Treatment of Chronic Hepatitis B with Tenofovir Disoproxil Fumarate in Ivory Coast

Abstract

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.

Treatment of Chronic Hepatitis B With Tenofovir At The University Teaching Hospital Campus of Lome (Togo)

“…The ALT of our patients was 72.87±19.4 IU/l. This result is comparable to the African data [6], but much less than the European and Asian data [12] where we had respectively found 110 IU/l and 155.4IU / l. The average DNA in our study was 7.56 ±8.01 log10 IU/ml. This rate is comparable to that of Kissi and al [6] who found 7.4±7.7log10 IU/ml, however it is much higher than the one of Sang Kyung Jun and al [12] who found 4.9±2.3 log10 IU/ml in Kore.…”

“…This remark is frequent in our practice where most of patients did not know they are hepatitis B virus carriers or they consulted late at the stage of cirrhosis. old which clearly shows that the population is young even younger than other studies from West Africa [6,8]. The mean age is higher in Europe than 45 years old [9,10].…”

“…This prospective study is the first to show the results of chronic hepatitis B treatment in Togo. Our methodology is similar to the one of Kissi and al in west Africa [6] and that of Nwokediuko and al [7] in Asia. Our sample was made of 75 patients with chronic hepatitis B and cirrhosis.…”

“…This result can be explained by the fact that the contamination of HBV in Africa is most often occurred through mother to child transmission and during childhood. There was male predominance (68%) as in majority of studies in Africa [6,8], Europe and in Asia [10][11][12]. The circumstances of HBV discovery varied and were mainly dominated by blood donation and cirrhosis.…”

Hépatite virale B: aspects cliniques, paracliniques et évolutifs dans le service d’Hépato Gastroentérologie de l’Hôpital Aristide Le Dantec: à propos de 728 cas

“…Une hépatite chronique active était présente chez 8,1% des patients. Chez ces patients, il y avait une cytolyse moyenne avec un taux moyen de transaminase à 4,3 N. Une étude réalisée en Côte d’Ivoire trouvait des valeurs plus basses avec un taux de transaminases de 1,9 N [7]. Des taux relativement peu élevés d’ADN viral B ont été retrouvés chez la majorité de nos patients avec une moyenne de 4,5 log10UI/ml.…”