Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients
Identifieur interne : 000158 ( Main/Exploration ); précédent : 000157; suivant : 000159Proportion and factors associated with Hepatitis B viremia in antiretroviral treatment naïve and experienced HIV co-infected Ghanaian patients
Auteurs : Timothy N. A. Archampong [Ghana] ; Margaret Lartey [Ghana] ; Kwamena W. Sagoe [Ghana] ; Adjoa Obo-Akwa [Ghana] ; Ernest Kenu [Ghana] ; Fizza S. Gillani [États-Unis] ; Hongmei Yang [États-Unis] ; Isaac Boamah [Ghana] ; Timothy Flanigan [États-Unis] ; Awewura Kwara [États-Unis]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2016.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Agents antiVIH (administration et posologie), Antiviraux (administration et posologie), Charge virale, Co-infection (traitement médicamenteux), Co-infection (virologie), Co-infection (épidémiologie), Femelle, Ghana (épidémiologie), Humains, Hépatite B (traitement médicamenteux), Hépatite B (virologie), Hépatite B (épidémiologie), Infections à VIH (traitement médicamenteux), Infections à VIH (virologie), Infections à VIH (épidémiologie), Jeune adulte, Lamivudine (administration et posologie), Mâle, Ténofovir (administration et posologie), VIH-1 (Virus de l'Immunodéficience Humaine de type 1) (), VIH-1 (Virus de l'Immunodéficience Humaine de type 1) (physiologie), Virus de l'hépatite B (), Virus de l'hépatite B (physiologie), Virémie (traitement médicamenteux), Virémie (virologie), Virémie (épidémiologie), Études transversales.
- MESH :
- administration et posologie : Agents antiVIH, Antiviraux, Lamivudine, Ténofovir.
- physiologie : VIH-1 (Virus de l'Immunodéficience Humaine de type 1), Virus de l'hépatite B.
- traitement médicamenteux : Co-infection, Hépatite B, Infections à VIH, Virémie.
- virologie : Co-infection, Hépatite B, Infections à VIH, Virémie.
- épidémiologie : Co-infection, Ghana, Hépatite B, Infections à VIH, Virémie.
- Adolescent, Adulte, Adulte d'âge moyen, Charge virale, Femelle, Humains, Jeune adulte, Mâle, VIH-1 (Virus de l'Immunodéficience Humaine de type 1), Virus de l'hépatite B, Études transversales.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adolescent, Adult, Anti-HIV Agents (administration & dosage), Antiviral Agents (administration & dosage), Coinfection (drug therapy), Coinfection (epidemiology), Coinfection (virology), Cross-Sectional Studies, Female, Ghana (epidemiology), HIV Infections (drug therapy), HIV Infections (epidemiology), HIV Infections (virology), HIV-1 (drug effects), HIV-1 (physiology), Hepatitis B (drug therapy), Hepatitis B (epidemiology), Hepatitis B (virology), Hepatitis B virus (drug effects), Hepatitis B virus (physiology), Humans, Lamivudine (administration & dosage), Male, Middle Aged, Tenofovir (administration & dosage), Viral Load, Viremia (drug therapy), Viremia (epidemiology), Viremia (virology), Young Adult.
- MESH :
- chemical , administration & dosage : Anti-HIV Agents, Antiviral Agents, Lamivudine, Tenofovir.
- geographic , epidemiology : Ghana.
- drug effects : HIV-1, Hepatitis B virus.
- drug therapy : Coinfection, HIV Infections, Hepatitis B, Viremia.
- epidemiology : Coinfection, HIV Infections, Hepatitis B, Viremia.
- physiology : HIV-1, Hepatitis B virus.
- virology : Coinfection, HIV Infections, Hepatitis B, Viremia.
- Adolescent, Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Viral Load, Young Adult.
Abstract
The global burden of Hepatitis B virus (HBV) and HIV co-infection is enormous. The risk of developing cirrhosis and hepatocellular cancer is associated with HBV DNA levels. The main objective of the study was to determine proportion of Hepatitis B viremia in ART-naïve and ART-experienced co-infected Ghanaian patients and factors associated with HBV viremia after at least 36 weeks of lamivudine with or without tenofovir containing ART.
Hepatitis B and HIV co-infected patients who were ART-naïve or had received at least 9 months of lamivudine-containing ART were enrolled in a cross-sectional study at Korle-Bu Teaching Hospital. Demographic and clinical data were collected and samples obtained for Hepatitis B serology, liver function tests and HBV DNA. Factors associated with viremia were determined using univariate and multivariate logistic regression analysis.
Of 3108 HIV-infected patients screened, 257 (8.3 %) were HBsAg-positive, of which 235 enrolled. Overall, 152 (64.7 %) were ART-experienced and 83 (35.3 %) were ART-naïve. Eighty-nine-percent of ART-naïve and 42.1 % of ART-experienced patients had HBV DNA > 20 IU/mL. In multivariate analysis of all patients, being ART-naïve (OR 10.1, 95 % CI 4.6 – 21.9) and elevated ALT (OR 3.7, 95 % CI 1.8 – 7.9) were associated with Hepatitis B viremia. In treatment experienced patients, elevated ALT (OR 4.8 CI 2.0 – 12.1) and male sex (OR 2.1, 95 % CI 1.0 – 4.2) were associated with Hepatitis B viremia.
Majority of ART-naïve (89 %) and 42 % of ART-experienced patients had detectable hepatitis B viremia > 20 IU/mL. An abnormal serum ALT was significantly associated with hepatitis B viremia in HBV and HIV co-infected patients irrespective of treatment status. Baseline and on-treatment ALT may be a useful non-invasive predictor of Hepatitis B viremia in resource-constrained countries in sub-Saharan Africa where infection is endemic and viral load tests are not widely available.
Url:
DOI: 10.1186/s12879-016-1342-4
PubMed: 26759172
PubMed Central: 4710995
Affiliations:
- Ghana, États-Unis
- Rhode Island, Région du Grand Accra, État de New York
- Accra, Legon (Ghana)
- Université du Ghana
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Le document en format XML
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A." last="Archampong">Timothy N. A. Archampong</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName><orgName type="university" n="3">Université du Ghana</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName><orgName type="university" n="3">Université du Ghana</orgName></affiliation></author><author><name sortKey="Sagoe, Kwamena W" sort="Sagoe, Kwamena W" uniqKey="Sagoe K" first="Kwamena W." last="Sagoe">Kwamena W. Sagoe</name><affiliation wicri:level="4"><nlm:aff id="Aff3">Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation></author><author><name sortKey="Obo Akwa, Adjoa" sort="Obo Akwa, Adjoa" uniqKey="Obo Akwa A" first="Adjoa" last="Obo-Akwa">Adjoa Obo-Akwa</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation></author><author><name sortKey="Kenu, Ernest" sort="Kenu, Ernest" uniqKey="Kenu E" first="Ernest" last="Kenu">Ernest Kenu</name><affiliation wicri:level="3"><nlm:aff id="Aff2">Korle-Bu Teaching Hospital, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Korle-Bu Teaching Hospital, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Gillani, Fizza S" sort="Gillani, Fizza S" uniqKey="Gillani F" first="Fizza S." last="Gillani">Fizza S. Gillani</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author><author><name sortKey="Yang, Hongmei" sort="Yang, Hongmei" uniqKey="Yang H" first="Hongmei" last="Yang">Hongmei Yang</name><affiliation wicri:level="2"><nlm:aff id="Aff6">Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY USA</nlm:aff><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Boamah, Isaac" sort="Boamah, Isaac" uniqKey="Boamah I" first="Isaac" last="Boamah">Isaac Boamah</name><affiliation wicri:level="4"><nlm:aff id="Aff3">Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><orgName type="university">Université du Ghana</orgName></affiliation></author><author><name sortKey="Flanigan, Timothy" sort="Flanigan, Timothy" uniqKey="Flanigan T" first="Timothy" last="Flanigan">Timothy Flanigan</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author><author><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><affiliation wicri:level="2"><nlm:aff id="Aff4">Warren Alpert Medical School of Brown University, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>Warren Alpert Medical School of Brown University, Providence</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff5">The Miriam Hospital, Providence, RI USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName><wicri:cityArea>The Miriam Hospital, Providence</wicri:cityArea></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Anti-HIV Agents (administration & dosage)</term><term>Antiviral Agents (administration & dosage)</term><term>Coinfection (drug therapy)</term><term>Coinfection (epidemiology)</term><term>Coinfection (virology)</term><term>Cross-Sectional Studies</term><term>Female</term><term>Ghana (epidemiology)</term><term>HIV Infections (drug therapy)</term><term>HIV Infections (epidemiology)</term><term>HIV Infections (virology)</term><term>HIV-1 (drug effects)</term><term>HIV-1 (physiology)</term><term>Hepatitis B (drug therapy)</term><term>Hepatitis B (epidemiology)</term><term>Hepatitis B (virology)</term><term>Hepatitis B virus (drug effects)</term><term>Hepatitis B virus (physiology)</term><term>Humans</term><term>Lamivudine (administration & dosage)</term><term>Male</term><term>Middle Aged</term><term>Tenofovir (administration & dosage)</term><term>Viral Load</term><term>Viremia (drug therapy)</term><term>Viremia (epidemiology)</term><term>Viremia (virology)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Agents antiVIH (administration et posologie)</term><term>Antiviraux (administration et posologie)</term><term>Charge virale</term><term>Co-infection (traitement médicamenteux)</term><term>Co-infection (virologie)</term><term>Co-infection (épidémiologie)</term><term>Femelle</term><term>Ghana (épidémiologie)</term><term>Humains</term><term>Hépatite B (traitement médicamenteux)</term><term>Hépatite B (virologie)</term><term>Hépatite B (épidémiologie)</term><term>Infections à VIH (traitement médicamenteux)</term><term>Infections à VIH (virologie)</term><term>Infections à VIH (épidémiologie)</term><term>Jeune adulte</term><term>Lamivudine (administration et posologie)</term><term>Mâle</term><term>Ténofovir (administration et posologie)</term><term>VIH-1 (Virus de l'Immunodéficience Humaine de type 1) ()</term><term>VIH-1 (Virus de l'Immunodéficience Humaine de type 1) (physiologie)</term><term>Virus de l'hépatite B ()</term><term>Virus de l'hépatite B (physiologie)</term><term>Virémie (traitement médicamenteux)</term><term>Virémie (virologie)</term><term>Virémie (épidémiologie)</term><term>Études transversales</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-HIV Agents</term><term>Antiviral Agents</term><term>Lamivudine</term><term>Tenofovir</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Agents antiVIH</term><term>Antiviraux</term><term>Lamivudine</term><term>Ténofovir</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>HIV-1</term><term>Hepatitis B virus</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coinfection</term><term>HIV Infections</term><term>Hepatitis B</term><term>Viremia</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coinfection</term><term>HIV Infections</term><term>Hepatitis B</term><term>Viremia</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>VIH-1 (Virus de l'Immunodéficience Humaine de type 1)</term><term>Virus de l'hépatite B</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>HIV-1</term><term>Hepatitis B virus</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Co-infection</term><term>Hépatite B</term><term>Infections à VIH</term><term>Virémie</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Co-infection</term><term>Hépatite B</term><term>Infections à VIH</term><term>Virémie</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coinfection</term><term>HIV Infections</term><term>Hepatitis B</term><term>Viremia</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Co-infection</term><term>Ghana</term><term>Hépatite B</term><term>Infections à VIH</term><term>Virémie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Cross-Sectional Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Viral Load</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Charge virale</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>VIH-1 (Virus de l'Immunodéficience Humaine de type 1)</term><term>Virus de l'hépatite B</term><term>Études transversales</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">The global burden of Hepatitis B virus (HBV) and HIV co-infection is enormous. The risk of developing cirrhosis and hepatocellular cancer is associated with HBV DNA levels. The main objective of the study was to determine proportion of Hepatitis B viremia in ART-naïve and ART-experienced co-infected Ghanaian patients and factors associated with HBV viremia after at least 36 weeks of lamivudine with or without tenofovir containing ART.</p></sec><sec><title>Methods</title><p id="Par2">Hepatitis B and HIV co-infected patients who were ART-naïve or had received at least 9 months of lamivudine-containing ART were enrolled in a cross-sectional study at Korle-Bu Teaching Hospital. Demographic and clinical data were collected and samples obtained for Hepatitis B serology, liver function tests and HBV DNA. Factors associated with viremia were determined using univariate and multivariate logistic regression analysis.</p></sec><sec><title>Results</title><p id="Par3">Of 3108 HIV-infected patients screened, 257 (8.3 %) were HBsAg-positive, of which 235 enrolled. Overall, 152 (64.7 %) were ART-experienced and 83 (35.3 %) were ART-naïve. Eighty-nine-percent of ART-naïve and 42.1 % of ART-experienced patients had HBV DNA > 20 IU/mL. In multivariate analysis of all patients, being ART-naïve (OR 10.1, 95 % CI 4.6 – 21.9) and elevated ALT (OR 3.7, 95 % CI 1.8 – 7.9) were associated with Hepatitis B viremia. In treatment experienced patients, elevated ALT (OR 4.8 CI 2.0 – 12.1) and male sex (OR 2.1, 95 % CI 1.0 – 4.2) were associated with Hepatitis B viremia.</p></sec><sec><title>Conclusions</title><p id="Par4">Majority of ART-naïve (89 %) and 42 % of ART-experienced patients had detectable hepatitis B viremia > 20 IU/mL. An abnormal serum ALT was significantly associated with hepatitis B viremia in HBV and HIV co-infected patients irrespective of treatment status. Baseline and on-treatment ALT may be a useful non-invasive predictor of Hepatitis B viremia in resource-constrained countries in sub-Saharan Africa where infection is endemic and viral load tests are not widely available.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Puoti, M" uniqKey="Puoti M">M Puoti</name></author><author><name sortKey="Airoldi, M" uniqKey="Airoldi M">M Airoldi</name></author><author><name sortKey="Bruno, R" uniqKey="Bruno R">R Bruno</name></author><author><name sortKey="Zanini, B" uniqKey="Zanini B">B Zanini</name></author><author><name sortKey="Spinetti, A" uniqKey="Spinetti A">A Spinetti</name></author><author><name sortKey="Pezzoli, C" uniqKey="Pezzoli C">C Pezzoli</name></author><author><name sortKey="Patroni, A" uniqKey="Patroni A">A Patroni</name></author><author><name sortKey="Castelli, F" uniqKey="Castelli F">F Castelli</name></author><author><name sortKey="Sacchi, P" 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Mondal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pruvost, A" uniqKey="Pruvost A">A Pruvost</name></author><author><name sortKey="Negredo, E" uniqKey="Negredo E">E Negredo</name></author><author><name sortKey="Theodoro, F" uniqKey="Theodoro F">F Theodoro</name></author><author><name sortKey="Puig, J" uniqKey="Puig J">J Puig</name></author><author><name sortKey="Levi, M" uniqKey="Levi M">M Levi</name></author><author><name sortKey="Ayen, R" uniqKey="Ayen R">R Ayen</name></author><author><name sortKey="Grassi, J" uniqKey="Grassi J">J Grassi</name></author><author><name sortKey="Clotet, B" uniqKey="Clotet B">B Clotet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nikolopoulos, Gk" uniqKey="Nikolopoulos G">GK Nikolopoulos</name></author><author><name sortKey="Paraskevis, D" uniqKey="Paraskevis D">D Paraskevis</name></author><author><name sortKey="Psichogiou, M" uniqKey="Psichogiou M">M Psichogiou</name></author><author><name sortKey="Hatzakis, A" uniqKey="Hatzakis A">A Hatzakis</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Ghana</li><li>États-Unis</li></country><region><li>Rhode Island</li><li>Région du Grand Accra</li><li>État de New York</li></region><settlement><li>Accra</li><li>Legon (Ghana)</li></settlement><orgName><li>Université du Ghana</li></orgName></list><tree><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Archampong, Timothy N A" sort="Archampong, Timothy N A" uniqKey="Archampong T" first="Timothy N. A." last="Archampong">Timothy N. A. Archampong</name></region><name sortKey="Archampong, Timothy N A" sort="Archampong, Timothy N A" uniqKey="Archampong T" first="Timothy N. A." last="Archampong">Timothy N. A. Archampong</name><name sortKey="Boamah, Isaac" sort="Boamah, Isaac" uniqKey="Boamah I" first="Isaac" last="Boamah">Isaac Boamah</name><name sortKey="Kenu, Ernest" sort="Kenu, Ernest" uniqKey="Kenu E" first="Ernest" last="Kenu">Ernest Kenu</name><name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name><name sortKey="Lartey, Margaret" sort="Lartey, Margaret" uniqKey="Lartey M" first="Margaret" last="Lartey">Margaret Lartey</name><name sortKey="Obo Akwa, Adjoa" sort="Obo Akwa, Adjoa" uniqKey="Obo Akwa A" first="Adjoa" last="Obo-Akwa">Adjoa Obo-Akwa</name><name sortKey="Sagoe, Kwamena W" sort="Sagoe, Kwamena W" uniqKey="Sagoe K" first="Kwamena W." last="Sagoe">Kwamena W. Sagoe</name></country><country name="États-Unis"><region name="Rhode Island"><name sortKey="Gillani, Fizza S" sort="Gillani, Fizza S" uniqKey="Gillani F" first="Fizza S." last="Gillani">Fizza S. Gillani</name></region><name sortKey="Flanigan, Timothy" sort="Flanigan, Timothy" uniqKey="Flanigan T" first="Timothy" last="Flanigan">Timothy Flanigan</name><name sortKey="Flanigan, Timothy" sort="Flanigan, Timothy" uniqKey="Flanigan T" first="Timothy" last="Flanigan">Timothy Flanigan</name><name sortKey="Gillani, Fizza S" sort="Gillani, Fizza S" uniqKey="Gillani F" first="Fizza S." last="Gillani">Fizza S. Gillani</name><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><name sortKey="Yang, Hongmei" sort="Yang, Hongmei" uniqKey="Yang H" first="Hongmei" last="Yang">Hongmei Yang</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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