HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa

BMC Infectious Diseases

Research Article

Victor de Ledinghen¹  Abdoulaye Ndiaye²  Alain Attia³  Akouda Patassi⁴  Moussa Seydi⁵  Judicaël Tine⁵  Gilles Wandeler⁶  Claver A. Dagnra⁷  François Dabis⁸  Antoine Jaquet⁸  Didier K. Ekouevi⁹ 

[1] Centre d’investigation de la fibrose hepatique, Hopital Haut-Leveque, CHU de Bordeaux & INSERM U1053, Université de Bordeaux, Bordeaux, France;Pavillon Spécial, Hôpital Aristide Le Dantec, Dakar, Sénégal;Service de hépato-gastroentérologie, CHU de Yopougon, Abidjan, Côte d’Ivoire;Service de maladies infectieuses et tropicales, CHU Sylvanus Olympio, Lomé, Togo;Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Sénégal;Service de maladies infectieuses et tropicales, CRCF, CHU de Fann, Dakar, Sénégal;Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland;Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland;Service de virologie, BIOLIM, Université de Lomé, Lomé, Togo;Université Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France;INSERM, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France;Université Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France;INSERM, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, F-33000, Bordeaux, France;Département de Santé Publique, Faculté des Sciences de la santé, Université de Lomé, Lomé, Togo;

关键词: Liver fibrosis;    HIV;    Hepatitis B;    Hepatitis C;    Africa;   

DOI  :  10.1186/s12879-016-1601-4

 received in 2015-06-10, accepted in 2016-05-27,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPrisoners represent a vulnerable population for blood-borne and sexually transmitted infections which can potentially lead to liver fibrosis and ultimately cirrhosis. However, little is known about the prevalence of liver fibrosis and associated risk factors among inmates in sub-Saharan Africa.MethodsScreening of liver fibrosis was undertaken in a randomly selected sample of male inmates incarcerated in Lome, Togo and in Dakar, Senegal using transient elastography. A liver stiffness measurement ≥9.5 KPa was retained to define the presence of a severe liver fibrosis. All included inmates were also screened for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Substances abuse including alcohol, tobacco and cannabis use were assessed during face-to-face interviews. Odds Ratio (OR) estimates were computed with their 95 % Confidence Interval (CI) to identify factors associated with severe liver fibrosis.ResultsOverall, 680 inmates were included with a median age of 30 years [interquartile range: 24–35]. The prevalence of severe fibrosis was 3.1 % (4.9 % in Lome and 1.2 % in Dakar). Infections with HIV, HBV and HCV were identified in 2.6 %, 12.5 % and 0.5 % of inmates, respectively. Factors associated with a severe liver fibrosis were HIV infection (OR = 7.6; CI 1.8–32.1), HBV infection (OR = 4.8; CI 1.8–12.8), HCV infection (OR = 52.6; CI 4.1–673.8), use of traditional medicines (OR = 3.7; CI 1.4–10.1) and being incarcerated in Lome (OR = 3.3; CI 1.1–9.8) compared to Dakar.ConclusionsHIV infection and viral hepatitis infections were identified as important and independent determinants of severe liver fibrosis. While access to active antiviral therapies against HIV and viral hepatitis expands in Africa, adapted strategies for the monitoring of liver disease need to be explored, especially in vulnerable populations such as inmates.

【 授权许可】

CC BY   
© The Author(s). 2016