Antiviral Therapy Eligibility and Low Treatment Coverage among Hepatitis B Virus Infected Patients in Tanzania

Abstract

Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility for antiviral therapy is typically determined based on the extent of HBV replication and liver damage. However, there is insufficient data available regarding the actual treatment needs and the overall characteristics of HBV-infected individuals in Tanzania. Therefore, the aim of this study is to fill this knowledge gap and provide valuable insights to aid in the planning of treatment programs. Materials and Methods: We conducted a cross-sectional study at Bugando Medical Centre in northwest Tanzania, examining the data of 340 patients who were diagnosed with chronic HBV infection and attending the hepatitis clinic. Data on sociodemographic, clinical, and investigation details were collected through electronic files and subsequently analyzed. The eligibility for HBV antiviral treatment was assessed using the criteria established by the World Health Organization (WHO). Results: Out of the 340 patients included in the study, the majorities were males 252 (74.1%) and had a median age of 36 years. Most patients came from outside of Mwanza city. Twenty-percent had significantly elevated alanine transaminase, and over one-third had high DNA levels (>2000 IU/L). The prevalences of liver cirrhosis and significant liver fibrosis were 15% and 15.3%, respectively. None of the patients were on antiviral therapy for hepatitis B. A total of 64 (18.8%) patients met the criteria for treatment eligibility. Male sex, older age, residing outside Mwanza city, and anemia (all with p < 0.05) were factors associated with treatment eligibility in the multivariate analysis. Conclusion and Recommendations: The significant number of HBV-infected patients is suitable for antiviral therapy but none of them have initiated the treatment. The significance of these findings is to emphasize the need for enhancing hepatitis B services in Tanzania.