IntroductionThough Senegal has one of the highest estimated prevalence rates of chronic hepatitis B virus (HBV) infection worldwide, epidemiological data in the general population are lacking and consequences of the infection remain undocumented. The ANRS-12356 AmBASS study aims at evaluating the health and socioeconomic burden of chronic HBV infection at the individual, household and population level. Its specific objectives are (1) to document the epidemiology of chronic HBV infection, including prevalence and risk factors; (2) to assess the acceptability of home-based testing and first clinic visit; (3) to investigate the repercussions of chronic HBV infection on living conditions; and (4) to estimate the public health impact of chronic HBV infection at the population level and the feasibility of a decentralised model of HBV test and treat.Methods and analysisThis multidisciplinary cross-sectional survey includes a twofold data collection: (1) home-based screening using dried blood spot (DBS) sampling and collection of sociodemographic, economic and behavioural data, and (2) additional clinical and biological data collection in chronic HBV carriers at the first clinic visit. The prevalence of chronic HBV infection will be estimated in the general population and in key subgroups. Risk factors for HBV acquisition in children will be explored using case-control analysis. HBV burden will be assessed through comparisons of health and economic outcomes between households affected by the disease versus non-affected households. Last, an economic evaluation will assess costs and health benefits of scaling-up HBV care.Ethics and disseminationThis study was approved by the Senegalese National Ethical Committee for Research in Health, and received authorisation from the Senegalese Ministry of Health and the French Commission on Information Technology and Liberties (Senegalese Protocol Number: SEN17/15). The study results will be presented in peer-review journals, international conferences and at a workshop with national stakeholders in order to contribute to the design of programmes to address the HBV pandemic.Trial registration numberNCT03215732; Pre-results.

Background and Aims Although people who inject drugs (PWID) are the core at‐risk population in the hepatitis C virus (HCV) epidemic in industrialized countries, few initiate treatment. Alcohol use disorder (AUD), common within this population, has been identified as a barrier to HCV treatment uptake in the general population. We investigated whether the arrival of new and well‐tolerated HCV treatments (direct‐acting antivirals: DAA) has improved HCV treatment uptake in French PWID compared with former treatments (pegylated interferon‐based treatments: Peg‐IFN). Design Using discrete‐time Cox proportional hazards models based on exhaustive care delivery data, we tested for associations between AUD (defined by AUD‐related long‐term illness status, diagnosis coding during hospitalization and/or AUD pharmacological treatment) and first HCV treatment delivery, after adjusting for gender, age, complementary universal health cover, liver disease severity and type of opioid agonist therapy (OAT) received. Separate analyses were performed for 2012–13 (Peg‐IFN era) and 2014–16 (DAA era). Setting France. Participants All French people chronically HCV‐infected who received OAT at least once during 2012–16 and were covered by the national health insurance (n = 24 831). Measurements Incidence rate of HCV treatment uptake, hazard ratios associated with AUD and other covariates. Findings Incidence rate (IR) of HCV treatment uptake per 100 person‐years was 6.56, confidence interval (CI) = 6.30–6.84; and IR = 5.70, 95% CI = 5.51–5.89 for Peg‐IFN‐based treatment (2012–13) and DAA (2014–16), respectively. After multiple adjustment, people with AUD not receiving related medication had 30 and 14% lower Peg‐IFN‐based treatment and DAA uptake, respectively, than those without AUD [hazard ratio (HR) = 0.70, 95% CI = 0.62–0.80 and HR = 0.86, 95% CI = 0.78–0.94]. No difference was observed between those treated for AUD and those without AUD. Conclusions Despite the benefits of direct‐acting antiviral treatment, untreated alcohol use disorder appears to remain a major barrier to hepatitis C virus treatment access for people who inject drugs in France.