Hepatitis B Care and Treatment in Zanzibar, Tanzania: A Demonstration Project Following 2015 WHO Treatment Guidelines, 2017–2021

Details

• Alternative Title:
  J Viral Hepat
• Personal Author:
  Said, Sanaa S. ; Shadaker, Shaun ; McMahon, Brian J. ; Armstrong, Paige A. ; Beckett, Geoff A. ; Kamili, Saleem ; Harris, Aaron M.
• Description:
  Zanzibar, a low-resource semiautonomous region of Tanzania, has an estimated prevalence of hepatitis B virus (HBV) infections of 3.6%. To assess the feasibility of care and treatment, a 5-year hepatitis B demonstration project was implemented in Zanzibar during January 2017-December 2021, following the 2015 WHO HBV care and treatment guidelines. Participants included adults (aged ≥ 18 years) who tested positive for HBV surface antigen and tested negative for HIV and hepatitis C antibody. Participants were examined for clinical signs of liver disease and testing was conducted at baseline to assess treatment eligibility and every 6-12 months thereafter. Tenofovir disoproxil fumarate (TDF) was provided at no cost to treatment-eligible participants. Clinical and laboratory data were analysed to assess improvement in proximal disease outcomes. Among 596 participants enrolled, the median age was 32 years (IQR 26-39) and 365 (61%) were male. Of those enrolled, 268 (45%) returned for ≥ 1 follow-up visit, with a median of 511 days of follow-up. Overall, 58 patients initiated treatment: 15 met treatment criteria based on liver cirrhosis alone; 13 by APRI > 1.5; among those with HBV DNA results, six met criteria based on HBV DNA levels and ALT activity; 24 met ≥ 2 criteria. Significant decreases in ALT activities, APRI scores and HBV DNA levels were observed among those treated. This hepatitis B care and treatment programme was demonstrated to be feasible in a low-resource setting. Despite challenges, testing and linkage to care is critical to decrease the global burden of hepatitis B.
• Subjects:
  Adult Antiviral Agents Female Hepatitis B Hepatitis B, Chronic Hepatitis B Surface Antigens Hepatitis B Virus Humans Male Middle Aged Practice Guidelines As Topic Prevalence Tanzania Tenofovir World Health Organization Young Adult

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• Keywords:
  Hepatitis B Treatment Zanzibar
• Source:
  J Viral Hepat. 32(1):e14051
• DOI:
  http://dx.doi.org/10.1111/jvh.14051
• Pubmed ID:
  39707980
• Pubmed Central ID:
  PMC11752844
• Document Type:
  Journal Article
• Funding:
  Tanzania Management and Development for Health/ ; CC/CDC HHSUnited States/ ; Gilead Sciences/
• Volume:
  32
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:0f94c5634f67067c0eb4e465d7aa8252ca06fc74142129494a780e921e50823e98ec3335ce8d95be4008bdcac5d00b721f79799cf37a181e78ad39e3a592f25a
• Download URL:
  https://stacks.cdc.gov/view/cdc/175941/cdc_175941_DS1.pdf
• File Type:
  [PDF - 531.17 KB ]