Real world clinical experience of Chronic Hepatitis B Treatment in SSA

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Abstract Background About three hundred fifty to four hundred million people are infected chronically with hepatitis B worldwide and about 780,000 people die annually of its complications. Ethiopia is located in the region of hepatitis B hyper-endemicity ranging from, 8–12%. However, up to 17% of HBV, infected patients present for care late with liver cirrhosis in sub-Saharan Africa (SSA). Fortunately, antiviral therapy of CHB has shown to be effective in preventing complications and improving survival even at stage of early cirrhosis. The goal of therapy is to decrease the morbidity and mortality associated with CHB. Tenofovir disoproxil fumarate (TDF) is among the oral antiviral approved for the treatment of CHB. TDF treatment has shown to be effective in a wider pool of the CHB populations. Literatures indicate long-term TDF treatment was associated with sustained virologic, biochemical, and serologic responses. Objectives To assess the outcome of TDF treatment of Chronic Hepatitis B patients at Adera Medical center in Addis Ababa, Ethiopia. Methods Hospital-based retrospective cross-sectional study was employed. Hundred forty-four CHB patients on TDF treatment were enrolled. Sociodemographic, clinical, and laboratory parameters were collected. The data was entered and analyzed using SPSS (SPSS, Version 23). Results The mean age of the participants is 35.52 ± 10.34. Three fourth of the patients (76.4%) are male. Fifteen patients have progressed to decompensation at the end of the study period. 93.1% of the participants are HBeAg negative, while 5.6% have attained loss of HBsAg on TDF A significant association (p < 0.01) between APRI improvement, with the duration of treatment, and baseline viral load was found. Paired sample t-test showed an improvement in the mean APRI score of 0.2 (CI: 0.07–0.367; p < 0.01). Conclusion TDF is safe and effective in reducing viral load and complications among our patients. Not only did it show benefits in improving liver parameters and suppression of viral load, but also it has attained a functional cure in some patients.

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