Characterization and assessment of HBV chronically infected patients: Identification of those eligible for treatment in the South West region of Cameroon

Abstract

BackgroundThe management of patients with chronic hepatitis B infection is quite complex because it requires an in-depth knowledge of the natural history of the disease. This study was aimed at characterizing HBV infected patients in order to determine the phase of the infection and identify the proportion eligible for treatment using 3 different guidelines.MethodsHBV chronically infected patients (negative for HIV and HCV) were enrolled and the following tests were done for them: ALT, AST, HBV viral load, HBV serologic panel and Full blood count. APRI score was calculated for all patients. These patients were classified into immunotolerant, immune clearance, immune control and immune escape phases of the infection. The WHO and the 2018 AASLD criteria was also used to identify those who need treatment. Patients were clinically examined for signs and symptoms. Questionnaire was administered to all participants to ascertain their treatment status. Statistical analysis was done using SPSS version 21.ResultsA total of 283 participants (101 females and 182 males) with a mean age of 31.3±8.5 were enrolled. Fifty-two (18.4%) were eligible for treatment (Immune clearance and immune escape phases) and they recorded a significantly higher mean APRI score (0.71±0.51) as compared to those in the immune control and immune tolerant phase (0.43±0.20). Based on WHO and AASLD criteria, 12(4.2%) and 15 (5.3%) were eligible for treatment respectively and these were all subsets of the 52 cases mentioned above. Six (2.1%) and 29 (10.2%) of those identified under the immune control phase were on tenofovir and traditional medication respectively.ConclusionConsidering treatment for patients in the immune clearance and immune escape phases of the infection can be a reliable strategy to implement in our setting as this may probably tie with considerations from other treatment guidelines. Fifty-two (18.4%) patients were eligible for treatment and none of them were among the 2.1% of patients put on Tenofovir based treatment. This calls for the need for more trained health experts to periodically assess patients, implement an adequate treatment guideline and place the right patients on treatment in Cameroon.

Serological and virological profile of patients with chronic hepatitis B infection in Eritrea

“…This study documented a higher proportion HBeAg negative (93.2%) compared to HBeAg positive (6.8%) patients in congruence with studies such as conducted by Di Bisceglie, et al [26]. Four out of ive our patients were in a low replicative phase of chronic hepatitis B characterized by HBeAg-negative status, detection of HBe antibodies (anti-HBe), and DNA concentration below 2000 IU/mL with normal ALT, who are considered as chronic inactive carriers in similar proportion to what some studies have shown [27][28][29][30]. The determination of high percentage of HBeAg negative patients with low HBV viral loads in our study implies that most of the HBV patients are not eligible for antiviral therapy due to minimal or absent liver injury with low risk of disease progression [12].…”

Epidemiological Factors Associated With Hbv Infection And Uptake Of Hbv Testing In South West Region Of Cameroon: What Can Be Done To Scale Up Hbv Testing In Our Setting?

“…Our study showed that males were more associated with HBV infection as compared to females. This has been established in previous studies [12,14,15] and could be attributed to hormonal and some protein expression differences. Oestrogen has been shown to play a protective role in females at reproductive age [16][17][18].…”

HBV Transmission Risk Assessment in Healthcare Workers, Household and Sexual Contacts of HBV Infected Patients in the Southwest Region of Cameroon

“…The HBV infected participants were earlier identified and enrolled as described in a previous study. 19 They subsequently linked us to their SPs and HHCs.…”

“…Chronic HBV patients enrolled in a previous study 19 at the Buea Regional Hospital between January 2016 and December 2017 linked us to their SPs and HHCs who were subsequently enrolled in this study. The high prevalence (8.0%) of HBV infection in the Southwest region of Cameroon 22 requires that we consider any HHC and/or SP of an HBV infected patient at risk of contracting the infection.…”