Abstract:
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.
摘要:
在2022年,世界卫生组织(WHO)估计,乙型肝炎病毒(HBV)感染造成150万人死亡,主要归因于慢性感染的并发症,肝硬化和肝细胞癌(HCC)。尽管有疫苗,2019年有2.96亿人慢性感染。亚洲和非洲是受这种感染影响最大的大陆,整个非洲大约有1亿人被感染。丁型肝炎或病毒(HDV),这是一种HBV的“卫星”病毒,经常被误解,其诊断仍然被忽视。然而,它与急性暴发性形式和慢性形式的肝炎有关,导致比HBV单一感染期间更快速地向肝硬化和HCC演变。HBV和HDV这两种病毒的研究近年来取得了很大进展,目前正在开发新的治疗方法。在患有人类免疫缺陷病毒(PlHIV)的人中,肝病是发病和死亡的主要原因。由于常见的传输模式,双重或三重HIV/HBV或HIV/HBV/HDV感染相对常见,特别是在HBV流行地区,如非洲。然而,虽然今天大多数共感染的患者受益于对艾滋病毒和HBV的有效治疗,后者对HDV不活跃。在非洲,乙型肝炎和丁型肝炎已经成为几项研究的主题。然而,这些共同感染的频率和临床后果在普通人群和PlHIV中的研究很少.这篇综述旨在更新非洲HDV共感染或三重感染(HIV-HBV-HDV)的流行病学和临床数据以及治疗观点。