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Ndow G, Cessay A, Cohen D, et al. Prevalence and clinical significance of occult hepatitis B infection in The Gambia, West Africa. J Infect Dis. 2021;doi: 10.1093/infdis/jiab327.
Ndow, G., Cessay, A., Cohen, D., Shimakawa, Y., Gore, M. L., Tamba, S., Ghosh, S., Sanneh, B., Baldeh, I., Njie, R., D'Alessandro, U., Mendy, M., Thursz, M., Chemin, I., & Lemoine, M. (2021). Prevalence and clinical significance of occult hepatitis B infection in The Gambia, West Africa. The Journal of infectious diseases, . https://doi.org/10.1093/infdis/jiab327
Ndow, Gibril, et al. "Prevalence and clinical significance of occult hepatitis B infection in The Gambia, West Africa." The Journal of infectious diseases vol. (2021). doi: https://doi.org/10.1093/infdis/jiab327
Ndow G, Cessay A, Cohen D, Shimakawa Y, Gore ML, Tamba S, Ghosh S, Sanneh B, Baldeh I, Njie R, D'Alessandro U, Mendy M, Thursz M, Chemin I, Lemoine M. Prevalence and clinical significance of occult hepatitis B infection in The Gambia, West Africa. J Infect Dis. 2021 Jun 23; doi: 10.1093/infdis/jiab327. Epub 2021 Jun 23. PMID: 34160616.
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J Infect Dis. 2021 Jun 23; doi: 10.1093/infdis/jiab327. Epub 2021 Jun 23.

Prevalence and clinical significance of occult hepatitis B infection in The Gambia, West Africa.

The Journal of infectious diseases

Gibril Ndow, Amie Cessay, Damien Cohen, Yusuke Shimakawa, Mindy L Gore, Saydiba Tamba, Sumantra Ghosh, Bakary Sanneh, Ignatius Baldeh, Ramou Njie, Umberto D'Alessandro, Maimuna Mendy, Mark Thursz, Isabelle Chemin, Maud Lemoine

Affiliations

  1. Division of Digestive Diseases, Department of Metabolism, Digestion & Reproduction, Imperial College London, UK.
  2. Disease Control & Elimination, MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia.
  3. INSERM U1052, CNRS UMR5286, Center de Recherche en Cancérologie, Université Claude Bernard, Lyon, France.
  4. Unité D'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.
  5. National Heart & Lung Institute, Faculty of Medicine, Imperial College London, UK.
  6. Edward Francis Small Teaching Hospital, Banjul, The Gambia.
  7. National Public Health Laboratories, Ministry of Health, The Gambia.
  8. School of Medicine & Allied Health Sciences, University of The Gambia.
  9. International Agency for Research on Cancer (IARC), World Health Organisation, Lyon, France.

PMID: 34160616 DOI: 10.1093/infdis/jiab327

Abstract

BACKGROUND: Prevalence of occult hepatitis B infection (OBI) and its clinical outcomes have been poorly studied in Africa.

METHOD: Using the PROLIFICA cohort, we compared the prevalence of OBI between HBsAg-negative healthy adults screened from the general population (controls) and HBsAg-negative patients with advanced liver disease (cases) and estimated the population attributable fraction for the effect of OBI on advanced liver disease.

RESULTS: OBI prevalence was significantly higher among the cases (15/82, 18.3%) than in the control group (31/330, 9.4%, p=0.03). Among participants with OBI, pre-S2 mutations were detected in 5/31 (16.1%) controls and 3/14 (21.4%) cases (p=0.7).After adjusting for age, sex, and anti-HCV serology, OBI was significantly associated with advanced liver disease [OR: 2.8 (95% CI: 1.3-6.0), p=0.006]. In HBsAg-negative people, the proportions of advanced liver disease cases attributable to OBI and HCV were estimated at 12.9% (7.5-18.1%) and 16.9% (15.2-18.6%), respectively.

CONCLUSION: OBI is endemic and an independent risk factor of advanced liver disease in The Gambia, West Africa. This implies that HBsAg-negative people with liver disease should be systematically screened for OBI. Moreover, the impact of infant hepatitis B immunization to prevent end-stage liver disease might be higher than previous estimates based solely on HBsAg-positivity.

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Keywords: Africa; Occult hepatitis B; advanced liver disease; cirrhosis; hepatocellular carcinoma; prevalence

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