Prevalence and Predictors of Liver Fibrosis in People Living with Hepatitis B in Senegal

Abstract

Hepatitis B virus (HBV) infection is the first cause of liver cirrhosis and cancer in West Africa. Although the exposure to additional environmental and infectious risk factors may lead to the faster progression of liver disease, few large-scale studies have evaluated the determinants of HBV-related liver fibrosis in the region. We used transient elastography to evaluate the prevalence of liver fibrosis and assessed the association between HBV markers and significant liver fibrosis in a cohort of people living with HBV in Dakar, Senegal. The prevalence of significant liver fibrosis was 12.5% (95% confidence interval [CI] 9.6%–15.9%) among 471 people with HBV mono-infection (pwHBV) and 6.4% (95% CI 2.6%–12.7%) in 110 people with HIV/HBV co-infection (pwHIV/HBV) on tenofovir-containing antiretroviral therapy (p = 0.07). An HBV viral load > 2000 IU/mL was found in 133 (28.3%) pwHBV and 5 (4.7%) pwHIV/HBV, and was associated with significant liver fibrosis (adjusted odds ratio (aOR) 1.95, 95% CI 1.04–3.66). Male participants (aOR 4.32, 95% CI 2.01–8.96) and those with elevated ALT (aOR 4.32, 95% CI 2.01–8.96) were especially at risk of having significant liver fibrosis. Our study shows that people with an HBV viral load above 2000 IU/mL have a two-fold increase in the risk of liver fibrosis and may have to be considered for antiviral therapy, independent of other disease parameters.

Predictors of Significant Histological Hepatic Abnormality in Treatment-Naive Patients Infected with HBeAg-Negative Chronic Hepatitis B

“…Comparing our findings with Ramírez Mena et al, we determined that an HBV-DNA level above 2000 IU/mL was associated with a roughly 2-fold increased risk for significant liver fibrosis, consistent with their results. Additionally, male gender and increased ALT were independent predictors for SHA in our study, compatible with Ramírez Mena et al's findings ( 15 ). Similarities were also observed in the study of Wang et al, where male gender and elevated ALT and viral load were independent predictors for liver fibrosis ( 16 ).…”

Chronic hepatitis B virus infection in Eastern Ethiopia: Clinical characteristics and determinants of cirrhosis

“…In this study, khat use, HBeAg positivity, and HBV viral load greater than 2000 IU/mL were independently associated with cirrhosis. The strong association between HBV DNA level and cirrhosis observed in our study is similar to reports from other African studies[ 39 , 40 ]. In the REVEAL-HBV cohort study, the HBV DNA level was the strongest predictor of progression to cirrhosis, and the risk increased significantly with increasing HBV DNA level, irrespective of HBeAg status and ALT levels[ 41 ].…”