Screening and diagnosis of HBV in low-income and middle-income countries.
Identifieur interne : 000A37 ( Ncbi/Checkpoint ); précédent : 000A36; suivant : 000A38Screening and diagnosis of HBV in low-income and middle-income countries.
Auteurs : Jean-Pierre Allain [Royaume-Uni] ; Ohene Opare-Sem [Ghana]Source :
- Nature reviews. Gastroenterology & hepatology [ 1759-5053 ] ; 2016.
Descripteurs français
- KwdFr :
- ADN viral (isolement et purification), Activation virale (physiologie), Anticorps antiviraux (métabolisme), Antigènes de surface du virus de l'hépatite B (métabolisme), Antigènes e du virus de l'hépatite virale B (métabolisme), Antiviraux (usage thérapeutique), Cirrhose du foie (diagnostic), Cirrhose du foie (psychologie), Cirrhose du foie (virologie), Co-infection (), Co-infection (diagnostic), Diagnostic précoce, Dépistage systématique (), Humains, Hépatite B chronique (), Hépatite B chronique (diagnostic), Hépatite B chronique (traitement médicamenteux), Infections à VIH (), Infections à VIH (diagnostic), Marqueurs biologiques (métabolisme), Pays en voie de développement, Production d'anticorps (physiologie), Résistance virale aux médicaments, Virus de l'hépatite B (immunologie).
- MESH :
- diagnostic : Cirrhose du foie, Co-infection, Hépatite B chronique, Infections à VIH.
- immunologie : Virus de l'hépatite B.
- isolement et purification : ADN viral.
- métabolisme : Anticorps antiviraux, Antigènes de surface du virus de l'hépatite B, Antigènes e du virus de l'hépatite virale B, Marqueurs biologiques.
- physiologie : Activation virale, Production d'anticorps.
- psychologie : Cirrhose du foie.
- traitement médicamenteux : Hépatite B chronique.
- usage thérapeutique : Antiviraux.
- virologie : Cirrhose du foie.
- Co-infection, Diagnostic précoce, Dépistage systématique, Humains, Hépatite B chronique, Infections à VIH, Pays en voie de développement, Résistance virale aux médicaments.
English descriptors
- KwdEn :
- Antibodies, Viral (metabolism), Antibody Formation (physiology), Antiviral Agents (therapeutic use), Biomarkers (metabolism), Coinfection (complications), Coinfection (diagnosis), DNA, Viral (isolation & purification), Developing Countries, Drug Resistance, Viral, Early Diagnosis, HIV Infections (complications), HIV Infections (diagnosis), Hepatitis B Surface Antigens (metabolism), Hepatitis B e Antigens (metabolism), Hepatitis B virus (immunology), Hepatitis B, Chronic (complications), Hepatitis B, Chronic (diagnosis), Hepatitis B, Chronic (drug therapy), Humans, Liver Cirrhosis (diagnosis), Liver Cirrhosis (psychology), Liver Cirrhosis (virology), Mass Screening (methods), Virus Activation (physiology).
- MESH :
- chemical , isolation & purification : DNA, Viral.
- chemical , metabolism : Antibodies, Viral, Biomarkers, Hepatitis B Surface Antigens, Hepatitis B e Antigens.
- complications : Coinfection, HIV Infections, Hepatitis B, Chronic.
- diagnosis : Coinfection, HIV Infections, Hepatitis B, Chronic, Liver Cirrhosis.
- drug therapy : Hepatitis B, Chronic.
- immunology : Hepatitis B virus.
- methods : Mass Screening.
- physiology : Antibody Formation, Virus Activation.
- psychology : Liver Cirrhosis.
- chemical , therapeutic use : Antiviral Agents.
- virology : Liver Cirrhosis.
- Developing Countries, Drug Resistance, Viral, Early Diagnosis, Humans.
Abstract
HBV testing and diagnosis of HBV-related liver disease in low-income and middle-income countries differs substantially from that in developed countries in terms of access to resources and expensive technologies requiring highly specialized staff. For identification and classification of HBV infection, genomic amplification methods to detect and quantify HBV DNA are often nonexistent or available only in central laboratories of major cities. When samples from peripheral locations do arrive, delays in receiving results generate loss to follow-up. Testing is often limited to measurement of hepatitis B surface antigen (HBsAg), alanine aminotransferase levels, aspartate aminotransferase to platelet ratio index and hepatitis B e antigen (HBeAg) to determine indications for antiviral therapy (AVT). Utilization of AVT is limited by cost and availability, particularly when patients are not covered by health insurance. The natural history of HBV infection is influenced by genotypes B and C in East Asia, where decades of immune tolerance have led to mostly vertical transmission; in sub-Saharan Africa, where genotypes A1 and E predominate, infection is transmitted horizontally between young children, followed by a nonreplicative phase. In both regions, cirrhosis and hepatocellular carcinoma are common and would be considerably ameliorated by AVT. Implementation of the HBV vaccine since the 1990s in Asia and 2000s in Africa has decreased the incidence of HBV, but vaccine failure and insufficiently effective prevention remain concerning issues.
DOI: 10.1038/nrgastro.2016.138
PubMed: 27625189
Affiliations:
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pubmed:27625189Le document en format XML
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<term>Antibody Formation (physiology)</term>
<term>Antiviral Agents (therapeutic use)</term>
<term>Biomarkers (metabolism)</term>
<term>Coinfection (complications)</term>
<term>Coinfection (diagnosis)</term>
<term>DNA, Viral (isolation & purification)</term>
<term>Developing Countries</term>
<term>Drug Resistance, Viral</term>
<term>Early Diagnosis</term>
<term>HIV Infections (complications)</term>
<term>HIV Infections (diagnosis)</term>
<term>Hepatitis B Surface Antigens (metabolism)</term>
<term>Hepatitis B e Antigens (metabolism)</term>
<term>Hepatitis B virus (immunology)</term>
<term>Hepatitis B, Chronic (complications)</term>
<term>Hepatitis B, Chronic (diagnosis)</term>
<term>Hepatitis B, Chronic (drug therapy)</term>
<term>Humans</term>
<term>Liver Cirrhosis (diagnosis)</term>
<term>Liver Cirrhosis (psychology)</term>
<term>Liver Cirrhosis (virology)</term>
<term>Mass Screening (methods)</term>
<term>Virus Activation (physiology)</term>
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<term>Activation virale (physiologie)</term>
<term>Anticorps antiviraux (métabolisme)</term>
<term>Antigènes de surface du virus de l'hépatite B (métabolisme)</term>
<term>Antigènes e du virus de l'hépatite virale B (métabolisme)</term>
<term>Antiviraux (usage thérapeutique)</term>
<term>Cirrhose du foie (diagnostic)</term>
<term>Cirrhose du foie (psychologie)</term>
<term>Cirrhose du foie (virologie)</term>
<term>Co-infection ()</term>
<term>Co-infection (diagnostic)</term>
<term>Diagnostic précoce</term>
<term>Dépistage systématique ()</term>
<term>Humains</term>
<term>Hépatite B chronique ()</term>
<term>Hépatite B chronique (diagnostic)</term>
<term>Hépatite B chronique (traitement médicamenteux)</term>
<term>Infections à VIH ()</term>
<term>Infections à VIH (diagnostic)</term>
<term>Marqueurs biologiques (métabolisme)</term>
<term>Pays en voie de développement</term>
<term>Production d'anticorps (physiologie)</term>
<term>Résistance virale aux médicaments</term>
<term>Virus de l'hépatite B (immunologie)</term>
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<term>Biomarkers</term>
<term>Hepatitis B Surface Antigens</term>
<term>Hepatitis B e Antigens</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coinfection</term>
<term>HIV Infections</term>
<term>Hepatitis B, Chronic</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coinfection</term>
<term>HIV Infections</term>
<term>Hepatitis B, Chronic</term>
<term>Liver Cirrhosis</term>
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<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Cirrhose du foie</term>
<term>Co-infection</term>
<term>Hépatite B chronique</term>
<term>Infections à VIH</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Hepatitis B, Chronic</term>
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<keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Virus de l'hépatite B</term>
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<keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Hepatitis B virus</term>
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<keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>ADN viral</term>
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<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Mass Screening</term>
</keywords>
<keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Anticorps antiviraux</term>
<term>Antigènes de surface du virus de l'hépatite B</term>
<term>Antigènes e du virus de l'hépatite virale B</term>
<term>Marqueurs biologiques</term>
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<keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Activation virale</term>
<term>Production d'anticorps</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Antibody Formation</term>
<term>Virus Activation</term>
</keywords>
<keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Cirrhose du foie</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Liver Cirrhosis</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term>
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<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antiviraux</term>
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<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Cirrhose du foie</term>
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<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Liver Cirrhosis</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Developing Countries</term>
<term>Drug Resistance, Viral</term>
<term>Early Diagnosis</term>
<term>Humans</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Co-infection</term>
<term>Diagnostic précoce</term>
<term>Dépistage systématique</term>
<term>Humains</term>
<term>Hépatite B chronique</term>
<term>Infections à VIH</term>
<term>Pays en voie de développement</term>
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<front><div type="abstract" xml:lang="en">HBV testing and diagnosis of HBV-related liver disease in low-income and middle-income countries differs substantially from that in developed countries in terms of access to resources and expensive technologies requiring highly specialized staff. For identification and classification of HBV infection, genomic amplification methods to detect and quantify HBV DNA are often nonexistent or available only in central laboratories of major cities. When samples from peripheral locations do arrive, delays in receiving results generate loss to follow-up. Testing is often limited to measurement of hepatitis B surface antigen (HBsAg), alanine aminotransferase levels, aspartate aminotransferase to platelet ratio index and hepatitis B e antigen (HBeAg) to determine indications for antiviral therapy (AVT). Utilization of AVT is limited by cost and availability, particularly when patients are not covered by health insurance. The natural history of HBV infection is influenced by genotypes B and C in East Asia, where decades of immune tolerance have led to mostly vertical transmission; in sub-Saharan Africa, where genotypes A1 and E predominate, infection is transmitted horizontally between young children, followed by a nonreplicative phase. In both regions, cirrhosis and hepatocellular carcinoma are common and would be considerably ameliorated by AVT. Implementation of the HBV vaccine since the 1990s in Asia and 2000s in Africa has decreased the incidence of HBV, but vaccine failure and insufficiently effective prevention remain concerning issues.</div>
</front>
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