IntroductionLe virus de l'hépatite B (VHB) est incriminé comme cause de cancer primitif du foie. Le stade de fibrose et d'autres facteurs environnementaux et génétiques seraient intriqués. Le but de notre travail était de déterminer l'incidence du carcinome hépatocellulaire (CHC) lors d'une infection chronique par le VHB et estimer le risque relatif (RR) de CHC lié au stade de la fibrose hépatique.MéthodesÉtude prospective de suivi d'une cohorte de patients porteurs chroniques du VHB sur une période de 5 ans (2009 à 2014). Etaient inclus les patients consécutifs qui ont subi un dosage de la charge virale B, une évaluation de la fibrose hépatique et un suivi régulier de tous les 6 à 12 mois par une échographie hépatique.RésultatsAu total 194 patients ont été retenus. L’âge moyen était de 39,1 ans. Parmi eux 112 étaient des hommes. L'incidence cumulée de CHC a été de 8,8% dans la population d’étude soit une incidence annuelle de 1,8%. Selon le stade de fibrose, 31 patients avaient une fibrose sévère ou une cirrhose (score Fibrotest >0,73). Parmi eux, l'incidence cumulée de CHC était de 35,5% soit une incidence annuelle estimée à 7,10%. Parmi 163 patients ayant une fibrose mineure, l'incidence cumulée de CHC était de 3,7% soit une incidence annuelle de 0,7%. Le RR lié à la cirrhose était de 9,7; IC 95%: (3,8-24,1%).ConclusionLe VHB expose au CHC jusqu’à 10 fois. La fibrose sévère et la cirrhose constituent des facteurs prédictifs de CHC chez le porteur chronique du VHB. Evaluer systématiquement la fibrose pour traiter précocement les malades pourra prévenir l’évolution vers la cirrhose et par là réduire la survenue du CHC.

Understanding the influence of the COVID-19 pandemic on hospital-based mortality in Burundi: a cross-sectional study comparing two time periods. Epidemiology and Infection 148, e280, 1-6.

EPO and low Hb levels (ESA hyporesponsive) had significantly higher risk of mortality (aHR 2.42, 95% CI 1.41-4.19, p=0.001). The high ERI group also had 36% higher incidence of hospitalisation (IRR 1.36, 95% CI 1.20-1.54, p<0.001) compared to low ERI group. The independent predictors of high ERI were female gender, low albumin, high ferritin, low transferrin saturation %, low BMI, high KT/V, high acuity status and increased hospital admissions in the exposure period. Conclusions: High ERI levels are associated with increased risk of allcause mortality and hospitalisation in incident HD patients. Lack of data on inflammatory markers is a study limitation.

diffusion and improve outcomes in sepsis-related AKI patients. The current study is aimed to assess the differential impact of post-dilution online hemodiafiltration on renal recovery, as compared to conventional high flux hemodialysis in non-critically ill CA-AKI patients with systemic inflammatory response syndrome (SIRS). Methods: The current study is a single-center, open-label, prospective, interventional, randomized trial done at the Department of Nephrology, PGIMER, Chandigarh, India. The trial was registered in the clinical trial registry of India bearing registration number CTRI/2017/09/009675. Noncritically ill hospitalized patients with a diagnosis of CA-AKI with SIRS were included in the study. Eligible patients were randomized to receive either online hemodiafiltration (OL-HDF) in post-dilution mode or conventional high-flux hemodialysis (HF-HD). The primary objective was to assess the feasibility to conduct the trial at larger scale and to observe any difference in dialysis independence at 30 days. Secondary objectives were to assess independently the improvement in the inflammatory milieu in terms of change in the quick sequential organ failure assessment (qSOFA) score, plasma Interleukin-6 (IL-6) level and bio-impedance based phase angle during the first week of dialysis initiation. Results: Eighty consecutive patients were enrolled as per sample size calculation. Baseline epidemiological, clinical and laboratory characteristics were comparable. Tropical illness, envenomation, rhabdomyolysis, and acute pancreatitis were among the common aetiologies. The mean total convective volume delivered per session in the intervention arm was 17.8 Litres. 83.3% in control and 71.1% in the intervention arm recovered their renal function and became dialysis independent at discharge or 30 days (p¼0.189). Time to renal recovery, hours spent on renal replacement therapy, intensive care unit (ICU) transfer rate and length of hospitalization were not different between both the groups (p>0.05) (Table1). No survival benefit of post-dilution OL-HDF was observed at discharge (p>0.05). Significant reduction in the cytokine (IL-6) concentration (Figure 1), improvement in qSOFA score and phase angle were observed at the end of the first week (of dialysis initiation) in both the arms. Conclusions: The current study does not support the notion of preferential utilization of post-dilution OL-HDF over conventional high flux HD in CA-AKI with SIRS. It urges to plan a larger trial to answer the raised concerns in a more generalizable manner.

Objective: To assess knowledges, attitudes, and practices of health personnel in Bujumbura hospitals with regard to hypertension during pregnancy. Methodology: This study has been conducted on health personnel of gynecology and obstetrics department of three national referral hospitals in Bujumbura. It is a descriptive cross-sectional study to assess knowledge, attitudes, and practices. Data were collected by a questionnaire and analyzed by Epi Info 7.2. Results: In a total of ninety-seven health workers participated in our study and 78.3% were paramedics with 53.6% of nurses and 24.7% of midwives. Medical doctors represented 21.6% of the participants. The sex ratio was 1.4 in favor of women. The professional experience was more than 5 years for 64.9% of participants. Concerning knowledge about hypertension; 74.2% of participants correctly defined hypertension during pregnancy. Despite this, only 48.4% respected conditions about its measurement. concerning attitude toword hypertension; 94.8% of participants informed their patients about the risks linked to hypertension in pregnancy before any therapeutic strategy. The antihypertensive drugs contraindicated during pregnancy were known by 54.6% of participants. To prevent preeclampsia, low doses of aspirin and calcium were prescribed by 42.2% of participants. Conclusion: Hypertension during pregnancy is a worrying situation for health personnel, which still has many theoretical and practical gaps.