Hepatitis B in Africa Collaborative Network: cohort profile and analysis of baseline data

Abstract

Approximately 80 million people live with chronic hepatitis B virus (HBV) infection in the WHO Africa Region. The natural history of HBV infection in this population is poorly characterized, and may differ from patterns observed elsewhere due to differences in prevailing genotypes, environmental exposures, co-infections, and host genetics. Existing research is largely drawn from small, singlecentre cohorts, with limited follow-up time. The Hepatitis B in Africa collaborative network (HEPSANET) was established in 2022 to harmonize the process of ongoing data collection, analysis, and dissemination from 13 collaborating HBV cohorts in eight African countries. Research priorities for the next five years were agreed through a modified Delphi survey prior to baseline data analysis being conducted. Baseline data on 4173 participants with chronic HBV mono-infection were collected, of whom 38.3% were women and median age was 34 years (interquartile range 28-42).81.3% of cases were identified through testing of asymptomatic individuals. HBeAg positivity was seen in 9.6% of participants. Follow-up of HEPSANET participants will generate evidence to improve the diagnosis and management of HBV in this region.

Antiviral Therapy Eligibility and Low Treatment Coverage among Hepatitis B Virus Infected Patients in Tanzania

“…These findings align with previous research findings from endemic areas to hepatitis B. Data from the African Multi-Country Research Collaborative Network showed that males make up more than 60% of patients registered in 13 cohorts of hepatitis clinics across 8 African Open Journal of Gastroenterology countries [19]. Furthermore, a community-based cross-sectional study in Zambia, reported that males had 2 -5 times higher eligibility for antiviral treatment [12] compared to females.…”

Genetic variation of TLR3 gene is associated with the outcome of hepatitis b infection in mauritanian patients: case control study

“…The patient group mainly consisted of older males with normal ALT and AFP levels. The majority of patients had HBeAg negative chronic infection (inactive carriers), which is commonly seen in patients with chronic HBV infection in African regions [ 33 , 34 ] and other parts of the world [ 35 ]. This HBV profile was generally associated with a positive prognosis and low severity of liver disease [ 36 ].…”

Development and evaluation of a simple treatment eligibility score (HEPSANET) to decentralise hepatitis B care in Africa: a cross-sectional study

“…We used the cross-sectional database established by the HEPSANET consortium. 17 , 19 Briefly, a systematic review was conducted to identify observational studies focusing on individuals with chronic HBV infection in SSA. These studies were at least required to provide data on fibrosis stage and platelet count.…”

“…All authors agreed to share data, and a total of 13 distinct cohorts from 8 countries participated in this database. 17 From this database, we included participants meeting the following criteria for this analysis: i) age 18 years or older, ii) have not commenced antiviral therapy; iii) fibrosis stage determined through a valid liver stiffness measurement using transient elastography 20 or liver histopathology; and iv) having data on ALT, AST, platelet count, and HBV DNA levels. We excluded participants if they met any of the following conditions: presence of metabolic disorders (e.g., diabetes, liver steatosis, hypertension, hyperlipidemia); co-infection with HIV, HCV, hepatitis D virus (HDV), or schistosomiasis; missing data pertaining to age or sex.…”

“…In response to the pressing need for a simplified care model that facilitates the decentralization of hepatitis B treatment, we sought to develop simple algorithms tailored to each level of healthcare facility (primary, district, and regional/provincial). Through the Hepatitis B in Africa Collaborative Network (HEPSANET), 17 we first conducted a questionnaire survey to map the availability of clinical and laboratory parameters at different levels of healthcare facilities in SSA. Second, using the largest cross-sectional dataset of treatment-naïve HBV-infected individuals who underwent comprehensive treatment eligibility assessment in SSA, we identified a minimal combination of locally-available tests that effectively identify HBV-infected individuals meeting the treatment eligibility criteria outlined in the 2017 European Association for the Study of the Liver (EASL) guidelines.…”