Open AccessPrevalence and Clinical Significance of Occult Hepatitis B Infection in The Gambia, West Africa
Author(s) -
Gibril Ndow,
Amie Cessay,
Damien Cohen,
Yusuke Shimakawa,
Mindy Gore,
Saydiba Tamba,
S. Monty Ghosh,
Bakary Sanneh,
Ignatius Baldeh,
Ramou Njie,
Umberto D’Alessandro,
Maimuna Mendy,
Mark Thursz,
Isabelle Chemin,
Maud Lemoine
Publication year - 2021
Publication title -
the journal of infectious diseases (online. university of chicago press)/the journal of infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.69
H-Index - 252
eISSN - 1537-6613
pISSN - 0022-1899
DOI - 10.1093/infdis/jiab327
Subject(s) - hbsag , medicine , liver disease , occult , odds ratio , population , attributable risk , hepatitis b , gastroenterology , disease , serology , hepatitis c , immunology , hepatitis b virus , epidemiology , pathology , virus , environmental health , antibody , alternative medicine
Background Prevalence and clinical outcomes of occult hepatitis B infection (OBI) have been poorly studied in Africa. Methods Using the PROLIFICA cohort, we compared the prevalence of OBI between hepatitis B surface antigen (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 cases (15/82, 18.3%) than controls (31/330, 9.4%, P = .03). After adjusting for age, sex, and anti-hepatitis C virus (HCV) serology, OBI was significantly associated with advanced liver disease (odds ratio, 2.8; 95% confidence interval [CI], 1.3–6.0; P = .006). In HBsAg-negative people, the proportions of advanced liver disease cases attributable to OBI and HCV were estimated at 12.9% (95% CI, 7.5%–18.1%) and 16.9% (95% CI, 15.2%–18.6%), respectively. Conclusions OBI is endemic and an independent risk factor for 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.