Little data exist on patients treated with tenofovir in Sub-Saharan Africa. Objective: To describe the clinical and laboratory characteristics of patients with viral hepatitis B treated with tenofovir. Material and methods: A descriptive single-center retrospective study, on chronic viral hepatitis B mono-infected, followed in the hepatogastroenterology department of the University Hospital of Yopougon and treated with tenofovir from February 2012 to February 2015. The studied parameters were demographic, clinical, biochemical, serological, virological, abdominal ultrasound. Liver fibrosis was assessed either by liver biopsy or non-invasive tests. Results: 110 patients were treated with tenofovir disoproxil fumarate with a mean age of 40.4 years and a male predominance. Clinical examination revealed jaundice in 9% of cases, hepatomegaly in 7.3% of cases, splenomegaly in 9.1% of cases and ascites in 15.5% of cases. The AST averaged 77.3 IU/l, the ALT 76.8 IU/l, prothrombin rate at 76.6% , albumin level at 32.3 g/l, total bilirubin at 29.9 g/l, alpha fetoprotein rate at 15.3 ng/ml. HBe antigen was negative in 76.2% of cases. The average rate of DNA at baseline was 7.4 log10 IU/l. 27.5% was cirrhotic. The average time of starting treatment was 23.7 months. Conclusion: TDF is the first-line treatment for chronic hepatitis B in our country, because it is a well-tolerated, potent therapy with a high threshold for resistance development. Our study population had an average age of 40.4 years. Virological profile was dominated by HBe antigen negative patients and high viral load of HVB DNA. One third of patients were at the stage of cirrhosis. This treatment must be delivered free of charge in all the country hospitals, which is going to improve significantly the natural evolution of the disease and to decrease the incidence of the HCC.

In Western countries, the current trend is to use sequential quadruple therapy or bismuth-based instead of triple therapy for the eradication of Helicobacter pylori (H. pylori). In sub-Saharan Africa, high prevalence area of the H. pylori infection, the effectiveness of these triple therapies widely used in routine has been little evaluated. The purpose of this study was to evaluate and compare the effectiveness of three patterns of first-line triple therapy based on combining a proton pump inhibitors (PPI), and 3 types of antibiotics: omeprazole (O), amoxicillin (A), clarythromycin (C) and metronidazole (M). Patients and Methods: This is a randomized clinical trial opened on 3 parallel arms: OAM (group 1 or G1), OAC (group 2 or G2) or OCM (group 3 or G3). The primary endpoint was H. pylori eradication rate after seven days triple therapy. H. pylori diagnosis infection was based on bacterium detection on the histological examination of the gastric biopsies. Histological control was performed 4 weeks after the end of treatment to assess H. pylori eradication rate. Results: The average age of our 153 patients included in the study (86 men) was 44.33 ± 11.72 years. The main reason of the endoscopy was the dyspeptic syndrome (75.16%). The gastroscopy was normal in 28.76%. A Gastric or duodenal peptic ulcer was found in 17% of cases and gastropathy in 45.75%. Histologically, the GC was active in 90.9% of cases, follicular in 35.3% of cases, atrophic in 22.5% of cases and was associated with intestinal metaplasia (IM) in 5.2% of cases. Patients of these three groups (n = 64 for G1, n = 56 for G2 and n = 33 for G3) were comparable for age, gender, endoscopy indications, alcohol consumption history or smoking, and A. S. Doffou et al. 201 anti-inflammatory drugs taking. Approximately 23% of patients experienced adverse reactions. The overall H. pylori eradication rate was 22.3%. There was no significant difference H. pylori eradication rate depending on the treatment used (28.1%, 21.4% and 15.1% for G1, G2 and G3, p = 0.34). Conclusion: The H. pylori eradication rate was poor regardless of the triple therapy used. It is desirable in the absence of bacteriological data on the primary and secondary resistance levels to optimize the eradication rate advocating the use of quadruple therapy at outset in first-line.

Objectif : Notre étude avait pour but d'évaluer les performances diagnostiques d'un test sérologique rapide Elisa (Pylorix ® ) chez des patients vus en endoscopie digestive en utilisant comme référence l'histologie. Patients et méthodes : Il s'agissait d'une étude prospective type cas-témoins qui a été menée au CHU de Cocody sur environ 3 mois. Ont été inclus 88 patients âgés de 14 à 78 ans reçus pour la réalisation d'une endoscopie digestive haute. Chez chacun d'entre eux, on appliquait le test Pylorix ® et réalisait systématiquement 5 biopsies gastriques (3 antrales et 2 fundiques) à la recherche d'Hélicobacter pylori à l'histologie (test de référence pour juger de la performance du test sérologique utilisé). Les patients ont ensuite été classés en fonction de leur statut sérologique en cas (test Pylorix ® positif) et en témoins (test Pylorix ® négatif). Cas et témoins ont été comparés selon le résultat de l'histologie. Résultats : L'âge moyen de nos patients était de 40,5 ±16,9 ans avec une médiane de 35 ans. Le sex-ratio était de 1,75 en faveur des femmes. Dix patients sur 88 (soit 11,4%) avaient pris des anti-ulcéreux au moins 30 jours avant l'endoscopie. L'épigastralgie était le principal motif d'examen avec 61,8% des cas. Sur le plan endoscopique, aucune lésion n'était objectivée dans 75% et 61,8% des cas respectivement dans le fundus et dans l'antre. L'aspect érythémateux était la lésion la plus fréquente avec 14,8% des cas dans le fundus et 21,6% des cas dans l'antre. Le test Pylorix ® utilisé était positif dans 40,9% des cas alors qu'à l'histologie la prévalence était à 54,5%. Comparées à l'histologie, les performances du Pylorix ® étaient : Se : 52,1%, Sp : 72,5%, VPP : 69,4%, VPN : 55,8%. Mais ces performances s'amélioraient chez les sujets sans anti-ulcéreux et/ou antibiotiques, alors qu'elles restaient médiocres chez ceux qui en avaient pris. Conclusion : Le test Pylorix ® utilisé dans notre étude montre des performances médiocres. Par conséquent, il ne peut être recommandé dans nos pratiques courantes. Mots clés Helicobacter pylori · Test sérologique · Endoscopie · HistologieAbstract Objective: The aim of our study was to evaluate the diagnostic performance of a rapid serological test ELISA (Pylorix ® ) in patients seen in digestive endoscopy using as reference histology. Patients and methods: This is a prospective case-control study was conducted at the University Hospital of Cocody about 3 months. Were included 88 patients aged 14 to 78 years old received for performing upper endoscopy. In each of them, we applied the test Pylorix ® and systematically realized five gastric biopsies (3 antrals and fundic 2) for looking for Helicobacter pylori at Histology (reference test to judge the performance of serological test used). Based on test results, patients were divided into two groups, i.e. case group (Pylorix ® test positive) and control group (Pylorix ® test negative). Case and control groups were compared according to the histology result. Results: The average age of our patients was 40.5 ± 16.9 y...

Context and objectives. Chronic viral hepatitis is a public health problem in Côte-d’Ivoire. A significant number of patients have little access to treatment due to the high costs of assessment and treatment. The objective of our study was to evaluate the costs of assessments and treatment of chronic viral hepatitis. Methods. This was an analytical cross-sectional observational study from March 1, 2019 to July 31, 2019 in the Hepato- Gastroenterology Consultation Service at the Yopougon University Hospital. The variables studied were socio-demographic and economic parameters. Results. 136 patients (men 53.6 %, average age 42 ± 12.2 years) were included. More than half of the patients (63.3 %) had a monthly income not exceeding 490.39 USD. The cost ofthe initial assessment was 223.13 USD and 351.14 USD for viral hepatitis B and C, respectively. Tenofovir and pegylated interferon were free of charge. Treatment with sofosbuvir + velpastavir cost 593.37 USD. The annual follow-up assessment was estimated at 237.02 USD for viral hepatitis B and 225.58 USD for viral hepatitis C. Conclusion. The assessment and treatment of chronic viral hepatitis have a cost that remains high for patients despite the universal health coverage.

HBsAg serum level (quantification) may be useful for managing hepatitis B virus (HBV) infection patients. However few studies especially in Africa have evaluated the association between HBsAg serum level and liver fibrosis severity. The objective of this study was to estimate the correlation between HBsAg serum level and liver fibrosis severity with treatment naïve chronic hepatitis B patients in Côte d'Ivoire. Methodology: It is a prospective study covering from February 1 st , 2014 to April 30 st , 2015 at Centre Hospitalier et Universitaire de Yopougon and a private medical office in Abidjan, Côte d'Ivoire. Inclusion criteria for patients were: HBsAg positive, known HBeAg status, serum HBsAg levels, serum HBV DNA levels, complex serum markers and absence of HCV, HDV, or HIV co-infection, drinking more than 30 g/day for men and 20 g/day in women over 10 years, metabolic disease and/or hepatic overload. Pearson's Chi-square test (r2), Anova, Spearman, T-Student, Pearson's (r) correlations and Mann Withney's Test were carried out as appropriate. A p value < 0.05 was taken as significant. Results: We recruited, 105 patients (77 men) of whom the medium age was 39.01 ± 9.72 years. Predominant hepatitis B viral genotype was E (93%). Less than 10% patients had an inactive HBV in HBeAg-negative. Patients had an average high HBsAg serum level (mean 12111.2 ± 10617.4 IU/ml) as well as the one viral load (mean 4.4 e7 ± 7.5 e7). Serum ALAT levels averaged at the upper limit of normal value. The average liver fibrosis score was 0.34 ± 0.22