Evidence map›Paper›PMID 37775742›Full record

ArticleBMC medicine2023

Five-year results of a treatment program for chronic hepatitis B in Ethiopia.

Hailemichael Desalegn, Stian Magnus Staurung Orlien, Hanna Aberra, Eyerusalem Mamo, Sine Grude, Kristina Hommersand, Nega Berhe, Svein Gunnar Gundersen, Asgeir Johannessen

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02344498 (Treatment of Hepatitis B in Resource-limited Settings - a Pilot Program in East Africa), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.4field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02344498 active not recruitingnot on this map

Treatment of Hepatitis B in Resource-limited Settings - a Pilot Program in East Africa

TypeobservationalSponsorOslo University HospitalRan2015 to 2026Enrolled7,350ConditionsHepatitis BArmsTenofovir disoproxil
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Hailemichael Desalegn *Medical Department, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Stian Magnus Staurung Orlien *Department of Paediatrics, Vestfold Hospital Trust, Tønsberg, Norway.
Hanna AberraMedical Department, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Eyerusalem MamoMedical Department, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Sine GrudeFaculty of Medicine, University of Oslo, Oslo, Norway.
Kristina HommersandFaculty of Medicine, University of Oslo, Oslo, Norway.
Nega BerheDepartment of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway.
Svein Gunnar GundersenDepartment of Global Development and Planning, University of Agder, Kristiansand, Norway.
Asgeir JohannessenDepartment of Infectious Diseases, Vestfold Hospital Trust, Tønsberg, Norway. johannessen.asgeir@gmail.com.ORCID http://orcid.org/0000-0001-5966-7166
Oslo University Hospital · NOSt. Paul's Hospital Millennium Medical College · ETUniversity of Oslo · NOSykehuset i Vestfold · NOUniversity of Agder · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn sub-Saharan Africa, less than 1% of treatment-eligible chronic hepatitis B (CHB) patients receive antiviral therapy. Experiences from local CHB programs are needed to inform treatment guidelines and policies on the continent. Here, we present 5-year results from one of the first large-scale CHB treatment programs in sub-Saharan Africa.

methodsAdults with CHB were enrolled in a pilot treatment program in Addis Ababa, Ethiopia, in 2015. Liver enzymes, viral markers, and transient elastography were assessed at baseline and thereafter at 6-month intervals. Tenofovir disoproxil fumarate was initiated based on the European Association for the Study of the Liver (EASL) criteria, with some modifications. Survival analysis was performed using the Kaplan-Meier method.

resultsIn total, 1303 patients were included in the program, of whom 291 (22.3%) started antiviral therapy within the initial 5 years of follow-up. Among patients on treatment, estimated 5-year hepatocellular carcinoma-free survival was 99.0% in patients without cirrhosis at baseline, compared to 88.8% in patients with compensated cirrhosis, and 54.2% in patients with decompensated cirrhosis (p < 0.001). The risk of death was significantly higher in patients with decompensated cirrhosis at baseline (adjusted hazard ratio 44.6, 95% confidence interval 6.1-328.1) and in patients older than 40 years (adjusted hazard ratio 3.7, 95% confidence interval 1.6-8.5). Liver stiffness declined significantly after treatment initiation; the median change from baseline after 1, 3, and 5 years of treatment was - 4.0 kPa, - 5.2 kPa, and - 5.6 kPa, respectively.

conclusionsThis pilot program demonstrates the long-term benefits of CHB therapy in a resource-limited setting. The high mortality in patients with cirrhosis underscores the need for earlier detection of CHB and timely initiation of antiviral treatment in sub-Saharan Africa.

trial registrationThe study was registered at ClinicalTrials.gov (NCT02344498) on January 26, 2015.

Indexed as

Carcinoma, HepatocellularHepatitis B, ChronicLiver NeoplasmsAdultAntiviral AgentsEthiopiaHumansLiver CirrhosisTenofovirAntiviral AgentsTenofovirAntiviral treatmentHepatitis B virusLongitudinal cohort studyResource-limited settingsSurvival analysis

Identifiers

PMID37775742
PMCPMC10543851
OpenAlexW4387166818

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.