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Introduction: men who have sex with men (MSM) are disproportionately affected by hepatitis B virus (HBV) and hepatitis C virus (HCV) worldwide. In Benin, there are no data on MSM. The purpose of this study was to estimate HBV and HCV prevalence and HBV-associated factors in MSM who were HIV negative. Methods: we conducted an analytical cross-sectional study. A two-degree random sampling was used to recruit 204 MSM. An immunochromatographic rapid test and enzyme immunoassays were used to detect HBV and HCV antigens/antibodies. Log-binomial regression was used to identify factors associated with HBV. Results: HbsAg positivity, history of hepatitis B infection and hepatitis C prevalences were 37.7%, 8.8 %, and 0.9 %, respectively. HBsAg positivity and history of hepatitis B were more prevalent in MSM aged ≥30 years compared to younger subjects: 16.7% versus 6.4% (p<0.0001) and 66.7% versus 28.8% (p<0.0001), respectively. Sexual intercourse under the effect of drug or alcohol and living in couple were also associated with HBV. conclusion: the prevalence of hepatitis C was low, but hepatitis B was common, especially among older MSM. Screening and vaccination against hepatitis B should be strengthened in this population. [ABSTRACT FROM AUTHOR]

Five hepatology communications were presented at ANGH meeting 2022. First, a french multicentric study on the evaluation of knowledge and practices on hepatitis B Delta. All patients with positive Ag Hbs must have a systematic search for a Delta infection. Secondly, the preliminary results of VULNAPSYS-C study which studies the psychological vulnerability factors linked to re-infections with the hepatitis C virus. Actions targeted at patients most at risk are essential to contribute to the elimination of the virus in France. Thirdly, a communication on the four missions carried out by the Breton association on Ag HBS screening in Benin. The policy of routine vaccination of infants at birth should lead to a fall in the prevalence of hepatitis B and its complications in Benin. Fourth, a french monocentric study on knowledge and practices on the identification and management of alcohol use disorder shows the difficulty of hospital doctors in identifying and managing these disorders. Finally, a practical study on the ambulatory ascites puncture in a non-university hospital center shows that the methods of this puncture are homogeneous on the whole. [ABSTRACT FROM AUTHOR]

Background: The Public Health Agency of Canada’s integrated bio-behavioural surveillance system—Tracks surveys—assesses the burden of HIV, hepatitis C and associated risks in key populations in Canada. From 2018–2020, Tracks surveys were successfully implemented by First Nations Health Services Organizations in Alberta and Saskatchewan. Methods: First Nations-led survey teams invited community members who identified as First Nations, Inuit or Métis to participate in Tracks surveys and testing for HIV, hepatitis C and syphilis. Information was collected on social determinants of health, use of prevention services, substance use, sexual behaviours and care for HIV and hepatitis C. Descriptive statistics are presented. Results: Of the 1,828 survey participants, 97.4% self-identified as First Nations and 91.4% lived in an on-reserve community. Over half (52.2%) were cisgender female, average age was 36.3 years, 82.5% lived in stable housing, 82% had access to primary healthcare and 73.8% reported having good to excellent mental health. Most participants (97%) had a family member who had experienced residential school. High proportions experienced stigma and discrimination (65.6%), financial strain (64.3%) and abuse in childhood (65.1%). Testing for HIV (62.8%) and hepatitis C (55.3%) was relatively high. Prevalence of HIV was 1.6% (of whom 64% knew their infection status). Hepatitis C ribonucleic acid prevalence was 5% (44.9% of whom knew their current infection status). Conclusion: Historical and ongoing experiences of trauma, and higher prevalence of hepatitis C were identified, reaffirming evidence of the ongoing legacies of colonialism, Indian Residential Schools and systemic racism. High participation in sexually transmitted blood-borne infection testing and prevention reflect the importance of First Nations-led culturally sensitive, safe and responsive healthcare services and programs to effect improved outcomes for First Nations peoples.

Background: Direct-acting antivirals (DAAs) are curative treatments for hepatitis C virus (HCV) infection, a condition affecting over 100,000 Ontarians. Although DAAs are covered under the public drug programs in Ontario, receiving prescriptions depends on access to healthcare. The aim of this study is to understand the relationship between DAA treatment rates and distance to prescriber in Ontario, Canada. Methods: We conducted a cross-sectional study and identified patients who filled a DAA prescription through the Ontario Drug Benefit (ODB) in 2019. We calculated crude (per 100,000 ODB recipients) and adjusted (by a regional HCV infection rate) DAA treatment rates by public health unit (PHU). We reported median distances to provider for all visit types, in-person visits, virtual visits, and proportions of visits that were virtual. Results: In 2019, the crude DAA treatment rate for Ontario is 83.0 patients per 100,000 ODB recipients. The HCV-adjusted DAA treatment rate ranges from 28.2 (Northwestern Ontario) to 188.5 (Eastern Ontario) per 100,000. In our primary analysis, patients in rural PHUs, including Northwestern and Porcupine, were among the highest median distances to prescriber for all visit types (1,195 km and 556 km, respectively). These PHUs also had the highest proportions of virtual visits (greater than 60%). Urban PHUs, such as Toronto and Ottawa, had smaller median distances for all visit types, with smaller proportions of virtual visits (10.8% and 12.4%, respectively). Conclusion: We observed heterogeneity in treatment rates, distance to DAA prescribers and use of virtual care in the management of HCV. Increasing use of telemedicine in regions with limited utilization of DAAs may improve access.

Background: Haliburton, Kawartha, Pine Ridge District Health Unit (HKPRDHU) investigated an exposure in an Ontario operatory dental facility related to a newly diagnosed hepatitis C virus (HCV) infection caused by a virus with an uncommon hepatitis C genotype. Lapses in Infection Prevention and Control (IPAC) and a second epidemiologically-linked case (with the same uncommon hepatitis C genotype) were identified, prompting a broader public health response and outbreak investigation. Objectives: a) To describe the investigation of a newly diagnosed case of hepatitis C; b) to describe the broader public health response, and c) to address a paucity in the literature related to the risk of disease transmission in dental settings due to IPAC lapses. Methods: A collaborative approach with two dental practices, public health partners and regulatory bodies was used. An IPAC inspection was completed to determine and mitigate the risk of blood borne infection transmission within the facilities. Appropriate protocols were followed for the IPAC investigation and public health response. Results: The investigation identified a risk of potential HCV transmission between two cases linked to the same dental facility. There were no other epi-linked cases of HCV identified. Challenges included a lack of adherence to IPAC standards in one of the dental settings and awareness in the dental community regarding HCV transmission, coordination with regulatory bodies and public health experts and low uptake of laboratory testing by patients. Conclusion: Despite the unique challenges associated with the investigation, HKPRDHU conducted a successful IPAC lapse investigation and public health response. Public health units need to maintain collaborative approaches with regulated health professionals, their regulatory bodies and public health experts.

Background: The Tracks survey of people who inject drugs (PWID) collected data in 14 sentinel sites across Canada (2017–2019). These findings describe the prevalence of human immunodeficiency virus (HIV), hepatitis C and associated risk behaviours among Indigenous participants. Methods: Information regarding socio-demographics, social determinants of health, use of prevention services and testing, drug use, risk behaviours, and HIV and hepatitis C testing, care and treatment was collected through interviewer-administered questionnaires. Biological samples were tested for HIV, hepatitis C antibodies and hepatitis C ribonucleic acid (RNA). Descriptive statistics were calculated and reviewed by an Indigenous-led advisory group using the Two-Eyed Seeing approach. Results: Of the 2,383 participants, 997 were Indigenous (82.9% First Nations, 14.9% Métis, 2.2% Inuit). Over half (54.5%) were cisgender male and the average age was 38.9 years. A large proportion (84.0%) reported their mental health as “fair to excellent”. High proportions experienced stigma and discrimination (90.2%) and physical, sexual and/or emotional abuse in childhood (87.5%) or with a sexual partner (78.6%). Use of a needle/syringe distribution program (90.5%) and testing for HIV (87.9%) and hepatitis C (87.8%) were high. Prevalence of HIV was 15.4% (78.2% were aware of infection status) and 36.4% were hepatitis C RNA-positive (49.4% were aware of infection status). Conclusion: High rates of HIV and hepatitis C were identified. Challenges in access to and maintenance of HIV and hepatitis C care and treatment were noted. This information informs harm reduction strategies, including the need to scale-up awareness of prophylaxis in a culturally relevant manner.

Résumé: L'hépatite C est une infection plus fréquente dans la population de malades avec maladies psychiatriques et les comorbidités psychiatriques sont plus fréquentes chez les patients atteints d'hépatite chronique virale C. Aucune étude prospective sur la prise en charge de l'hépatite C en milieu psychiatrique en France n'avait été encore publiée. Les données actuelles sur la prévalence et la prise en charge de l'hépatite C en milieu psychiatrique sont insuffisantes. Dans notre expérience, le nombre de sérologies réalisées chez les entrants en milieu psychiatrique augmentait sur quatre ans avec une couverture du dépistage qui passait de 24 % à 100 %. En 2020, une charge virale C a été réalisée à tous les patients ayant eu une sérologie C positive. Tous les patients ayant une charge virale positive ont bénéficié d'une évaluation de la fibrose par élastometrie hépatique et ont été traités par antiviraux directs. Une coopération organisée entre soignants (équipe mobile d'hépatologie et laboratoire de biologie médicale) a permis d'augmenter le taux de dépistage et de prise en charge du VHC en hôpital psychiatrique. L'hospitalisation et/ou le suivi en milieu psychiatrique reste un facteur de risque de l'hépatite C et doit amener à un dépistage des hépatites virales. Des études prospectives de plus grande envergure sont nécessaires. Hepatitis C is a more common infection in the psychiatric population and psychiatric comorbidities are more common in patients with chronic viral hepatitis C. No prospective studies on hepatitis C management in a psychiatric setting in France had not been yet published. Current data on the prevalence and management of hepatitis C in psychiatric settings are scarce. In our experience, the number of serologies performed among entrants along 4 years increased with coverage of screening from 24% to 100%. In 2020, a C viral load was achieved in all patients with positive C serology. All patients with a positive viral load were assessed for fibrosis with transient elastometry and treated with direct antiviral agents. A cooperation between organized caregivers (hepatology mobile team and medical biology laboratory) has increased the rate of screening and management of HCV in psychiatric hospitals. Hospitalization and/or psychiatric follow-up is a risk factor for hepatitis C and should lead to hepatitis screening. Larger prospective studies are needed. [ABSTRACT FROM AUTHOR]

Background: The Tracks survey of people who inject drugs (PWID) collected data in 14 sentinel sites across Canada (2017–2019). Objective: To describe the prevalence of human immunodeficiency virus (HIV) and hepatitis C and associated risk behaviours and to examine trends over time. Methods: Information regarding socio-demographics, social determinants of health, use of prevention services and testing, drug use, risk behaviours, and HIV and hepatitis C testing, care and treatment was collected through interviewer-administered questionnaires. Biological samples were tested for HIV, hepatitis C antibodies and hepatitis C ribonucleic acid (RNA). Descriptive statistics were calculated and trends over time were assessed. Results: Of the 2,383 participants, 65.6% were cisgender male, 42.2% were Indigenous, 48.0% completed some high school or less, 62.6% lived in unstable housing and 75.7% had ever been incarcerated. Average age was 40.1 years. The majority experienced stigma and discrimination (88.7%) and physical, sexual and/or emotional abuse in childhood (85.0%) or with a sexual partner (75.9%). The majority reported use of a needle/syringe distribution program (90.1%) and tested for HIV (90.5%) and hepatitis C (90.9%). Among participants who had ever had sex, the majority (59.2%) reported inconsistent condom use during vaginal and/or anal sex with a casual sex partner. Prevalence of HIV was 10.3% (82.9% were aware of infection status) and many (36.9%) were hepatitis C RNA-positive (50.1% were aware of infection status). Most surveillance indicators remained relatively stable from Phase 1 to Phase 4. Changes were found in substances used, and improvements were noted related to HIV and hepatitis C prevalence and care cascade indicators. Conclusion: Many PWID in Canada were living in unstable housing and experienced high levels of stigma and discrimination. Prevalence of HIV and hepatitis C was high in some areas. These findings contribute to the evidence base used to inform targeted prevention and control measures.

Introduction: hepatitis C is a public health problem worldwide, in particular in sub-Saharan Africa. The purpose of this study is to determine the seroprevalence of hepatitis C virus antibodies and associated factors during a voluntary general population screening program in Benin. Method: we conducted a descriptive and analytical cross-sectional study in 4 big cities of 4 different departments in Benin in July 2016. All volunteers of all ages, residing in these targeted cities, who gave their informed consent were included in the study. ImuMed HCV Rapid Diagnostic Test (Healgen Scientific LLC, USA) was used. Logistic regression analysis was also used to identify factors associated with hepatitis C virus infection. Results: a total of 2809 volunteers with an average age of 25.9 ± 16.5 years (ranging from 0 to 86 years) were included in the study; 53.9% (1514/2809) of them were men and 46.1% (1295/2809) were women. More than half of the study population consisted of single (59.1%; 1612/2726); 41.3% (1074/2809) were pupils or students. VHC Seroprevalence was 1.5% (42/2809). In multivariate analysis, the variables significantly associated with anti-HCV carriage were: be 60 years old and older (aOR: 46.9, 95% CI 10.2-216.0; p<0.0001) and a history of alcoholism (aOR: 6.3; 95% CI 95% 3.3-12.1; p < 0.0001). Conclusion: in the general population, the seroprevalence of anti-HCV antibodies was 1.5%. HCV infection mainly occurred in people aged 60 years and older and in those with a history of alcoholism. [ABSTRACT FROM AUTHOR]

The treatment of chronic hepatitis C virus (HCV) infection in chronic hemodialysis patients remains an issue of great concern for nephrologists. In 2008 the kidney disease improving global outcomes working group suggested the use of pegylated interferon in end stage kidney disease patients treated by dialysis. Since then, series and some clinical trials on different direct-acting antiviral agents have shown better efficacy and tolerance than interferon-based regimens. Data on the efficacy, tolerance and the right dose of sofosbuvir in this population are still unclear. We report a case of chronic HCV genotype 1b infection in a 47-year-old patient on maintenance hemodialysis successfully treated by a combination of sofosbuvir and ledipasvir for 12 weeks. Evolution was marked by the complete regression of the hepatic cytolysis, a complete and sustained virologic response with HCV viral load undetectable for a 24 months follow-up period. No adverse reaction was found. The treatment of HCV genotype 1 or 4 infection in patients on maintenance hemodialysis is possible with sofosbuvir based regimens with a good efficacy/safety ratio in the absence of current recommended drugs for patients with eGFR30ml/min/1.73m2. The prescription of sofosbuvir should be encouraged amongst this population in this setting.

INTRODUCTION: Active or chronic exacerbated forms of hepatitis C virus (HCV) infection subsequently progress to liver disease and human defensins has been determined to have some level of anti-viral properties invitro whilst the expression of T helper-1 cytokines is known to promote complete recovery from acute HCV infection. The study sought to determine relationship between these immune responses. METHODS: a cross sectional descriptive study design was employed. Hundred and thirty-two individuals were assessed were assessed for to anti-HCV, HCV RNA, serum levels of human alpha defensins 1 (HAD-1) and human beta defensins 1 (HBD-1). T helper 1 cytokines (IL-2, IFN gamma, TNF alpha) secreted in serum were also analyzed using commercial ELISA assay. The study was conducted in Kumasi, Obuasi and Daboya in Ghana. RESULTS: the serum mean concentrations of HAD-1, HBD-1, IL-2, IFN gamma and TNF alpha showed no significant difference in concentrations among participants with chronic, spontaneously recovered or negative to HCV infection (p=0.05). Persons with hepatitis B co-infection were more likely to develop chronic HCV infection (p=0.039). HAD-1 and HBD-1 showed significant positive association with IL-2 (p=0.000) whilst only HAD-1 positively correlated with IL-2 (p=0.000). CONCLUSION: the immunological markers determined had no association with the status of HCV infection. HAD-1 increased with increasing levels of IL-2. These findings suggest that during HCV infection, inflammatory response through the production of cytokines by IL-2 cells may affect the release of HAD-1 and HBD-1.

INTRODUCTION: HIV, Hepatitis B and Hepatitis C pose a public health challenge in Sub-Saharan Africa, and there are only few studies on co-infection of these viruses done in rural areas in Northern Nigeria. This study provides a rural perspective on HIV-Hepatitis co-infection in a Northern Nigerian community. METHODS: This cross-sectional study was carried out amongst PLWHA in a rural community hospital over a three-month period. Socio-demographic data and other relevant information were obtained from the participants and case notes using an interviewer-administered questionnaire. Hepatitis B surface antigen and antibody to Hepatitis C virus were assayed from serum using enzyme-linked immunosorbent assay (ELISA) kits developed by LabACON®. Chi-square test was used to compare categorical variables and logistic regression modelling was used to determine correlates of co-infection in the population. RESULTS: A total of 281 individuals participated in the study. The prevalence of Hepatitis B co-infection, Hepatitis C co-infection and triple infection was 6.0%, 14.6% and 1.1% respectively. Using Chi-square test, none of the socio-demographic characteristics, WHO Clinical Stage, viral suppression had significant association with Hepatitis B co-infection, however marital status was significantly associated with Hepatitis C co-infection and level of education was significantly associated with triple infection (p = 0.05). Logistic regression modelling generated no significant results. CONCLUSION: Co-infection of viral hepatitis (particularly Hepatitis C) in PLWHA is common in rural Northern Nigeria, and significant correlates include lack of formal education and being married. There is need for provider-initiated routine counselling and screening of PLWHA for viral hepatitis, with adequate follow-up and treatment of co-infected individuals and Hepatitis B vaccination for those without co-infection.

In this article, I argue that the Canadian government’s position against screening for hepatitis C virus (HCV) and publicly funding HCV treatment is ethically unjustifiable. Cost of medication and likelihood of widening existing health inequality are the government’s argument for not funding HCV treatment and for also not having a screening program. I object to this position and argue in favour of a screening program and public funding of HCV treatment. I argue that these barriers are ethically unjust. Conclusively, being denied screening and early treatment is to be denied the best possible outcome.

Sub-Saharan Africa has approximately 10.15 million people viraemic with chronic hepatitis C virus infection, extensive genotype and sub-genotype diversity is present, in addition to novel hepatitis C genotypes. Many of the unusual genotypes have extensive baseline resistance associated substitutions with direct acting antiviral therapy treatment outcome data, limited. We report a patient found to have a novel genotype 7b variant with extensive baseline resistance associated substitutions. There is a clear need for a better understanding of the virological characteristics of hepatitis C populations in sub-Saharan Africa to guide best optimal treatment decisions in national hepatitis C elimination programmes.

Résumé: Les Flavivirus, dont fait partie le virus de la dengue (DENV), sont la cause de maladies qui sont actuellement l'une des préoccupations majeures de l'Organisation mondiale de la santé (OMS). La dengue est la maladie humaine transmise par arthropode la plus répandue dans le monde. Face à l'accroissement du nombre de cas de dengue et de dengue sévère, de l'expansion du territoire de son vecteur dû aux mouvements des populations et au réchauffement climatique, il est important de trouver des mesures pour contrecarrer le virus. À l'heure actuelle, aucun traitement spécifique n'est disponible. Malgré le grand nombre de composés exerçant une activité antivirale in vitro , rares sont ceux qui ont été évalués en études cliniques. Le développement d'antiviraux est une stratégie prometteuse et complémentaire à la production de vaccin. Cette revue introduit la notion d'antiviraux anti-DENV à action directe versus les antiviraux anti-DENV ciblant l'hôte. Elle souligne la nécessité de disposer de multiples antiviraux et la pertinence de maintenir les recherches sur le sujet. Dengue virus (DENV) is part of the Flaviviridae family and has been classify by the Word Health Organization (WHO) as one of the top 10 health concerns. It is the most widespread mosquito-borne human disease. Considering the increasing number of severe dengue, the expansion of the vector territory due to climate change and population movement, it is urgent to find a way to counteract the virus. Indeed, currently there is no treatment available and despite the large number of molecules that proved efficacy in vitro rare are the compounds that have been further evaluated and lead to clinical trials. Development of antiviral is a promising complementary strategy to vaccine production. This review introduces the DENV antivirals and the notions of direct acting antiviral versus host targeted antiviral. It underlines the importance to develop multiple potent antivirals and the relevance to maintain research on this matter. [ABSTRACT FROM AUTHOR]

Introduction: hepatitis C is an infection which can be passed from mother to child. The purpose of this study was to investigate the prevalence of colonization by anti-HCV antibodies in pregnant women living in Cotonou and to identify factors associated with it. Methods: we conducted a cross-sectional study of 253 pregnant women admitted for prenatal care in four major maternity hospitals in Cotonou (Benin) from 01/06/2018 to 01/09/2018. Anti-HCV antibodies were detected using rapid diagnostic tests. A venous blood sample was collected from pregnant women tested positive for anti-HCV before confirmatory serological tests and screening tests for gestational diabetes. Results: the prevalence of anti-HCV antibodies was 1.2% (3/253 pregnant women). Factors associated with HCV carriage couldn't be identified given the low number of positive cases. However, pregnant women who were carriers of hepatitis C antibodies had higher mean age (32 ± 3) compared to the remainder of the population (29.58 ± 5.5). Potential risk factors for HCV infection were scarifications, piercing, tattooing, sharing of manicure equipment, a history of surgery and blood transfusions. The prevalence of gestational diabetes in our study population was 7.9% (20/253). No association was found between gestational diabetes and hepatitis C. Conclusion: the prevalence of anti-HCV antibodies in pregnant women living in Cotonou was low. A national-level study is needed to identify factors associated with this infection. [ABSTRACT FROM AUTHOR]

Objective: To determine the seroprevalence of HIV, syphilis and viral hepatitis C and B in the volunteer blood donor population in our community to protect the health of recipients. Population and methodology: Crosssectional study carried out from January 1st to December 31st, 2018 among volunteer donors of blood, among the 2958 retained, 667 were excluded during the biological qualification of the blood bags collected constituting the sample of this study. Results: HIV was the leading cause of exclusion with 6.7% of cases and followup of viral hepatitis C with 6.59% of cases, followed by syphilis with 6.1% and finally viral hepatitis B 3.41% with cases; The 21 to 30 age group was the most excluded with 51.4% of the cases while the male subjects were the most excluded than the female subjects with 99.1% of the cases. Most of the excluded donors were singles representing 72.1% of the cases. The unemployed, students and resourceful people make up the professions of the excluded donors with respectively 31.8%; 30.1% and 17.3 cases; the communes of Mangobo, Kabondo, and Makiso constitute the municipalities of origin of our excluded donors with respectively 47.4%; 30.1% and 14.5% of cases. Conclusion: Despite scientific advances, the risk of transmitting infectious agents through the transfusion of blood or its derivatives can never be zero. It is true that the performance of appropriate tests reduces this risk, it does not does not eliminate because no communicable disease can be detected with complete certainty. [ABSTRACT FROM AUTHOR]

Viral hepatitis is a serious public health problem. Its epidemiology is not precisely known in Morocco. Our objective was to assess the prevalence of HBV and HCV in a particular population of "blood donors" at the Regional Blood Transfusion Centre in Oujda. A retrospective study was conducted from May 1, 2013 to May 31, 2015. Thirty-one thousand nine hundred and fifty-two blood donors were tested. Antigen detection was made according to ELISA technique (MonolisaTMHBs Ag ULTRA). HCV research was performed by ELISA using the kit '' Monolisa HCV Ag-Ab ULTRA ''. 177 blood donors included, they are divided into 155 male (87.6%) and 22 female (12.4%) subjects with a ratio of 7. The average age was 37.64 , 12 years. Six cases were positive for HCV with an overall prevalence of 0.02%. The population study by sex shows a prevalence of 0.004% for 23177 male sera and 0.057% for 8775 female sera. Six donors were HCV positive, of which 05 were female (83.33%) and one was male (16.66%). The average age was 43 , 14 years. Co-infection with HCV HBV-HCV and HCV-Syphilis and HCV-HIV are absent. Co-infection with HBV and HIV was found in one case. HBV-syphilis co-infection was found in 04 cases. Chronic viral hepatitis is a real global health problem. Its prevalence is currently estimated at 0.55% for HBV and 0.02% for HCV, reclassifying Morocco as a low endemic area. The prevention remains the most effective method to successfully control HBV and HCV infection.

INTRODUCTION: Approximately eighty million people around the world are living with hepatitis C, and 700,000 people die every year, due to hepatitis C related complications. In Seychelles, a total of 777 cases of hepatitis C were reported from 2002 to 2016, but up to mid of 2016, the cases were not being treated. Treatment with Harvoni, a combination of sofosbuvir and ledipasvir (SOF/LDV), is now being offered on the condition that the patient does not, or has stopped, injecting drugs. This paper is the first to establish the cost effectiveness of treating all cases of Hepatitis C in Seychelles with Harvoni, as compared to no treatment. METHODS: Data extracted from literature was used to populate an economic model to calculate cost-effectiveness from Seychelles' Government perspective. The model structure was also informed by the systematic review and an accompanying grading of economic models using the Consolidated Health Economic Evaluation Reporting Standard (CHEERS) checklist. A Markov model was developed, employing a lifetime horizon and costs and benefits were analysed from a payer's perspective and combined into incremental cost effectiveness ratios (ICERs). RESULTS: The direct-acting antiviral (DAA), Harvoni, was found to be cost-saving in Seychelles HCV cohort, as compared to no treatment, with an ICER of , 753.65/QALY. The treatment was also cost-saving when stratified by gender, with the ICER of male and female being , 783.74/QALY and 635.20/QALY, respectively. Moreover, the results obtained from acceptability curves showed that treating patients with Harvoni is the most cost-effective option, even for low thresholds. CONCLUSION: Treating hepatitis C cases in Seychelles is cost-saving. It is worth developing a treatment programme to include all cases of hepatitis C, regardless of status of drug injection.

INTRODUCTION: The paucity of data on hepatitis' epidemiology in Menoua Division, West Region, Cameroon, prompted us to assess the prevalence of viral and non-viral hepatitis in this area. METHODS: a retrospective exhaustive study based on records of patients from January 2008 to June 2014 was conducted in 9 health centres in Menoua Division. Targeted subjects were patients who did not receive hepatitis vaccines for the past year and have been screened for hepatitis B virus (HBV), hepatitis C virus (HCV) and/or a blood transaminase. Associations between variables were quantified with odd ratios (OR) and 95% confidence interval (CI). Cochran-Armitage test of linear trend was used for testing proportions of ordinal variables. Fisher's exact test was used for testing the association between 2 qualitative variables when expected counts were less than 5. RESULTS: the overall prevalence were 9.6% and 6.7% for HBV and HCV respectively. HBV mostly infected people aged 21-30 (12.4%) while the prevalence of HCV increased with age up to 35.4% (p=0.03). A 0.6% co-infection was observed. Thirty percent of positive HBV or HCV had high transaminase while 13% of patients with elevated transaminase showed negative viral serology. CONCLUSION: these results show that hospital-based prevalence of HCV and HBV in Menoua Division is under the Cameroon's national range but point out the fact that non-viral hepatitis might be a serious case of concern in this area. There is therefore, a need to identify the risk-factors of non-viral hepatitis.

Résumé: Certaines pratiques sexuelles telles que le chemsex (usage de substances psychoactives pour booster ses performances et sensations sexuelles) ou les plans slam (mêmes objectifs que le chemsex mais en utilisant des substances injectées en intraveineuse), notamment dans la population des hommes ayant des relations sexuelles avec des hommes (HSH), favorisent les infections sexuellement transmissibles (IST). La transmission sexuelle de l'hépatite B se fait principalement par les fluides sexuels (sperme, sécrétions vaginales) et la salive tandis que l'hépatite C se transmet principalement lors de pratiques sexuelles traumatiques entraînant une effraction muqueuse. Le virus de l'hépatite A étant excrété dans les selles, se transmet via des pratiques oro-anales. L'épidémie européenne d'hépatite A de 2016-2017 a touché les HSH présentant des facteurs de risque tels que des partenaires sexuels anonymes multiples, des relations sexuelles en groupe, et des pratiques oro- et digito-anales. D'autres virus transmis par contact sexuel ou via la salive (cytomégalovirus, Epstein-Barr Virus ou Herpes Simplex Virus) peuvent occasionner des hépatites plus souvent symptomatiques chez des patients fragiles (femmes enceintes ou immunodéprimés). Les modes de détection de ces infections s'appuient sur des tests biologiques indirects (sérologie) et directs (détection du génome et de l'antigène). Les hépatites A et B aiguës sont à déclaration obligatoire. Des moyens de prévention existent en fonction du type de transmission. La vaccination contre l'hépatite A est recommandée pour les HSH ou les individus ayant des pratiques oro-anales. L'usage du préservatif, de seringues et de pailles à usage unique lors des plans chemsex et slam sont des mesures préventives générales des IST. Enfin, la PrEP ou prophylaxie préexposition est un moyen de prévention de la transmission du VIH, voire du VHB et partiellement de l' Herpes virus. High risk sexual practices among men who have sex with men (MSM) are important route of sexually transmitted infections (STI). Transmission of hepatitis B is mainly through sexual fluids (sperm and vaginal secretions) and saliva, while hepatitis C is mainly transmitted through violent sexual practices leading to mucosal break-in. The hepatitis A virus, being excreted in the stool, is transmitted via oro-anal practices. The 2016-2017 European epidemic of hepatitis A has affected MSM with risk factors such as anonymous sexual partners, group sex, and oral and digito-anal practices. Other viruses transmitted by sexual contact or via saliva (Cytomegalovirus, Epstein-Barr Virus or Herpes Simplex Virus) can cause hepatitis, most often in fragile patients (pregnant women or immunosuppressed patients). The detection methods are based on indirect (serological) and direct (genome and antigen detection) biological tests. Acute Hepatitis A and B must be notified. Prevention depends on the type of transmission. Vaccination against hepatitis A is recommended for MSM or those with oro-anal practices. The use of single-use condoms, syringes, and straws in the chemsex and slam are general preventative measures. Finally, pre-exposure prophylaxis (PrEP) is a means of preventing HIV transmission and eventually HBV and Herpes virus. [ABSTRACT FROM AUTHOR]

Introduction: men who have sex with men (MSM) are disproportionately affected by hepatitis B virus (HBV) and hepatitis C virus (HCV) worldwide. In Benin, there are no data on MSM. The purpose of this study was to estimate HBV and HCV prevalence and HBV-associated factors in MSM who were HIV negative., Methods: we conducted an analytical cross-sectional study. A two-degree random sampling was used to recruit 204 MSM. An immunochromatographic rapid test and enzyme immunoassays were used to detect HBV and HCV antigens/antibodies. Log-binomial regression was used to identify factors associated with HBV., Results: HbsAg positivity, history of hepatitis B infection and hepatitis C prevalences were 37.7%, 8.8 %, and 0.9 %, respectively. HBsAg positivity and history of hepatitis B were more prevalent in MSM aged ≥30 years compared to younger subjects: 16.7% versus 6.4% (p<0.0001) and 66.7% versus 28.8% (p<0.0001), respectively. Sexual intercourse under the effect of drug or alcohol and living in couple were also associated with HBV., Conclusion: the prevalence of hepatitis C was low, but hepatitis B was common, especially among older MSM. Screening and vaccination against hepatitis B should be strengthened in this population., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Luc Béhanzin et al.)

In France, medical care of inmates is performed by sanitary units belonging to public hospital service. Hepatitis C and hepatitis B are more frequent in jail than in general population. Screening, diagnostic screening and treatment of chronic viral hepatitis are identical but submitted to constraints of prison organization. Efficiency of HCV treatments is identical but an insufficient number of prisoners reaches to direct acting antivirals. Hepatitis B is more difficult to set in charge due to long lasting treatments. All hepatologists have to get involved on their practice, in partnership with the medical teams of the sanitary units. [ABSTRACT FROM AUTHOR]

The hepatitis C appears on epidemic mode less than forty years ago. After virus identification, several treatments more and more effective were approved with a possibility, for the next ten years, to observe a total eradication of the disease. Treatments are less and less expansive, have a better safety and tolerability, with an efficacy close to 100 %. Nevertheless, we still need to treat only patients who need to be treated in a global approach of the hepatic disease. [ABSTRACT FROM AUTHOR]

Résumé Il est primordial de maintenir une recherche active dans le domaine de l’infectiologie compte tenu des phénomènes de résistance et de la grande variabilité des germes, particulièrement de certains types de virus. Les thérapeutiques anti-infectieuses doivent être savamment orchestrées et contrôlées afin de maîtriser la propagation des infections dans le monde. Summary It is essential to continue active research in the field of infectious diseases, given resistance phenomena and the high variability of germs, particularly of certain types of virus. Anti-infective therapies must be carefully managed and controlled in order to curb the spread of infections in the world. [ABSTRACT FROM AUTHOR]

Résumé Les débuts de l’emploi du sang collecté et séché sur papier buvard – « dried blood spot » (DBS) – remonte au milieu du XX e siècle. Le prélèvement DBS peut être réalisé en dehors des structures de soins, par ponction capillaire, transporté de manière simple et sûre par voie postale, et utilisé avec la plupart des méthodes de laboratoire pour l’analyse d’anticorps, d’antigène, ou d’acides nucléiques. Ces caractéristiques avantageuses expliquent l’intérêt croissant pour ce mode de prélèvement et de transport du sang. Le prélèvement DBS a montré son utilité clinique pour améliorer le diagnostic in vitro des maladies infectieuses dans les populations d’accès difficiles, les populations clés et chez les personnes vivant dans les pays à faibles ressources économiques. Le DBS est utilisable à toutes les étapes de la cascade thérapeutique : dépistage, confirmation, quantification des acides nucléiques, génotypages de résistances. C’est dans le domaine de la prise en charge du VIH et des hépatites virales B et C que le plus d’études basées sur le DBS ont été réalisées. Les performances des tests ARN VIH sur DBS pour l’identification de l’échec virologique sous traitements sont élevées mais pas optimales, du fait de la dilution du sang séché dans le tampon d’élution qui réduit la sensibilité analytique et de la contamination par l’ADN proviral intracellulaire. Des performances élevées sont rapportées pour le diagnostic VIH pédiatrique et le diagnostic des hépatites B et C. La variabilité des méthodes pré-analytiques – notamment la préparation des DBS et l’extraction des acides nucléiques – limite les possibilités de comparaisons inter-laboratoires. Trop peu de fabricants ont proposé des notices techniques pour l’usage de leurs trousses sur DBS et les approbations réglementaires des tests commercialisés pour l’usage sur DBS demeurent exceptionnelles. Le prélèvement sur DBS malgré ces limites et contraintes est un outil majeur pour améliorer l’accès au diagnostic des maladies infectieuses dans le monde et fait désormais l’objet de recommandations internationales. The use of blood collected and dried on filter paper - dried blood spot (DBS) - have started in the middle of the 20 th century. DBS sampling can be performed outside care facilities, by capillary puncture, transported in a simple and safe manner by mail, and used with most laboratory methods for antibodies, antigen, or nucleic acids testing. The benefits of this blood collection and transport means explain the growing interest for DBS in the recent years. DBS sampling has shown clinical utility to improve in vitro diagnostics of infectious diseases in hard to reach populations, key populations and people living in low-income countries. DBS can be used at all stages of the therapeutic cascade: screening, confirmation, quantification of nucleic acids, resistance genotyping. Numerous studies dedicated to HIV, viral hepatitis B and C diagnosis using DBS have been reported. The performance of HIV RNA testing on DBS to identified virological failure on therapy is high but not optimal due to the dilution of dried blood in the elution buffer that reduces the analytical sensitivity and due to the contamination by intracellular HIV DNA. Good sensibility and sensitivity have been reported for infant HIV diagnosis and diagnosis of hepatitis B and C using DBS. Variabilities in the pre-analytical steps - including DBS preparation and nucleic acid extraction - limit inter-laboratory comparisons. Too few manufacturers have proposed technical notes for using their assays on DBS and very few assays have pursued regulatory approval for in vitro diagnostic on DBS. Regulatory approvals remain exceptional. Despite these limitations, DBS sampling is a main tool to improve access to infectious disease diagnosis worldwide and is now recommended by international recommendations. [ABSTRACT FROM AUTHOR]

The May 10th 2001 ministerial arrest gives official access to Assisted Reproductive Technologies (ART) to couples where one or both partners are infected with Human Immunodeficiency Virus (HIV), Hepatitis B or C virus. The clinical and biological best practices guide frames this care with recommendations specific to those couples. They focus on access conditions to this care, laboratory organization, and creation of adapted processes for viral risk, specifically manipulation of high risk samples. It is indeed necessary to warrant a viral circuit separated in time and/or space from other non-infected samples. The clinical and biological best practices guide's latest recommendations take into account the evolution of recommendations on natural conception possibilities for viral risk couples. As a matter of fact, the recently revised recommendations as per defined by the June 30th 2017 ministerial arrest and actually updating the one from April 11th 2008 allowed the easing of mandatory dispositions in a viral risk context. [ABSTRACT FROM AUTHOR]

Résumé Les cryoglobulines sont des immunoglobulines qui précipitent au froid. Elles se manifestent par une vascularite systémique associant purpura, arthralgies, neuropathie périphérique, hypocomplémentémie et néphropathie glomérulaire. L’atteinte rénale caractéristique est une glomérulonéphrite membranoproliférative exsudative, caractérisée par une prolifération mésangiale, des dépôts membraneux constitués d’immunoglobulines et de complément, une infiltration par des cellules mononucléées, la présence de thrombi intracapillaires. La glomérulonéphrite cryoglobulinémique se manifeste par un syndrome néphritique ou néphrotique, associé à une hypertension artérielle sévère, et peut aboutir à l’insuffisance rénale terminale. L’hépatite C reste la première cause de cryoglobulinémie mixte, et la mise en route d’un traitement antiviral efficace fait partie de la prise en charge thérapeutique, associé à un traitement par rituximab, permettant une déplétion lymphocytaire B, la disparition de la cryoglobuline et l’amélioration des paramètres néphrologiques. La cryoglobulinémie monoclonale reste plus rare, mais doit faire rechercher une hémopathie lymphoïde ou plasmocytaire, dont la prise en charge spécifique est nécessaire pour traiter la néphropathie secondaire. Cryoglobulins are immunoglobulins that undergo reversible precipitation at low temperatures. They can induce systemic vasculitis, characterized by purpuric cutaneous lesions, arthritis, peripheral neuropathy, hypocomplementemia and glomerular disease. Renal pathology reveals membranoproliferative glomerulonephritis, with particularly intense mesangial cell proliferation and infiltration by macrophages, associated with intracapillary thrombi. This renal disease presents as a nephritic syndrome, with heavy proteinuria, haematuria severe hypertension and rapidly progressive kidney failure that can lead to end-stage renal disease. Hepatitis C is the main cause of mixed (type 2 or 3) cryoglobulinemia and requires the initiation of a specific antiviral therapy, together with immunosuppressive drugs. Rituximab is now considered as the best immunosuppressive therapy in this situation, inducing B-cell depletion, clearance of circulating cryoglobulin and resolution of renal symptoms. Monoclonal (type 1) cryoglobulinemia, is a rare condition, but it usually reveals an B-cell or a plasma cell proliferation, that require a specific hematological treatment to obtain remission of the renal disease. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Viral hepatitis is challenging for health and blood safety. Studies carried out on blood donors can help find the frequency and trending of hepatitis B and C infections in a community and also safety of donation. The study aim is to determine the prevalence of HBV and HCV in Karaj blood donors over a four year period between 2010 to 2013. METHODS: this study reports the results of a cross sectional seroepidemiological study of hepatitis B and C in blood donors. Data on hepatitis infection and demographic characteristics of donors were gathered from blood donor registries. Frequency of hepatitis infections were described with 95% confidence interval. Chi square and logistic regression were used for analysis. RESULTS: the frequency of HBV and HCV infection in Karaj blood donors was 0.40% and 0.18% respectively. In first time donors, HBV and HCV positivity risk was respectively 3.59 and 4.8 fold in people with primary education (OR=3.59; 95% CI between 2.68-4.80) comparing to academic level. Frequency of hepatitis B has decreased significantly (P=0.001) during study period but frequency of Hepatitis C has not changed significantly. CONCLUSION: the frequencies of HBV and HCV infection in Karaj blood donor population is low. There are equal infection rates within both genders. This must be considered in controlling transmission of infection in this area.

INTRODUCTION: to estimating the seroprevalence of HIV, hepatitis B, hepatitis C and syphilis among blood donors in the Aïoun hospital.Methods: this is a retrospective study from 1 January 2010 to 31 December 2015.Results: on the five-year study period, 1,123 donors were collected. Of these, 182 were HIV-positive, an overall prevalence of 16.2% with predominance in male with a sex ratio Man/Woman of 5.2. The average age of donors was 32.7 ± 10 years (range 17-73 years). The most represented that age group 21-30 years (40.5%). The seroprevalence found were 1.2% for HIV, 11.8% for HBV, HCV 0.2% and 3% for syphilis. Co-infection was found in 0.7% of which 0.5% of dual HIV HBV/Syphilis and 0.2% in HBV/HIV.Conclusion: the transmission of infectious agents related to transfusion represents the greatest threat to transfusion safety of the recipient. Therefore, a rigorous selection and screening of blood donors are highly recommended to ensure blood safety for the recipient.

INTRODUCTION: Haemodialysis (HD) patients are potentially susceptible to infection with blood borne viral agents especially; Human Immunodeficiency Virus (HIV), hepatitis B (HBV) and hepatitis C Viruses (HCV), compared to the general population. We described their epidemiology in two newly created haemodialysis units in Cameroon: the Buea and Bamenda haemodialysis centres.

Résumé Un homme de 42 ans, ancien héroïnomane et toxicomane, est traité par buprénorphine haut dosage. En outre, ce patient a contracté une hépatite C pour laquelle du peginterféron alpha-2b et de la ribavirine lui ont été prescrits. Summary A 42-year-old man, a former heroine and drug addict, is treated with high-dose buprenorphine. In addition, this patient has contracted hepatitis C for which peginterferon alfa-2b and ribavirin have been prescribed. [ABSTRACT FROM AUTHOR]

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hepatology is not just about treating hepatitis C, which has been radically transformed with direct-acting anti-viral drugs. The task remains immense. In the field of viral hepatitis, screening for people living with HCV must be structured, vaccination against HBV must become widespread, and treatment of hepatitis B must progress towards real healing, not just viro-suppression. The alcoholic liver disease should be taken charge in its entirety: natural history of hepatic involvement, addictological intervention, work in human and social sciences. The emergence of liver damage associated with the metabolic syndrome will upset the organization of our care structures. As for the so-called rare diseases of the liver - autoimmune, biliary, vascular - the newly restructured pathways will allow to better understand the physio-pathological mechanisms and to advance the therapeutic management. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the second most common cause of cancer deaths worldwide. In France, the incidence of HCC is increasing, especially those developed on dysmetabolic and hepatitis C-related liver disease. The mechanisms of carcinogenesis induced by the hepatitis C virus (HCV) and on metabolic syndrome have in common the insulin resistance. The aims of this review are to describe how HCV and metabolic syndrome generate insulin resistance and thereby promote hepatic carcinogenesis, and to summarize data on preventive and curative interventions targeting insulin resistance for treatment of HCC developed on dysmetabolic and hepatitis C-related liver diseases [ABSTRACT FROM AUTHOR]

Copyright of Journal Africain D'Hépato-Gastroentérologie is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Research in the field of human milk and breastfeeding has become multidisciplinary. This paper aims to provide some up to date knowledge, arbitrarily selected, highlighting the dynamism of research in the field of human lactation and breastfeeding. The benefits of breastfeeding on maternal metabolic and cardiovascular health, the influence of maternal metabolic status on her ability to lactate, the inactivation mechanism of hepatitis C virus by human breast milk, the influence of intravenous fluids during parturition on early newborn weight loss, as well as the problems that remain in defining accurately normal and excessive newborn weight loss and the importance of reconsidering traditional breastfeeding postures are successively addressed. [ABSTRACT FROM AUTHOR]

Résumé Le traitement de l’infection par le virus de l’hépatite C (VHC) a considérablement progressé au cours des dernières années avec l’apparition des nouvelles molécules antivirales ciblant spécifiquement et directement le virus. Les bithérapies classiques associant interféron et ribavirine ont évolué vers des trithérapies associant une antiprotéase, puis vers des associations nouvelles, de deux, trois, voire quatre médicaments, s’affranchissant généralement du recours à l’interféron ou à la ribavirine. Ces traitements associent une grande efficacité, une bonne tolérance et une faible durée. Summary Treatment for the hepatitis C virus (HCV) has progressed significantly over recent years with the arrival of new antiviral molecules targeting the virus specifically and directly. Traditional dual therapies combining interferon and ribavirin firstly evolved towards triple therapies combining a protease inhibitor, then towards new combinations of two, three or even four drugs, generally eliminating the use of interferon or ribavirin. These treatments offer high efficacy and good tolerance and are generally short in duration. [ABSTRACT FROM AUTHOR]

Résumé Toute hépatite C chronique doit faire l’objet, avant l’initiation d’un traitement, d’un bilan, incluant le diagnostic sérologique et virologique, et la détermination de la sévérité de la maladie. Si la ponction biopsie hépatique reste la règle, les instances sanitaires encouragent toutefois le recours aux marqueurs non invasifs spécifiques pour uniformiser les résultats cliniques. Summary In cases of chronic hepatitis C, a thorough assessment must always be carried out before any treatment begins. This assessment must include a serological and virological diagnosis and the seriousness of the disease must be established. While a liver biopsy is still the rule, health authorities encourage the use of specific non-invasive markers to standardise the clinical results. [ABSTRACT FROM AUTHOR]

INTRODUCTION: hepatocellular carcinoma (HCC) is a global public health problem. Hepatitis C virus (HCV) infection accounts for close to 24% of HCC in developing countries especially when associated with cirrhosis. There exists no vaccine against HCV to prevent the occurrence of HCV-related HCC. A sound knowledge of the epidemiology and prevention of the initial infection is vital. The aim of our study was to determine the epidemiologic profile of HCV-related HCC in Cameroon to improve its management. METHODS: it was a prospective study of histologically proven HCV-related HCC seen in two University Centers in Yaounde, Cameroon from March 2012 to January 2013. Demographic data (age, gender), alcohol abuse (=80g/day), presence of cirrhosis, tobacco abuse and parenteral exposition were analyzed. RESULTS: twenty-six patients with histologically proven HCV related HCC were included (18 men (69.2%) and 8 women (30.8%); mean age +/- SD, 61.46+/-10.18 years). A total of 22 (84.6%) patients had a parenteral exposition, 02 (7.7%) patients were alcoholics and 06 (23.1%) patients were smokers. The proportion of patients with cirrhosis was 69.2% against 30.8% cirrhosis-free. Patients with cirrhosis were relatively younger than those cirrhosis-free (mean age +/- SD, 59.05+/-10.05 years vs 66.87+/- 8.72 years, p=0.06). HCV-related HCC was more prevalent in 60 years and above patients (53.8%, 95%CI: 33.4-73.4). The relative risk of HCC among alcoholics patients was high (RR: 1.5, 95%CI: 1.13-1.99, p=0.05).

INTRODUCTION: assessing the knowledge, attitudes, practices and behaviors among blood donors in South Kivu and identify risk factors for viral markers. METHODS: a descriptive and analytical cross-sectional study involved 595 blood donors in the city of Bukavu (Head city of the province of South Kivu) in the eastern Democratic Republic of Congo. RESULTS: our sample consisted of 70.3 % men with a median age of 23 and 77% of young people fewer than 30 years. The score of knowledge and attitude of blood donor's volunteer on blood safety were assessed at 23.5% and 79.1 %. A statistically significant difference was observed between the loyal and new blood donors volunteer (25.1% vs 64.6% p = 0.001); between blood donors volunteer of low and high education level (p = 0.04 ). Motivation to donate blood in 95.9% of cases respect ethical rules of donation. The prevalence of viral markers in blood donors is as follows: 4.8% hepatitis B, 3.9% hepatitis C, 1.6% HIV. For HIV, the low level of education and replacement blood donors are most at risk , the antigen of hepatitis B is observed in blood donors over 30 years , blood donors living couple. CONCLUSION: general knowledge on blood safety is very low in the first link in the chain transfusion (blood donors). A good education of this population conducted by the transfusion service reinforced building (training and support) is needed.

Résumé Compte tenu des phénomènes de résistance et de la grande variabilité des germes, notamment de certains types de virus, il apparaît particulièrement important de maintenir une recherche active dans le domaine de l’infectiologie. La lutte contre le sida, mais surtout contre l’hépatite C bénéficient d’avancées notables. Summary Given the phenomena of the resistance and significant variability of germs and notably certain types of viruses, it is essential that active research in the field of infectiology is maintained. The fight against AIDS, and especially hepatitis C are benefiting from major advances. [ABSTRACT FROM AUTHOR]

Copyright of Journal Africain D'Hépato-Gastroentérologie is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)