Chronic Viral Hepatitis B: Epidemio-Clinical, Paraclinical and Evolutionary Aspects of Patients on Tenofovir in A Decentralized Area in Senegal
Agbogbenkou Tevi Dela-dem Lawson*, Diallo BM, Sidibé M, Thioub D, Touré S and Diop SA
ABSTARCT
Introduction: Chronic hepatitis B is a widespread disease worldwide. The WHO estimates that there were 260 million chronic carriers in 2019 with 820,000 deaths per year. In Senegal, there is a prevalence of 8.5% of HBV carriers with 17% of chronic carriers. As part of its management, an assessment is necessary to define the stage of the infection and the appropriate treatment strategy. The general objective of this study was to determine the evolution of the clinical and paraclinical parameters studied during the monitoring of patients under antiviral treatment. Methodology: Open, descriptive, retrospective cohort study with analytical aim, conducted in the period from January 1, 2017 to June 30, 2022. Included were all patients aged 18 years or older, followed as outpatients for chronic hepatitis B and treated with Tenofovir disoproxil fumarate in two internal medicine departments of hospitals in the Thiès region of Senegal.
Results: We collected 48 cases of chronic carriers of the hepatitis B virus. The predominance was male (58.33%) with a sex ratio of 1.4. The discovery was fortuitous in 64.58% of cases. The clinical signs were dominated by the alteration of the general condition (14.58%) followed by abdominal pain (18.75%) and physical asthenia (8.33%). The HBV viral load was performed in all patients with a mean level of 24,424,931.5 IU/mL (±124,213,733.4 IU/mL). Fibroscan was performed in 43 patients (89.58%) with a mean value of 9.38 kPa ±11.11. The mean duration of treatment was 31 months (9-53 months). At the end of the study period, 21 patients were followed up regularly and 28 were lost to follow-up. There were 19 patients with an undetectable viral load, and 2 who had reactivation of viral replication.
Conclusion: The management of chronic HBV infection is complex in low-income countries. It requires therapeutic compliance and strict and rigorous monitoring of the evaluation of clinical and paraclinical parameters in decentralized areas.
