Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Department of Medical Education, University of Balamand, Beirut, Lebanon.
Am J Trop Med Hyg. 2023 Sep 11;109(5):1161-1165. doi: 10.4269/ajtmh.23-0236. Print 2023 Nov 1.
There is a lack of real-world data on hepatitis B (HBV) treatment in Africa. We conducted a single-center 18-month prospective cohort study in Ethiopia to understand clinical, laboratory, and demographic variables associated with HBV treatment. One hundred fifty HBV-positive patients were included: 51 on treatment, 99 with no treatment. Median age was similar between groups. Those on treatment were more likely to be male (86%), report higher coffee intake (90% versus 70%, P < 0.05), lower khat intake (0% versus 9%, P = 0.08), lower alcohol consumption (0% versus 5%, P = 0.1), and had attained higher levels of education (56% versus 42%, P = 0.19). Individuals on treatment had higher median aspartate aminotransferase (AST), alanine aminotransferase (ALT), HBV DNA, and median Aminotransferase-to-Platelet Ratio Index and Fibrosis-4 scores. At 6 and 12 months, those on treatment showed a decrease in median AST, ALT, and fibrosis scores and had less hepatocellular carcinoma development at 6 months (2% versus 4%). Our study highlights potential demographic disparities in HBV treatment as well as benefits in a real-life setting in Africa.
在非洲,有关乙型肝炎 (HBV) 治疗的真实世界数据较为缺乏。我们在埃塞俄比亚的一家中心进行了一项为期 18 个月的单中心前瞻性队列研究,以了解与 HBV 治疗相关的临床、实验室和人口统计学变量。共纳入 150 名 HBV 阳性患者:51 名接受治疗,99 名未接受治疗。两组的中位年龄相似。接受治疗的患者更可能为男性(86%),报告更高的咖啡摄入量(90%对 70%,P < 0.05),更低的恰特草摄入量(0%对 9%,P = 0.08),更低的酒精摄入量(0%对 5%,P = 0.1),并且受教育程度更高(56%对 42%,P = 0.19)。接受治疗的患者中位天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、HBV DNA 以及中位转氨酶血小板比值指数和纤维化 4 评分更高。在 6 个月和 12 个月时,接受治疗的患者 AST、ALT 和纤维化评分中位数下降,并且在 6 个月时更少发生肝细胞癌(2%对 4%)。我们的研究强调了 HBV 治疗中潜在的人口统计学差异,以及在非洲实际环境中的获益。