Patient-reported outcomes with direct-acting antiviral treatment for hepatitis C in West and Central Africa (TAC ANRS 12311 trial)

Marcellin, Fabienne; Mourad, Abbas; Lemoine, Maud; Kouanfack, Charles; Seydi, Moussa; Carrieri, Patrizia; Attia, Alain; Protopopescu, Camélia; Lacombe, Karine; Boyer, Sylvie

doi:10.1016/j.jhepr.2022.100665

Cited by 4 publications

(3 citation statements)

References 52 publications

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“…Another study of 1,564 patients, of whom 47% had cirrhosis, suggested that mean PROs scores improved slightly in the overall cohort, and age, baseline mental health issues, and a higher number of health comorbidities were predictors of PROs improvements [ 31 ]. Sofosbuvir-based DAAs therapy was associated with a significant improvement in PROs 6 months after treatment end in patients with CHC [ 32 ]. However, long-term effects on patient HRQoL after HCV clearance are still lacking.…”

Section: Discussionmentioning

confidence: 99%

Sustained virologic response improved the long-term health-related quality of life in patients with chronic hepatitis C: a prospective national study in China

Huang,

Shang,

Chen

et al. 2024

BMC Infect Dis

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Background To investigate the trends in health-related quality of life (HRQoL) among hepatitis C virus (HCV) patients and to assess the longitudinal impact of antiviral therapy on their well-being. Methods In this prospective multicenter observational study in adults with HCV infection, sociodemographic, clinical characteristics and EQ-5D questionnaires were collected. Generalized estimating equation (GEE) models were used to assess the associations between these variables and changes in HRQoL over time. Results 456 patients were included, with a median age of 46.5 (36.5–57.0) years, of which 262 (57.5%) were males and 44 (9.6%) had cirrhosis. 335 patients (73.5%) receiving antiviral therapy and 61.8% achieved sustained virologic response (SVR). The baseline EQ-5D utility and EQ-VAS were 0.916 ± 0.208 and 80.6 ± 13.0. In multivariable analysis of GEE estimation, achieving SVR24 was positively associated with EQ-5D utility (p = 0.000) and EQ-VAS (p = 0.000) over time. Age and income were shown to be significant predictors of EQ-5D utility, while gender, age and genotype were associated with EQ-VAS over time. Conclusions SVR improved long-term HRQoL in HCV patients in the first few years following viral clearance. Certain sociodemographic factors, such as gender, age, income as well as genotype, significantly influenced long-term changes in patients’ quality of life. Trial registration NCT01594554. Registration date: 09/05/2012.

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Section: Discussionmentioning

confidence: 99%

Sustained virologic response improved the long-term health-related quality of life in patients with chronic hepatitis C: a prospective national study in China

Huang,

Shang,

Chen

et al. 2024

BMC Infect Dis

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“…However, the lack of national Hepatitis C screening and treatment guidelines is reflected by a diversity in diagnostic and treatment protocols across care providers, resulting in unnecessary costs and possible sub-optimal clinical outcomes. Additionally, central organisation of Hepatitis C care, insufficient technical and human capacity for HCV testing, alongside high costs associated with diagnosis and treatment (generally paid out-of-pocket), substantially limit access to HCV diagnosis and care [ 13 ]. Most PLHCV in Cameroon are unaware of their status, with a negative impact on transmission and disease progression [ 14 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Anti-hepatitis C antibody carriage and risk of liver impairment in rural-Cameroon: adapting the control of hepatocellular carcinoma for resource-limited settings

Kamga Wouambo,

Panka Tchinda,

Kagoue Simeni

et al. 2023

BMC Infect Dis

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Background The Viral hepatitis elimination by 2030 is uncertain in resource-limited settings (RLS), due to high burdens and poor diagnostic coverage. This sounds more challenging for hepatitis C virus (HCV) given that antibody (HCVAb) sero-positivity still lacks wide access to HCV RNA molecular testing. This warrants context-specific strategies for appropriate management of liver impairment in RLS. We herein determine the association between anti-HCV positivity and liver impairment in an African RLS. Methods A facility-based observational study was conducted from July-August 2021 among individuals attending the “St Monique” Health Center at Ottou, a rural community of Yaounde,Cameroon. Following a consecutive sampling, consenting individuals were tested for anti-HCV antibodies, hepatitis B surface antigen (HBsAg) and HIV antibodies (HIVAb) as per the national guidelines. After excluding positive cases for HBsAg and/or HIVAb, liver function tests (ALT/AST) were performed on eligible participants (HBsAg and HIVAb negative) and outcomes were compared according to HCVAb status; with p < 0.05 considered statistically significant. Results Out of 306 eligible participants (negative for HBsAg and HIVAb) enrolled, the mean age was 34.35 ± 3.67 years. 252(82.35%) were female and 129 (42.17%) were single. The overall HCVAb sero-positivity was 15.68%(48/306), with 17.86% (45/252) among women vs. 5.55%(3/54) among men [OR (95%CI) = 3.69(2.11-9.29),p = 0.04]. HCVAb Carriage was greater among participants aged > 50 years compared to younger ones [38.46%(15/39) versus 12.36% (33/267) respectively, OR(95%CI) = 4.43(2.11-9.29), p < 0.000] and in multipartnership [26.67%(12/45)vs.13.79%(36/261) monopartnership, OR (95%CI) = 2.27(1.07-4.80),p = 0.03]. The liver impairment rate (abnormal ALT+AST levels) was 30.39%(93/306), with 40.19%(123/306) of abnormal ALT alone. Moreover, the burden of Liver impairment was significantly with aged> 50 versus younger ones [69.23% (27/39) versus 24.72%(66/267) respectively, p < 0.000). Interestingly, the burden of liver impairment (abnormal AST + ALAT) was significantly higher in HCVAb positive (62.5%, 30/48) versus HCVAb negative (24.42%, 63/258) participants, OR: 3.90 [1.96; 7.79], p = 0.0001. Conclusions In this rural health facility, HCVAb is highly endemic and the burden of liver impairment is concerning. Interestingly, HCVAb carriage is associated with abnormal liver levels of enzyme (ALT/AST), especially among the elderly populations. Hence, in the absence of nuclei acid testing, ALT/AST are relevant sentinel markers to screen HCVAb carriers who require monitoring/care for HCV-associated hepatocellular carcinoma in RLS.

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“…However, the lack of national Hepatitis C screening and treatment guidelines is reflected by a diversity in diagnostic and treatment protocols across care providers, resulting in unnecessary costs and possible sub-optimal clinical outcomes. Additionally, central organisation of Hepatitis C care, insufficient technical and human capacity for HCV testing, alongside high costs associated with diagnosis and treatment (generally paid out-of-pocket), substantially limit access to HCV diagnosis and care [13]. Most PLHCV in Cameroon are unaware of their status, with a negative impact on transmission and disease progression [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Anti-Hepatitis C Antibody Carriage and Risk of Liver Impairment in Rural-Cameroon: Adapting the Control of Hepatocellular Carcinoma for Resource-Limited Settings

Kamga Wouambo,

Panka Tchinda,

Kagoue Simeni

et al. 2023

Preprint

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Background: The global Viral hepatitis elimination by 2030 is uncertain in resource-limited settings (RLS), due to high burdens and poor diagnostic coverage. This sounds more challenging for hepatitis C virus (HCV) given that antibody (HCVAb) sero-positivity still lacks wide access to HCV RNA molecular testing. This warrants context-specific strategies for appropriate management of liver impairment in RLS. We herein determine the association between anti-HCV positivity and liver impairment in an African RLS. Methods: A facility-based observational study was conducted from July-August 2021 among individuals attending the St Monique Health Center at Ottou, a rural community of Yaounde,Cameroon. Following a consecutive sampling, consenting individuals were tested for anti-HCV antibodies, hepatitis B surface antigen (HBsAg) and HIV antibodies (HIVAb) as per the national guidelines. After excluding positive cases for HBsAg and/or HIVAb, liver function tests (ALT/AST) were performed on eligible participants (HBsAg and HIVAb negative) and outcomes were compared according to HCVAb status; with p<0.05 considered statistically significant. Results: Out of 306 eligible participants (negative for HBsAg and HIVAb) enrolled, the mean age was 34.35±3.67 years. 252(82.35%) were female and 129 (42.17%) were single. The overall HCVAb sero-positivity was 15.68%(48/306), with 17.86% (45/252) among women vs. 5.55%(3/54) among men [OR (95%CI)=3.69(2.11-9.29),p=0.04]. HCVAb Carriage was greater among participants aged >50 years compared to younger ones [38.46%(15/39) versus 12.36% (33/267) respectively, OR(95%CI)=4.43(2.11-9.29), p<0.000] and in multipartnership [26.67%(12/45)vs.13.79%(36/261) monopartnership, OR (95%CI)= 2.27(1.07-4.80),p=0.03]. The liver impairment rate (abnormal ALT+AST levels) was 30.39%(93/306), with 40.19%(123/306) of abnormal ALT alone. Moreover, the burden of Liver impairment was significantly with aged>50 versus younger ones [69.23% (27/39) versus 24.72%(66/267) respectively, p<0.000). Interestingly, the burden of liver impairment (abnormal AST+ALAT) was significantly higher in HCVAb positive (62.5%, 30/48) versus HCVAb negative (24.42%, 63/258) participants, OR: 3.90 [1.96; 7.79], p=0.0001. Conclusions: In this rural health facility, HCVAb is highly endemic and the burden of liver impairment is concerning. Interestingly, HCVAb carriage is associated with abnormal liver levels of enzyme (ALT/AST), especially among the elderly populations. Hence, in the absence of nuclei acid testing, ALT/AST are relevant sentinel markers to screen HCVAb carriers who require monitoring/care for HCV-associated hepatocellular carcinoma in RLS. Keywords Hepatitis C Virus antibodies (HCVAb), ASAT/ALAT, liver impariment, hepatotoxicity, Cameroon.

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Patient-reported outcomes with direct-acting antiviral treatment for hepatitis C in West and Central Africa (TAC ANRS 12311 trial)

Cited by 4 publications

References 52 publications

Sustained virologic response improved the long-term health-related quality of life in patients with chronic hepatitis C: a prospective national study in China

Sustained virologic response improved the long-term health-related quality of life in patients with chronic hepatitis C: a prospective national study in China

Anti-hepatitis C antibody carriage and risk of liver impairment in rural-Cameroon: adapting the control of hepatocellular carcinoma for resource-limited settings

Anti-Hepatitis C Antibody Carriage and Risk of Liver Impairment in Rural-Cameroon: Adapting the Control of Hepatocellular Carcinoma for Resource-Limited Settings

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