Battlefield against hepatitis B infection and HCC in Africa

Abstract

Please cite this article as: Lemoine, M., Thursz, M.R., Field battle against hepatitis B infection and HCC in Africa, Hepatology (2016), doi: http://dx.doi.org/10.1016/j. jhep.2016.10.013 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Journal of

Prevalence and burden of hepatitis D virus infection in the global population: a systematic review and meta-analysis

“…We further divided the data into two groups based on the study population in 1977–2016: according to the year 1977–1996 (group A) and 1997–2016 (group B), considering the fact that the HBV vaccine was recommended to be included into the expanded programme of immunisation (EPI) for all countries since 1997 17. As expected, the prevalence of HDV infection in group B was lower than that in group A (online supplementary appendix figures S3 and S4).…”

“…Most immigrants originate from high to low epidemic regions 4 29. Therefore, although HBV vaccination programme was recommended to be included in the EPI for all countries,17 HDV prevalence in European countries has ceased to decline and has even increased in some countries 4…”

“…Locations with lower SDI always have a higher prevalence of HBV and have fewer improvements in socioeconomic conditions when compared with those with higher SDI overtime 4. HBV vaccination may be a cost-effective method to prevent viral hepatitis in lower SDI countries 17. Additionally, issues with use of unscreened blood products, unsafe medical procedures and restricted access to antiviral treatments still remain to be solved in poor-resourced countries 1.…”

Immune Tolerant Chronic Hepatitis B: The Unrecognized Risks

“…This is particularly relevant in endemic areas where HBeAg positivity can persist into childbearing years, rendering the mother highly infectious. HBeAg loss at an earlier age in Sub-Saharan African populations makes MTCT only accountable for 10% of CHB [100,101] compared with an estimated 40% of total infections in China [102]. Those women in Africa who are highly infectious are often those co-infected with HIV, in whom the risk of MTCT is increased further [100,103].…”

“…HBeAg loss at an earlier age in Sub-Saharan African populations makes MTCT only accountable for 10% of CHB [100,101] compared with an estimated 40% of total infections in China [102]. Those women in Africa who are highly infectious are often those co-infected with HIV, in whom the risk of MTCT is increased further [100,103]. At present, only 96 countries include a birth dose vaccine in the immunisation programme, equating to the protection of around 39% of new born babies [92].…”