[非洲三角洲肝炎:流行病学和临床特点]。

Medecine tropicale et sante internationale Pub Date : 2023-10-03 eCollection Date: 2023-12-31 DOI:10.48327/mtsi.v3i4.2023.430
Françoise Lunel Fabiani, Ahmed El Bara, Cheikh Tijani Hamed, Hélène LE Guillou Guillemette
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引用次数: 0

摘要

据世界卫生组织(WHO)估计,2022年,乙型肝炎病毒(HBV)感染导致150万人死亡,其中大部分人死于慢性感染、肝硬化和肝细胞癌(HCC)并发症。尽管有疫苗可用,但 2019 年仍有 2.96 亿人受到慢性感染。亚洲和非洲是受这种感染影响最严重的大洲,整个非洲约有 1 亿人受到感染。Delta 或 D 型肝炎病毒(HDV)是 HBV 的 "卫星 "病毒,常常被误解,其诊断仍被忽视。然而,与单一 HBV 感染相比,HDV 与急性暴发性和慢性肝炎相关,导致肝硬化和 HCC 的发展更为迅速。近年来,对 HBV 和 HDV 这两种病毒的研究取得了很大进展,目前正在开发新的治疗方法。在人类免疫缺陷病毒(PlHIV)感染者中,肝病是发病和死亡的主要原因。由于常见的传播方式,HIV/HBV 或 HIV/HBV/HDV 双重或三重感染相对常见,尤其是在非洲等 HBV 流行地区。然而,尽管目前大多数合并感染的患者都能从针对 HIV 和 HBV 的有效治疗中获益,但后者对 HDV 的治疗并不积极。在非洲,乙型肝炎和丁型肝炎已成为多项研究的主题。本综述旨在更新流行病学和临床数据,以及非洲 HDV 合并感染或三重感染(HIV-HBV-HDV)的治疗前景。
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[Delta hepatitis in Africa: epidemiological and clinical particularities].

In 2022, the World Health Organization (WHO) estimated that hepatitis B virus (HBV) infections caused 1.5 million deaths, mostly attributable to complications from chronic infections, cirrhosis and hepatocellular carcinoma (HCC). Despite the availability of a vaccine, 296 million people were chronically infected in 2019. Asia and Africa are the continents most affected by this infection, with around 100 million people infected in Africa as a whole.Hepatitis Delta or D virus (HDV), which is a "satellite" virus of HBV, is often misunderstood and its diagnosis remains neglected. However, it is associated with acute fulminant forms and chronic forms of hepatitis leading to a more rapid evolution towards cirrhosis and HCC than during HBV mono-infection. Research on these two viruses HBV and HDV has progressed a lot in recent years, and new treatments are currently in development.In people living with the human immunodeficiency virus (PlHIV), liver disease is a major cause of morbidity and mortality. Due to common modes of transmission, dual or triple HIV/HBV or HIV/HBV/HDV infections are relatively common, particularly in HBV endemic regions such as Africa. However, while today most co-infected patients benefit from effective treatment against both HIV and HBV, the latter is not active against HDV. In Africa, hepatitis B and D have already been the subject of several studies. However, the frequency and clinical consequences of these co-infections have been little studied in the general population and in PlHIV.This review seeks to update the epidemiological and clinical data and the therapeutic perspectives of HDV co-infections or triple infections (HIV-HBV-HDV) in Africa.

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