Epidemiological and Clinical Characteristics of Inactive Carriers of Hepatitis B Virus: A Descriptive Cross-Sectional Study in Burkina Faso

Document Type : Descriptive & Survey

Authors
E. N. Somé 1
A. N. Guingané 2
I. Zongo 1
M. L. Ouédraogo 2
M. Drabo 1
R. Sombié 2
1 Institut de Recherche en Sciences de la Santé (IRSS), Biomedical and public health department, Ouagadougou, Burkina Faso
2 University Joseph Ki-Zerbo, UFR/SdS, gastro-enterology department-Zerbo, UFR/SdS, gastro-enterology department
10.52547/iem.7.3.237
Abstract
Backgrounds: This study aimed to describe the epidemiological and clinical characteristics of inactive HBV chronic carriers at the gastroenterology department of the university teaching hospital Yalgado Ouedraogo.

Materials & Methods: This descriptive cross-sectional study was conducted from January 1, 2007 to December 31, 2014 by employing a prospective data collection method. It was a census of all cases meeting the eligibility criteria. All patients with chronic viral hepatitis B (VHB) and ≥15 years of age and presenting the following signs were included in this study: positive result on hepatitis B surface antigen test for at least 6 months, normal levels of alanine amino-transferase for at least one year, positive anti-HBe antibodies, negative HBeAg, and viral DNA < 20,000 IU/mL.

Findings: The mean age of patients was 35 years, and the mean duration of HBsAg carriage was 6 years. The physical examination was normal in all participants. Ultrasound exam was normal in 150 (92.6%) participants and showed a fatty liver in 12 (7.4%) participants. Overall 4.4% of participants developed severe fibrosis, and no patient developed cirrhosis. The main indications for drug treatment included the existence of a family history of hepatocellular carcinoma (36.7%), the presence of active hepatitis (33.3%), and the progression of the fibrosis (30%).

Conclusion: This study confirms the importance of close follow up of HBV-infected patients to dramatically reduce the risk of developing complications such as cirrhosis or hepatocellular carcinoma.

Keywords

1. Revill PA, Penicaud C, Brechot C, Zoulim F. Meeting the Challenge of Eliminating Chronic Hepatitis B Infection. Genes (Basel). 2019;10(4). doi: 10.3390/genes10040260. PubMed PMID: 30939846; PubMed Central PMCID: PMCPMC6523454.
2. MacLachlan JH, Cowie BC. Hepatitis B virus epidemiology. Cold Spring Harbor perspectives in medicine. 2015;5(5):a021410. doi: 10.1101/cshperspect.a021410. PubMed PMID: 25934461; PubMed Central PMCID: PMCPMC4448582.
3. Vallet-Pichard A, and Pol S. Hepatitis B virus treatment beyond the guidelines: special populations and consideration of treatment withdrawal. Ther Adv Gastroenterol. 2014;7(4):148 –55. doi: 10.1177/.
4. Hu J, Protzer U, Siddiqui A. Revisiting Hepatitis B Virus: Challenges of Curative Therapies. J Virol. 2019;93(20). doi: 10.1128/JVI.01032-19. PubMed PMID: 31375584; PubMed Central PMCID: PMCPMC6798116.
5. Anderson RT, Lim SG, Mishra P, Josephson F, Donaldson E, Given B, et al. Challenges, Considerations, and Principles to Guide Trials of Combination Therapies for Chronic Hepatitis B Virus. Gastroenterology. 2019;156(3):529-33 e4. doi: 10.1053/j.gastro.2018.11.062. PubMed PMID: 30529300.
6. Soriano V, Barreiro P, Cachay E, Kottilil S, Fernandez-Montero JV, de Mendoza C. Advances in hepatitis B therapeutics. Ther Adv Infect Dis. 2020;7:2049936120965027. doi: 10.1177/2049936120965027. PubMed PMID: 33117536; PubMed Central PMCID: PMCPMC7570774.
7. Mavilia MG, Wu GY. Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis. J Clin Transl Hepatol. 2017;5(2):119-29. Epub 2017/07/01. doi: 10.14218/JCTH.2016.00067. PubMed PMID: 28660149; PubMed Central PMCID: PMCPMC5472932.
8. Spearman C, Afihene M, Ally R, Apica B, Awuku Y, Cunha L, et al. Viral hepatitis in sub-Saharan Africa 1: Hepatitis B in sub-Saharan Africa: strategies to achieve the 2030 elimination targets. Lancet. 2017;2:900 - 9. doi: 10.1016/S2468-1253(17)30295-9.
9. Keane E, Funk A, Shimakawa Y. Systematic review with meta-analysis: the risk of mother-to-child transmission of hepatitis B virus infection in sub-Saharan Africa. Aliment Pharmacol Ther 2016;44:1005–17. doi: 10.1111/apt.13795.
10. Breakwell L, Tevi-Benissan C, Childs L, Mihigo R, Tohme T. The status of hepatitis B control in the African region. The Pan African Medical Journa. 2017;27 (Supp 3)(17). doi: 10.11604/pamj.supp.2017.27.3.11981.
11. Meda N, Tuaillon E, Kania D, Tiendrebeogo A, Pisoni A, Zida S, et al. Hepatitis B and C virus seroprevalence, Burkina Faso: a cross-sectional study. Bull World Health Organ. 2018;96(11):750-9. Epub 2018/11/21. doi: 10.2471/BLT.18.208603. PubMed PMID: 30455530; PubMed Central PMCID: PMCPMC6239015.
12. European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. Journal of hepatology. 2017;67:370–98.
13. Magalhaes MJ, Pedroto I. Hepatitis B Virus Inactive Carriers: Which Follow-up Strategy? GE Port J Gastroenterol. 2015;22(2):47-51. doi: 10.1016/j.jpge.2015.01.009. PubMed PMID: 28868373; PubMed Central PMCID: PMCPMC5580143.
14. Mandé AR. Le cancer primitif du foie: aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs au centre hospitalier universitaire Yalgado Ouédraogo. [Thèse de doctorat en médecine]. UFS/SDS Section médecine Université de Ouagadougou. 2014;246:159.
15. M'Bengue AK, Doumbia M, Denoman SR, Ouattara DN, Adoubi I, Pineau P. A major shift of viral and nutritional risk factors affects the hepatocellular carcinoma risk among Ivorian patients: a preliminary report. Infect Agent Cancer. 2015;10:18. doi: 10.1186/s13027-015-0013-1. PubMed PMID: 26131017; PubMed Central PMCID: PMCPMC4486136.
16. Amougou MA, Noah DN, Moundipa PF, Pineau P, Njouom R. A prominent role of Hepatitis D Virus in liver cancers documented in Central Africa. BMC infectious diseases. 2016;16(1):647. doi: 10.1186/s12879-016-1992-2. PubMed PMID: 27821080; PubMed Central PMCID: PMCPMC5100184.
17. Khelifa F, Thibault V. Characteristics of hepatitis B viral strains in chronic carrier patients from North-East Algeria. Pathol Biol (Paris). 2009;57(1):107-13. doi: 10.1016/j.patbio.2008.07.031. PubMed PMID: 18835106.
18. Kim WR. Epidemiology of hepatitis B in the United States. Hepatology. 2009;49(5 Suppl):S28-34. doi: 10.1002/hep.22975. PubMed PMID: 19399791; PubMed Central PMCID: PMCPMC3290915.
19. Zarski JP, Marcellin P, Leroy V, Trepo C, Samuel D, Ganne-Carrie N, et al. Characteristics of patients with chronic hepatitis B in France: predominant frequency of HBe antigen negative cases. J Hepatol. 2006;45(3):355-60. doi: 10.1016/j.jhep.2006.03.007. PubMed PMID: 16750585.
20. Mak D, Babb de Villiers C, Chasela C, Urban MI, Kramvis A. Analysis of risk factors associated with hepatocellular carcinoma in black South Africans: 2000-2012. PloS one. 2018;13(5):e0196057. doi: 10.1371/journal.pone.0196057. PubMed PMID: 29718992; PubMed Central PMCID: PMCPMC5931658.
21. P. KADENDE, D. ENGELS, J. NDORICIMPA, E. NDABANEZE, D. HABONIMANA, G. MARERWA, et al. Les cancers digestifs au Burundi: premiers résultats d’une enquête menée à Bujumbura. Médecine d'Afrique Noire. 1990;37(10):552 - 61.
22. Bryere J, Dejardin O, Launay L, Colonna M, Grosclaude P, (Francim) elRfdrdc. Socio-économic environment and cancer incidence in France. BEH. 2017;4:68 - 77.
23. Sia R. Les hépatites virales chroniques au Centre hospitalier Universitaire Yalgado Ouédraogo : aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs. [Thèse] Ouagadougou (PA): . 2009;Univ de Ouagadougou.:1-77.
24. Akinyemiju T, Abera S, Ahmed M, Alam N, Alemayohu MA, Allen C, et al. The Burden of Primary Liver Cancer and Underlying Etiologies From 1990 to 2015 at the Global, Regional, and National Level. JAMA Oncology. 2017;3(12):1683. doi: 10.1001/jamaoncol.2017.3055.
25. Jaquet A, Tchounga B, Tanon A, Bagny A, Ekouevi DK, Traore HA, et al. Etiology of hepatocellular carcinoma in West Africa, a case-control study. International journal of cancer Journal international du cancer. 2018;143(4):869-77. doi: 10.1002/ijc.31393. PubMed PMID: 29569722; PubMed Central PMCID: PMCPMC6041181.
26. Jaquet A, Wandeler G, Nouaman M, Ekouevi DK, Tine J, Patassi A, et al. Alcohol use, viral hepatitis and liver fibrosis among HIV-positive persons in West Africa: a cross-sectional study. Journal of the International AIDS Society. 2017;20:21424. doi: 10.1080/17582652.2017.1291752.
27. Rotman Y, Brown TA, Hoofnagle JH. Evaluation of the patient with hepatitis B. Hepatology. 2009;49(5 Suppl):S22-7. doi: 10.1002/hep.22976. PubMed PMID: 19399815; PubMed Central PMCID: PMCPMC2881483.
28. Samant H. Correlation of Quantitative HbsAg with Quantitative HBV DNA in Different Phases of Chronic Hepatitis B (CHB) Patients. Journal of Liver Research, Disorders & Therapy. 2016;1(3). doi: 10.15406/jlrdt.2016.01.00014.
29. Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT, American Gastroenterological Association I. American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148(1):215-9; quiz e16-7. doi: 10.1053/j.gastro.2014.10.039. PubMed PMID: 25447850.
30. Villeneuve J-P, Desrochers M, Infante-Rivard C, Willems B, Raymond G, Bourcier M, et al. A long-term follow-up study of asymptomatic hepatitis B surface antigen—Positive carriers in montreal. Gastroenterology. 1994;106(4):1000-5. doi: 10.1016/0016-5085(94)90760-9.
Infection Epidemiology and Microbiology
Volume 7, Issue 3
July 2021
Pages 237-244