Seroepidemiology of hepatitis B and C virus infections among blood donors in Ethiopia

Hundie, Gadissa Bedada; Raj, V. Stalin; Gebremichael, Daniel; Haagmans, Bart L.

doi:10.1002/jmv.24770

Cited by 11 publications

(12 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The low HIV prevalence in our CHB cohort, therefore, is mirroring the HIV prevalence in the general population in Ethiopia, which is estimated to be 1.2% [12]. Similarly, the low proportion with HBV/HCV co-infection in our study is probably a reflection of the overall low prevalence of HCV in Ethiopia [32]. The presence of anti-HDV antibodies in our study was also relatively low, which is in line with a previous study from East Africa; however, available data from the region is scarce [33].…”

Section: Discussionmentioning

confidence: 56%

Early experiences from one of the first treatment programs for chronic hepatitis B in sub-Saharan Africa

et al. 2017

View full text Add to dashboard Cite

BackgroundTreatment for chronic hepatitis B (CHB) is virtually absent in sub-Saharan Africa. Here we present early experiences from a pilot program for treatment of CHB in Ethiopia.MethodsAdults (≥18 years) with CHB were included in a cohort study at St. Paul’s Hospital Millennium Medical College, Addis Ababa, from February 2015. The baseline assessment included liver function tests, viral markers and transient elastography (Fibroscan 402, Echosense, France). Logistic regression models were used to identify predictors of fibrosis. Tenofovir disoproxil fumarate (TDF) was initiated based on the European Association for the Study of the Liver (EASL) criteria, with some modifications. The initial 300 patients underwent a more comprehensive evaluation and are presented here.ResultsOne-hundred-and-thirty-eight patients (46.0%) were women and median age was 30 years (interquartile range 26–40). Co-infections were rare: four patients (1.3%) were anti-HCV positive, 11 (3.7%) were anti-HDV positive, whereas 5 (1.7%) had HIV-infection. The majority were hepatitis B e-antigen (HBeAg) negative (n = 262; 90.7%) and had a normal (≤40 U/L) alanine aminotransferase (ALT) (n = 245; 83.1%). Of 268 patients with a valid Fibroscan result, 79 (29.5%) had significant fibrosis (>7.9 kPa). Independent predictors of fibrosis were male sex, age > 35 years and viral load >20,000 IU/ml. In total, 74 patients (24.7%) started TDF therapy, of whom 46 (62.2%) had cirrhosis.ConclusionsThe majority were HBeAg negative and had normal ALT. However, one quarter of the patients were in need of antiviral treatment, underscoring the need to scale up CHB treatment on the African continent.Trial registration NCT02344498 (ClinicalTrials.gov identifier). Registered 16 January 2015.

show abstract

Section: Discussionmentioning

confidence: 56%

Early experiences from one of the first treatment programs for chronic hepatitis B in sub-Saharan Africa

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The largest HCV survey of blood donors conducted on 56,885 donors in five regional blood banks found HCV prevalence of 0.5%. 26 In other studies elsewhere in Ethiopia, HCV prevalence in blood donors ranges from 0.2% to 1.3% 2,5,55-57 A 6-year retrospective study of 11,382 blood donors from 2008 to 2015 found a significant increase in HCV prevalence (P-value for linear trend = 0.001). 33 Universal screening and treatment for HCV infection of all blood donors will ensure access to HCV treatment, which in turn accentuates micro-elimination.…”

Section: Resultsmentioning

confidence: 90%

“…One of the opportunities that positively support future HCV elimination initiatives is the low prevalence of the infection in the population, although data came from sparse reports of subpopulationbased studies. 2,4,10,26 The implication of having low burden in the country is that the limited healthcare resources could be directed toward screening and treatment of HCV infection in most at-risk populations. An expert review identified that injecting drug use is low in Ethiopia.…”

Section: Resultsmentioning

confidence: 99%

A Path to Ending Hepatitis C in Ethiopia: A Phased Public Health Approach to Achieve Micro-Elimination

Taye

2019

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Ethiopia's hepatitis C virus (HCV) prevalence is predicted to rise by 2030. To halt this increasing trend, a suitable approach to the elimination of HCV is needed. This review explores the current status, challenges, and opportunities and outlines a strategy for the micro-elimination approach in Ethiopia. I searched PubMed and EMBASE using combined Medical Subject Heading databases for the literature on HCV micro-elimination. A phased public health approach to HCV micro-elimination, including preparation/capacity building (phase I), implementation (phase II), and rollout and scale-up (phase III), targeting people living with HIV, prisoners, chronic hepatitis and cancer patients, blood donors, and pregnant women is a pragmatic strategy to Ethiopia. This can be implemented at general and tertiary care referral hospitals with a future scale-up to district hospitals through task-shifting by training general practitioners, nurses, laboratory technologists, and pharmacists. Availability of the highly effective direct-acting antivirals (DAAs) can be ensured by expanding the existing program that provides highly subsidized DAAs through an agreement with Gilead Sciences, Inc. and eventually aiming at domestic generic manufacturing. The significant enablers to HCV microelimination in Ethiopia include the control of healthcare-associated HCV infection, blood safety, access to affordable testing and pan-genotypic DAAs, task-shifting, multisectoral partnership, and regulatory support. General populationbased HCV screening and treatment are not cost-effective for Ethiopia because of high cost, program complexity, and disease epidemiology.

show abstract

“…A total of 56,885 sera were collected, of which 294 were tested anti-HCV antibody positive in Ethiopia [17]. Of these, 98 sera were stored at −80°C until use and shipped to the Netherlands for further molecular study.…”

Section: Methodsmentioning

confidence: 99%

Genetic diversity of hepatitis C virus in Ethiopia

et al. 2017

Self Cite

View full text Add to dashboard Cite

Hepatitis C virus (HCV) is genetically highly divergent and classified in seven major genotypes and approximately hundred subtypes. These genotypes/subtypes have different geographic distribution and response to antiviral therapy. In Ethiopia, however, little is known about their molecular epidemiology and genetic diversity. The aim of this study was to investigate the distribution and genetic diversity of HCV genotypes/subtypes in Ethiopia, using 49 HCV RNA positive samples. HCV genotypes and subtypes were determined based on the sequences of the core and the nonstructural protein 5B (NS5B) genomic regions. Phylogenetic analysis revealed that the predominant was genotype 4 (77.6%) followed by 2 (12.2%), 1 (8.2%), and 5 (2.0%). Seven subtypes were identified (1b, 1c, 2c, 4d, 4l, 4r and 4v), with 4d (34.7%), 4r (34.7%) and 2c (12.2%) as the most frequent subtypes. Consistent with the presence of these subtypes was the identification of a potential recombinant virus. One strain was typed as genotype 2c in the NS5B region sequence and genotype 4d in the core region. In conclusion, genotype 4 HCV viruses, subtypes 4d and 4r, are most prevalent in Ethiopia. This genotype is considered to be difficult to treat, thus, our finding has an important impact on the development of treatment strategies and patient management in Ethiopia.

show abstract

Seroepidemiology of hepatitis B and C virus infections among blood donors in Ethiopia

Cited by 11 publications

References 20 publications

Early experiences from one of the first treatment programs for chronic hepatitis B in sub-Saharan Africa

Early experiences from one of the first treatment programs for chronic hepatitis B in sub-Saharan Africa

A Path to Ending Hepatitis C in Ethiopia: A Phased Public Health Approach to Achieve Micro-Elimination

Genetic diversity of hepatitis C virus in Ethiopia

Contact Info

Product

Resources

About