Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire; Programme PACCI, site ANRS Côte d'Ivoire, Abidjan, Cote d'Ivoire.
Service des maladies infectieuses et de pneumologie, CHU Sylvanus-Olympio, Lomé, Togo.
Med Mal Infect. 2017 Oct;47(6):394-400. doi: 10.1016/j.medmal.2017.04.011. Epub 2017 May 23.
We aimed to describe changes in hepatitis B screening practices over a 3-year period among HIV-infected patients in West Africa.
A medical chart review was conducted in urban HIV treatment centers in Ivory Coast (3 sites), Benin, Burkina Faso, Senegal, and Togo (1 site each). Among patients who started antiretroviral treatment between 2010 and 2012, 100 per year were randomly selected from each clinic. Demographic, clinical, and laboratory data was collected using a standardized questionnaire. We assessed changes in the proportion of patients screened over time and identified predictors of screening in a multivariable logistic regression.
A total of 2097 patients were included (median age: 37 years, 65.4% of women). Overall, 313 (14.9%) patients had been screened for hepatitis B, with an increase from 10.6% in 2010 to 18.9% in 2012 (P<0.001) and substantial differences across countries. In multivariable analysis, being aged over 45 years (adjusted odds ratio: 1.34 [1.01-1.77]) and having an income-generating activity (adjusted odds ratio: 1.82 [1.09-3.03]) were associated with screening for hepatitis B infection. Overall, 62 HIV-infected patients (19.8%, 95% confidence interval: 15.5-24.7) were HBsAg-positive and 82.3% of them received a tenofovir-containing drug regimen.
Hepatitis B screening among HIV-infected patients was low between 2010 and 2012. The increasing availability of HBsAg rapid tests and tenofovir in first-line antiretroviral regimen should improve the rates of hepatitis B screening.
本研究旨在描述 3 年间西非地区感染 HIV 的患者乙型肝炎病毒（HBV）筛查实践的变化。
在科特迪瓦（3 个地点）、贝宁、布基纳法索、塞内加尔和多哥（各 1 个地点）的城市 HIV 治疗中心开展了病历回顾。在 2010 年至 2012 年间开始接受抗逆转录病毒治疗的患者中，每年从每个诊所随机抽取 100 名患者。使用标准化问卷收集人口统计学、临床和实验室数据。我们评估了随时间推移患者筛查比例的变化，并在多变量逻辑回归中确定了筛查的预测因素。
共纳入 2097 例患者（中位年龄：37 岁，65.4%为女性）。总体而言，313 例（14.9%）患者接受了 HBV 筛查，2010 年筛查率为 10.6%，2012 年为 18.9%（P<0.001），各国之间存在显著差异。在多变量分析中，年龄超过 45 岁（调整优势比：1.34[1.01-1.77]）和有创收活动（调整优势比：1.82[1.09-3.03]）与 HBV 感染筛查相关。总体而言，62 例 HIV 感染者（19.8%，95%置信区间：15.5-24.7）HBsAg 阳性，其中 82.3%接受了含替诺福韦的药物治疗方案。
2010 年至 2012 年间，HIV 感染者的 HBV 筛查率较低。随着 HBsAg 快速检测和一线抗逆转录病毒方案中替诺福韦的可及性增加，HBV 筛查率有望提高。
