Retention in Care among People Living with Chronic Hepatitis B Virus Infection in Burkina Faso: A 17-Year Retrospective Cohort Study

Abstract

Background/ Aim : Retention in care remains a major challenge in the care programs for people with chronic Hepatitis B virus (PL-HBV). This study aimed to evaluate non-retention in care and identify its associated factors among PL-HBV in the HEPSANET cohort at the Yalgado Ouédraogo University Hospital. Patients and Method: This was a retrospective, analytical cohort study conducted over 17 years (January 2006-January 2023). People living with the hepatitis B virus who were at least 18 years old and who did not have decompensated cirrhosis or a hepatocellular carcinoma (HCC) at the time of inclusion were included in the study. Results: This study included 569 patients with a mean age of 32.92 years. The majority were men (58.9%) and had a high level of education (university) (78.7%). A family history of the first degree of hepatocellular carcinoma (HCC) was found in 10.5% of patients. Considering body mass index, 22.8% were overweight and 11.9% were obese. Biologically, HBeAg was negative in 84.8% of patients, and the viral load was less than 2000 IU/mL in 58.5%. Evaluation of liver fibrosis showed that 62.8% of patients had mild fibrosis (F0 - F1). The median survival time was 4.12 years. (IQC: 3:35 - 4:89). The retention rate in care was 67.47% at 01 year old, 55.68% at 03 years old, 45.51% at 05 years old, 30.61% at 10 years old, and 12.03% at 15 years. Factors significantly associated with non-retention among people living with chronic hepatitis B included male sex [adjusted HR 0.58; 95% CI: 0.35 - 0.96], secondary education level [adjusted HR 1.74; 95% CI: 1.00 - 3.02], overweight [adjusted HR 0.72; 95% CI: 0.54 - 0.97], obesity [adjusted HR 0.39; 95% CI: 0.24 - 0.64], and initiation of antiviral treatment [adjusted HR 0.36; 95% CI: 0.28 - 0.47]. Conclusion: Our study revealed low retention in care among people living with chronic hepatitis B, particularly among women and untreated patients, with a progressive decline over time. It is necessary to intensify the sensitization of in order to maintain them in care.