Nouaman Marcellin, Vinikoor Michael, Seydi Moussa, Ekouevi Didier, Coffie Patrick, Mulenga Lloyd, Tanon Aristophane, Egger Matthias, Dabis François, Jaquet Antoine, Wandeler Gilles (2018), High prevalence of binge drinking among people living with HIV in four African countries, in Journal of the International AIDS Society
, 21(12), e25202.
Ford Nathan, Scourse Roz, Lemoine Maud, Hutin Yvan, Bulterys Marc, Shubber Zara, Donchuk Dmytro, Wandeler Gilles (2018), Adherence to Nucleos(t)ide Analogue Therapies for Chronic Hepatitis B Infection: A Systematic Review and Meta-Analysis, in Hepatology Communications
, 2(10), 1160-1167.
Hector Jonas, Vinikoor Michael, Chilengi Roma, Ehmer Jochen, Egger Matthias, Wandeler Gilles (2018), No Impact of Hepatitis B Virus Infection on Early Mortality Among Human Immunodeficiency Virus–Infected Patients in Southern Africa, in Clinical Infectious Diseases
, 67(8), 1310-1311.
Vinikoor Michael J, Sinkala Edford, Kanunga Annie, Muchimba Mutinta, Nsokolo Bright, Chilengi Roma, Wandeler Gilles, Mulenga Joseph, Chisenga Tina, Bhattacharya Debika, Saag Michael S, Foster Graham, Fried Michael W, Kelly Paul (2018), Chronic hepatitis B virus monoinfection at a university hospital in Zambia, in World Journal of Hepatology
, 10(9), 622-628.
Vinikoor Michael J., Sinkala Edford, Chihota Belinda, Kanunga Annie, Wandeler Gilles (2018), Hepatitis B therapy as HIV prevention in Africa: a case series from Zambia, in Hepatology
, 69(1), 458-460.
Béguelin Charles, Fall Fatou, Seydi Moussa, Wandeler Gilles (2018), The current situation and challenges of screening for and treating hepatitis B in sub-Saharan Africa, in Expert Review of Gastroenterology & Hepatology
, 12(6), 537-546.
Wandeler Gilles, Coffie Patrick A, Kuniholm Mark H, Ocama Ponsiano, Egger Matthias (2018), Issues with measuring hepatitis prevalence in resource-limited settings, in The Lancet
, 391(10123), 835-836.
Tine Judicaël, Diallo Mouhamadou Baïla, Dabis François, Manga Noel M., Dia Ndeye Mery, Seydi Moussa, Wandeler Gilles, Jaquet Antoine, Fall Fatou (2017), Prevention and Care of Hepatitis B in Senegal; Awareness and Attitudes of Medical Practitioners, in The American Journal of Tropical Medicine and Hygiene
, 97(2), 389-395.
Background: Hepatitis B Virus (HBV) infection is a major cause of morbidity and mortality in HIV-infected patients across the world. Between 5 and 15% of HIV-infected individuals suffer from a chronic HBV infection, which is the main cause of hepatocellular carcinoma globally. HIV infection has a profound impact on the natural history of viral hepatitis including the acceleration of the progression to end-stage liver disease. Although it is now recognized that tenofovir should be part of the initial antiretroviral therapy in HIV/HBV-coinfected individuals, its impact on long-term HBV virological outcomes and liver-related disease in sub-Saharan Africa (SSA) has not been studied in detail. For instance, changes in liver fibrosis stage and the occurrence of cirrhosis during therapy have not been assessed over the long run in the region and simple tools to monitor the progression of liver disease have not been validated properly. Objectives: The overarching aim of my Ambizione-PROSPER follow-up proposal is to assess long-term HIV- and HBV-related clinical and virological outcomes among HIV/HBV-coinfected individuals in SSA and Switzerland. My main objectives for year 4 of this fellowship are:- Objective Y4.1: To assess the impact of HBV infection on HIV-related outcomes in SSA, including HIV suppression, CD4 recovery and mortality.- Objective Y4.2: To evaluate two-year virological outcomes in treated HIV/HBV-coinfected patients in southern Africa, West Africa and Switzerland, and to assess HBV resistance patterns and changes in liver fibrosis stage.- Objective Y4.3: To analyze the diagnostic validity of simple serologic scores in predicting liver fibrosis and cirrhosis in HIV/HBV-coinfected patients.Methods: My project is based on dedicated HBV cohorts within the International epidemiological Databases to Evaluate AIDS (IeDEA) in SSA and the Swiss HIV Cohort Study (SHCS). Clinical and virological outcomes in HIV/HBV-coinfected patients from SSA will be compared with data from the SHCS. The virological analyses will be performed in dedicated laboratories in SSA. Liver fibrosis assessment will be based on non-invasive serological scores and transient elastography. I will use time-to-event analyses taking into account competing risks for the analysis of longitudinal clinical data and multivariable linear mixed-effect models for assessing trajectories of markers of liver disease and CD4 cell counts. The validity of serologic scores in predicting liver fibrosis in Zambia will be undertaken by using the area under the receiving operating curve (AUROC).Significance: A better understanding of the burden and determinants of HBV infection in HIV-infected individuals is expected to improve its detection, treatment and monitoring. This project builds on existing, well-established cohorts in Southern Africa, West Africa and Switzerland with detailed, longitudinal clinical and virological data. This international network provides an ideal platform to study HBV epidemiology and treatment outcomes and will inform HBV clinical guidelines and related health policy.