A Seven-Year Retrospective Study on the Surveillance of Hepatitis B in Laos

Paboriboune, Phimpha; Vial, Thomas; Chassagne, François; Sitbounlang, Philavanh; Soundala, Sengaloun; Bertani, Stéphane; Sengmanothong, Davone; Babin, François-Xavier; Steenkeste, Nicolas; Dény, Paul; Pineau, Pascal; Deharo, Eric

doi:10.1155/2018/9462475

Cited by 7 publications

(7 citation statements)

References 28 publications

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“…All patients presenting at CILM were diagnosed anti-HCV(?) using rapid point-of-care tests with questionable efficacy according to our experience (Paboriboune et al 2018). This diagnosis was established during routine health check-ups or specialized gastroenterology consultations.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C in Laos: A 7-Year Retrospective Study on 1765 Patients

et al. 2018

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Hepatitis C virus (HCV) is a global health concern, notably in Southeast Asia, and in Laos the presentation of the HCV-induced liver disease is poorly known. Our objective was thus to describe a comprehensive HCV infection pattern in order to guide national health policies. A study on a group of 1765 patients formerly diagnosed by rapid test in health centres was conducted at the Centre of Infectiology Lao Christophe Merieux in Vientiane. The demographic information of patients, their infection status (viral load: VL), liver function (aminotransferases) and treatments were analysed. Results showed that gender distribution of infected people was balanced; with median ages of 53.8 for men and 51.6 years for women (13-86 years). The majority of patients (72%) were confirmed positive (VL > 50 IU/mL) and 28% of them had high VL (> 6log). About 23% of patients had level of aminotransferases indicative of liver damage (> 40 IU/mL); but less than 20% of patients received treatment. Patients rarely received a second sampling or medical imaging. The survey also showed that cycloferon, pegylated interferon and ribavirin were the drugs prescribed preferentially by the medical staff, without following any international recommendations schemes. In conclusion, we recommend that a population screening policy and better management of patients should be urgently implemented in the country, respecting official guidelines. However, the cost of biological analysis and treatment are significant barriers that must be removed. Public health resolutions should be immediately enforced in the perspective of meeting the WHO HCV elimination deadline by 2030.

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Section: Discussionmentioning

confidence: 99%

Hepatitis C in Laos: A 7-Year Retrospective Study on 1765 Patients

et al. 2018

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“…Among the patients, 10.6% had both a high level of HBV DNA over 10,000 IU/mL and elevated aminotransferases. However, only 2.4% of them received treatment for chronic hepatitis [10,11].…”

Section: Hepatitis B Virusmentioning

confidence: 99%

“…More recently, a retrospective study conducted on 1765 HCV-infected patients showed that, in Vientiane, 28% had high viral loads (>6log10). About 23% of patients had levels of aminotransferases indicative of liver damage >40 IU/mL, but less than 20% of them received antiviral drugs [10,11]. In Laos, circulating strains overwhelmingly belong to genotype 6 >95%, the Southeast Asian version of HCV, with frequent viral isolates specific to the local population [18][19][20].…”

Section: Hepatitis C Virusmentioning

confidence: 99%

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The Threat of Multiple Liver Carcinogens in the Population of Laos: A Review

Sitbounlang

Marchio

Deharo

et al. 2021

Livers

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Laos is a landlocked country in South East Asia, ranking fifth for primary liver cancer incidence worldwide. Risk factors that might explain this worrying situation are poorly known. We conducted a review of the literature concerning the etiologies of terminal liver diseases in Laos. A double infectious burden with hepatitis B and C viruses and the liver fluke Opisthorchis viverrini seems to be the main cause of the high liver cancer incidence. Moreover, it was also suggested that mutagenic substances frequently found in tobacco, alcoholic beverages, fermented fish, and mold-contaminated cereals or nuts, which are all substances heavily consumed by Lao people, lead to the accumulation of DNA mutations in the liver cell genome causing tumor processes. However, the respective proportions of liver cancer cases attributable to each category of infections and substances consumed, as well as the histological nature of the neoplasia are still not precisely documented in Laos. The international medical and scientific communities as well as public health stakeholders should urgently consider the alarming situation of liver health in Laos to stimulate both research and subsequent implementation of prevention policies.

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“…The recommended upper limit of normal (ULN) for ALT for guiding the management of chronic HBV infection is >ULN, where ULN is defined by local laboratory . Elevated liver enzymes have been reported in HBV‐infected individuals in several Asian studies . Elevated ALT levels have been positively correlated with HBV DNA positivity, liver stiffness and an increased risk of fibrosis, cirrhosis and HCC in Asian patients with chronic HBV infection .…”

Section: Pre‐treatment Assessments In Individuals With Chronic Hbv Inmentioning

confidence: 99%

Asian consensus recommendations on optimizing the diagnosis and initiation of treatment of hepatitis B virus infection in resource‐limited settings

Gane

Charlton

Mohamed

et al. 2019

Journal of Viral Hepatitis

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Asia has an intermediate‐to‐high prevalence of and high morbidity and mortality from hepatitis B virus (HBV) infection. Optimization of diagnosis and initiation of treatment is one of the crucial strategies for lowering disease burden in this region. Therefore, a panel of 24 experts from 10 Asian countries convened, and reviewed the literature, to develop consensus guidance on diagnosis and initiation of treatment of HBV infection in resource‐limited Asian settings. The panel proposed 11 recommendations related to diagnosis, pre‐treatment assessment, and indications of therapy of HBV infection, and management of HBV‐infected patients with co‐infections. In resource‐limited Asian settings, testing for hepatitis B surface antigen may be considered as the primary test for diagnosis of HBV infection. Pre‐treatment assessments should include tests for complete blood count, liver and renal function, hepatitis B e‐antigen (HBeAg), anti‐HBe, HBV DNA, co‐infection markers and assessment of severity of liver disease. Noninvasive tests such as AST‐to‐platelet ratio index, fibrosis score 4 or transient elastography may be used as alternatives to liver biopsy for assessing disease severity. Considering the high burden of HBV infection in Asia, the panel adopted an aggressive approach, and recommended initiation of antiviral therapy in all HBV‐infected, compensated or decompensated cirrhotic individuals with detectable HBV DNA levels, regardless of HBeAg status or alanine transaminase levels. The panel also developed a simple algorithm for guiding the initiation of treatment in noncirrhotic, HBV‐infected individuals. The recommendations proposed herein, may help guide clinicians, to optimize the diagnosis and improvise the treatment rates for HBV infection in Asia.

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A Seven-Year Retrospective Study on the Surveillance of Hepatitis B in Laos

Cited by 7 publications

References 28 publications

Hepatitis C in Laos: A 7-Year Retrospective Study on 1765 Patients

Hepatitis C in Laos: A 7-Year Retrospective Study on 1765 Patients

The Threat of Multiple Liver Carcinogens in the Population of Laos: A Review

Asian consensus recommendations on optimizing the diagnosis and initiation of treatment of hepatitis B virus infection in resource‐limited settings

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