of non-steroidal anti-inflammatory drugs (NSAIDs) was found in 81.5% of cases. The management was medical and/or surgical with an overall mortality rate of 7.7%. Conclusion: The PUD rate decreased from 10.12% to 6.59% in 5 years. The complications are dominated by stomach perforations. They are relative increase and seem related to NSAIDs. Better management of this disease requires awareness of the population to selfmedication.

No abstract

Optimization of hepatitis B virus (HBV) testing and linkage to treatment may help curtail the HBV disease burden in Africa. Therefore, a panel of 10 experts from Africa convened, reviewed the literature and developed 10 recommendations for optimizing the diagnosis and treatment initiation for HBV infection in Africa. In resource-constrained African settings, a single hepatitis B surface antigen assay may be considered as the primary test for HBV diagnosis. Pre-treatment assessments should include tests for complete blood count, liver/renal function, hepatitis B e-antigen (HBeAg), anti-HBe, HBV DNA, co-infection, and disease severity assessment. Non-invasive alternatives to liver biopsy include aspartate aminotransferase-to-platelet ratio index, fibrosis score-4, and transient elastography. Antiviral therapy should be initiated in HBV-infected, cirrhotic individuals with detectable HBV DNA, regardless of alanine transaminase levels or HBeAg status. This consensus document may be a useful guide to clinicians for optimizing the diagnosis and treatment initiation for HBV infection in Africa.

No abstract

No abstract