Department of Infectious Diseases, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Graduate School of Health Sciences, University of Bern, 3010 Bern, Switzerland.
Viruses. 2022 Jul 24;14(8):1614. doi: 10.3390/v14081614.
Hepatitis B virus (HBV) infection is the first cause of liver cirrhosis and cancer in West Africa. Although the exposure to additional environmental and infectious risk factors may lead to the faster progression of liver disease, few large-scale studies have evaluated the determinants of HBV-related liver fibrosis in the region. We used transient elastography to evaluate the prevalence of liver fibrosis and assessed the association between HBV markers and significant liver fibrosis in a cohort of people living with HBV in Dakar, Senegal. The prevalence of significant liver fibrosis was 12.5% (95% confidence interval [CI] 9.6%−15.9%) among 471 people with HBV mono-infection (pwHBV) and 6.4% (95% CI 2.6%−12.7%) in 110 people with HIV/HBV co-infection (pwHIV/HBV) on tenofovir-containing antiretroviral therapy (p = 0.07). An HBV viral load > 2000 IU/mL was found in 133 (28.3%) pwHBV and 5 (4.7%) pwHIV/HBV, and was associated with significant liver fibrosis (adjusted odds ratio (aOR) 1.95, 95% CI 1.04−3.66). Male participants (aOR 4.32, 95% CI 2.01−8.96) and those with elevated ALT (aOR 4.32, 95% CI 2.01−8.96) were especially at risk of having significant liver fibrosis. Our study shows that people with an HBV viral load above 2000 IU/mL have a two-fold increase in the risk of liver fibrosis and may have to be considered for antiviral therapy, independent of other disease parameters.
乙型肝炎病毒 (HBV) 感染是西非肝硬化和肝癌的首要病因。尽管接触其他环境和感染性危险因素可能导致肝病更快进展，但很少有大规模研究评估该地区 HBV 相关肝纤维化的决定因素。我们使用瞬时弹性成像评估了塞内加尔达喀尔一组 HBV 感染者中肝纤维化的流行情况，并评估了 HBV 标志物与显著肝纤维化之间的关联。在 471 名 HBV 单感染（pwHBV）患者中，显著肝纤维化的患病率为 12.5%（95%置信区间 [CI] 9.6%−15.9%），而在 110 名接受含替诺福韦的抗逆转录病毒治疗的 HIV/HBV 共感染（pwHIV/HBV）患者中，患病率为 6.4%（95%CI 2.6%−12.7%）（p = 0.07）。在 133 名（28.3%）pwHBV 和 5 名（4.7%）pwHIV/HBV 中发现 HBV 病毒载量>2000 IU/mL，且与显著肝纤维化相关（调整后的优势比 [aOR] 1.95，95%CI 1.04−3.66）。男性参与者（aOR 4.32，95%CI 2.01−8.96）和 ALT 升高者（aOR 4.32，95%CI 2.01−8.96）发生显著肝纤维化的风险特别高。我们的研究表明，HBV 病毒载量超过 2000 IU/mL 的人发生肝纤维化的风险增加一倍，可能需要考虑进行抗病毒治疗，而无需考虑其他疾病参数。
