ArticlePloS one2020
Eligibility for hepatitis B antiviral therapy among adults in the general population in Zambia.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa.Nature communications · 2023Pooled it
- Prevalence of liver cirrhosis in individuals with hepatitis B virus infection in sub-Saharan Africa: Systematic review and meta-analysis.Liver international : official journal of the International Association for the Study of the Liver · 2021Pooled it
- Management of chronic hepatitis B in Uganda: A five-year experience following the initiation of a national sensitization and care campaign.Journal of virus eradication · 2025Article
- Prevalence of hepatitis B virus infection and treatment eligibility in Lesotho, Southern Africa: a population-based cross-sectional study with case-based follow-up.BMJ public health · 2024Article
- Viral hepatitis testing and treatment in community pharmacies: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Hepatitis B infection: Evaluation of demographics and treatment of chronic hepatitis B infection in Northern-western Tanzania.PloS one · 2024Article
- A Novel and Simplified Score for Determining Treatment Eligibility for Patients with Chronic Hepatitis B.Viruses · 2023Article
- Cost-effectiveness of different monitoring strategies in a screening and treatment programme for hepatitis B in The Gambia.Journal of global health · 2023Article
- HBV continuum of care using community- and hospital-based screening interventions in Senegal: Results from the PROLIFICA programme.JHEP reports : innovation in hepatology · 2022Article
- Hepatitis B Vaccination Impact and the Unmet Need for Antiviral Treatment in Blantyre, Malawi.The Journal of infectious diseases · 2022Article
- Hepatitis B virus (HBV) viral load, liver and renal function in adults treated with tenofovir disoproxil fumarate (TDF) vs. untreated: a retrospective longitudinal UK cohort study.BMC infectious diseases · 2021Article
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
Abstract
introductionWe evaluated antiviral therapy (AVT) eligibility in a population-based sample of adults with chronic hepatitis B virus (HBV) infection in Zambia. MATERIALS AND
methodsUsing a household survey, adults (18+ years) were tested for hepatitis B surface antigen (HBsAg). Sociodemographic correlates of HBsAg-positivity were identified with multivariable regression. HBsAg-positive individuals were referred to a central hospital for physical examination, elastography, and phlebotomy for HBV DNA, hepatitis B e antigen, serum transaminases, platelet count, and HIV-1/2 antibody. We determined the proportion of HBV monoinfected adults eligible for antiviral therapy (AVT) based on European Association for the Study of the Liver (EASL) 2017 guidelines. We also evaluated the performance of two alternative criteria developed for use in sub-Saharan Africa, the World Health Organization (WHO) and Treat-B guidelines.
resultsAcross 12 urban and 4 rural communities, 4,961 adults (62.9% female) were tested and 182 (3.7%) were HBsAg-positive, 80% of whom attended hospital follow-up. HBsAg-positivity was higher among men (adjusted odds ratio [AOR], 1.37; 95% confidence interval [CI], 0.99-1.87) and with decreasing income (AOR, 0.89 per household asset; 95% CI, 0.81-0.98). Trends toward higher HBsAg-positivity were also seen at ages 30-39 years (AOR, 2.11; 95% CI, 0.96-4.63) and among pregnant women (AOR, 1.74; 95% CI, 0.93-3.25). Among HBV monoinfected individuals (i.e., HIV-negative) evaluated for AVT, median age was 31 years, 24.6% were HBeAg-positive, and 27.9% had HBV DNA >2,000 IU/ml. AVT-eligibility was 17.0% by EASL, 10.2% by WHO, and 31.1% by Treat-B. Men had increased odds of eligibility. WHO (area under the receiver operating curve [AUROC], 0.68) and Treat-B criteria (AUROC, 0.76) had modest accuracy. Fourteen percent of HBsAg-positive individuals were HIV coinfection, and most coinfected individuals were taking tenofovir-containing antiretroviral therapy (ART).
conclusionApproximately 1 in 6 HBV monoinfected adults in the general population in Zambia may be AVT-eligible. Men should be a major focus of hepatitis B diagnosis and treatment. Further development and evaluation of HBV treatment criteria for resource-limited settings is needed. In settings with overlapping HIV and HBV epidemics, scale-up of ART has contributed towards hepatitis B elimination.
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