Management of Viral Hepatitis B in A Regional Hospital Center of Senegal

Abstract

Introduction: Viral hepatitis B represents a major public health concern in Senegal. The objective of this study was to assess its management in a hospital center in Senegal located 70 km from the capital. Patients and Methods: This retrospective, longitudinal, and descriptive study was conducted from August 1, 2018 to July 31, 2021, in the Internal Medicine Department of the Regional Hospital Center of Thiès. Using hospitalization and consultation records, we included all patients diagnosed with viral hepatitis B confirmed by positive HBsAg. Collected data included epidemiological, clinical, paraclinical, therapeutic, and outcome variables. Data analysis was performed with the SPSS software, version 26.0. Results: A total of 138 patients were included: 119 with chronic viral hepatitis B, 10 with cirrhosis, and 9 with liver cancer. There were 77 women (55.8%). The mean age was 35 years (range: 17 - 70 years). The average diagnostic delay was 51.6 months. Family history of HCC or cirrhosis among first-degree relatives was present in 14 patients (10%). Diagnosis followed screening in 57 patients (80.3%) and blood donation in 11 patients (15.5%). Physical examination was normal in 76.1% of cases. Viral load was detectable in 88.9% of cases, with a mean level of 5,347,256.4 IU/ml. HBeAg was positive in 3 cases (6.6%). Significant fibrosis was identified in 6 patients (11.76%). The serological profile among patients with chronic hepatitis was assessed in 22 cases (18.5%). HBeAg-negative hepatitis was observed in 59% of these cases. Tenofovir disoproxil fumarate (TDF) was prescribed to 29 patients, with a complete virological response achieved in 5 cases. Conclusion: Significant progress has been achieved in the management of viral hepatitis B in Senegal. Nevertheless, our study demonstrates that further efforts are required to improve access to technical facilities and the standardization of clinical practices.