دورية أكاديمية
A new approach to prevent, diagnose, and treat hepatitis B in Africa
| العنوان: | A new approach to prevent, diagnose, and treat hepatitis B in Africa |
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| المؤلفون: | Spearman, C. Wendy, Andersson, Monique, Bright, Bisi, Davwar, Pantong, Desalegn, Hailemichael, Guingane, Alice Nanelin, Johannessen, Asgeir, Kabagambe, Kenneth, Lemoine, Maud, Matthews, Philippa, Ndow, Gibril, Riches, Nicholas, Shimakawa, Yusuke, Sombié, Roger, Stockdale, Alexander, Taljaard, Jantjie, Vinikoor, Michael, Wandeler, Gilles, Okeke, Edith, Sonderup, Mark |
| المساهمون: | University of Cape Town, University of Oxford, Stellenbosch University, LiveWell Initiative Lagos, University of Jos Nigeria, Saint Paul Hospital Millennium Medical College, Ethiopia, Centre hospitalier universitaire de Bodogodo Ouagadougou, Burkina Faso (CHU-B), Vestfold Hospital Tønsberg, Norway, National Organisation for People Living With Hepatitis B Kampala, Imperial College London, London School of Hygiene and Tropical Medicine Fajara, Gambia, London School of Hygiene and Tropical Medicine (LSHTM), The Francis Crick Institute London, University College of London London (UCL), University College London Hospitals (UCLH), Liverpool School of Tropical Medicine (LSTM), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Université Paris Cité (UPCité)-Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur Paris (IP)-Conservatoire National des Arts et Métiers CNAM (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité)-Institut Pasteur Paris (IP)-Conservatoire National des Arts et Métiers CNAM (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Centre Hospitalier Universitaire Yalgado Ouédraogo Ouagadougou, Burkina Faso (CHUYO), Université Joseph Ki-Zerbo Université de Ouagadougou, Burkina Faso (UJZK), Malawi Liverpool Wellcome Trust Clinical Research Programme (MLW), Liverpool School of Tropical Medicine (LSTM)-University of Liverpool-Wellcome Trust-University of Malawi, University of Liverpool, Tygerberg Academic Hospital, University of Alabama at Birmingham Birmingham (UAB), Centre for Research in Infectious Diseases Yaoundé (CRID), University of Zambia Lusaka (UNZA), Universität Bern / University of Bern (UNIBE), BB received funding from GILEAD Sciences for the Women Hepatitis Champions Training in Mauritius, Nigeria, and Egypt. HEPSANET (Hepatitis B in Africa Collaborative Network: https://www.hepsanet.orgTest) was funded by the European Association for the Study of the Liver (EASL) and John C Martin Foundation. KK has received funding from GILEAD Sciences for NOPLHB. ML has received funding from MRC UKRI. PCM receives funding from the Wellcome Trust (ref 110110/Z/15/Z), The Francis Crick Institute, and the UCL NIHR Biomedical Research Centre. PCM receives funding for a PhD student from GSK and this is outside the the scope of this work. GN has received funding from GILEAD Sciences for research. AJS is funded by a National Institute for Health and Care Research (UK) Senior Clinical Lectureship at the University of Liverpool. YS receives research funding from GILEAD Sciences and research materials from Abbott and Fujirebio Inc. MJV holds a grant from the U.S. National Institutes of Health (grant number, R01AI147727). GW is supported by a Professorship grant from the Swiss National Science Foundation, PP00P3_211025. GW has received unrestricted research grants from Gilead Sciences and Roche Diagnostics. |
| المصدر: | ISSN: 2731-913X ; BMC Global and Public Health ; https://pasteur.hal.science/pasteur-04363871Test ; BMC Global and Public Health, 2023, 1 (1), pp.24. ⟨10.1186/S44263-023-00026-1⟩. |
| بيانات النشر: | HAL CCSD |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Hepatitis B, Africa, Advocacy, Prevention, Treatment, [SHS]Humanities and Social Sciences, [SDV]Life Sciences [q-bio] |
| الوصف: | International audience ; There are 82 million people living with hepatitis B (PLWHB) in the World Health Organization Africa region, where it is the main cause of liver disease. Effective vaccines have been available for over 40 years, yet there are 990,000 new infections annually, due to limited implementation of hepatitis B birth dose vaccination and antenatal tenofovir prophylaxis for highly viraemic women, which could eliminate mother-to-child transmission. Despite effective and cheap antiviral treatment which can suppress hepatitis B virus replication and reduce the risk of hepatocellular carcinoma (HCC), < 2% of PLWHB are diagnosed, and only 0.1% are treated. As a result, PLWHB are frequently diagnosed only when they have already developed decompensated cirrhosis and late-stage HCC, and consequently 80,000 hepatitis B-associated deaths occur each year. Major barriers include complex treatment guidelines which were derived from high-income settings, lack of affordable diagnostics, lack or insufficient domestic funding for hepatitis care, and limited healthcare infrastructure. Current treatment criteria may overlook patients at risk of cirrhosis and HCC. Therefore, expanded and simplified treatment criteria are needed. We advocate for decentralized community treatment programmes, adapted for low-resource and rural settings with limited laboratory infrastructure. We propose a strategy of treat-all except patients fulfilling criteria that suggest low risk of disease progression. Expanded treatment represents a financial challenge requiring concerted action from policy makers, industry, and international donor agencies. It is crucial to accelerate hepatitis B elimination plans, integrate hepatitis B care into existing healthcare programmes, and prioritize longitudinal and implementation research to improve care for PLWHB. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | pasteur-04363871; https://pasteur.hal.science/pasteur-04363871Test; https://pasteur.hal.science/pasteur-04363871/documentTest; https://pasteur.hal.science/pasteur-04363871/file/s44263-023-00026-1.pdfTest |
| DOI: | 10.1186/S44263-023-00026-1 |
| الإتاحة: | https://doi.org/10.1186/S44263-023-00026-1Test https://pasteur.hal.science/pasteur-04363871Test https://pasteur.hal.science/pasteur-04363871/documentTest https://pasteur.hal.science/pasteur-04363871/file/s44263-023-00026-1.pdfTest |
| حقوق: | http://creativecommons.org/licenses/byTest/ ; info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.51CFDE8F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/S44263-023-00026-1 |
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