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Co-infection VIH-VHB au sud du Sahara : données épidémiologiques, cliniques et thérapeutiques

Hepatitis B virus and human immunodeficiency virus co-infection in sub-Saharan Africa: epidemiological, clinical and therapeutic data

  • Published:
Journal Africain d’Hépato-Gastroentérologie

Résumé

En Afrique subsaharienne, la co-infection VIH-VHB a plusieurs particularités: sa prévalence est élevée. L’infection virale B ne semble cependant pas plus fréquente chez les sujets VIH positifs que chez les sujets VIH négatifs. Le pronostic est plus sévère, du fait d’un diagnostic souvent tardif de l’infection virale B (recherche d’une co-infection non systématique), à un stade avancé de l’infection VIH, lors de la mise en route des médicaments antirétroviraux (ARV). Les difficultés de la prise en charge de cette co-infection sont liées également aux limites de la subvention des ARV qui ne prend en compte qu’un seul médicament actif sur le virus B (la lamivudine) dans le cadre de la trithérapie antirétrovirale. L’amélioration de la qualité de la prise en charge et du pronostic de cette co-infection passe par la résolution de ces différents problèmes et l’application des recommendations sur le traitement de cette co-infection.

Abstract

In sub-Saharan Africa, co-infection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) has several characteristics, one of which is its high prevalence. The rate of HBV infection, however, appears to be similar in HIV-positive and HIV-negative individuals. In cases of co-infection, the prognosis is poorer because of the often-late detection of HVB infection (screening for co-infection is not systematic) at an advanced stage of HIV infection, when antiretroviral therapy (HAART) has already been started. The difficulties in treating this co-infection are exacerbated by limits on antiretroviral drug (ARV) subsidies. In co-infected patients requiring HAART, lamivudine is the only covered drug active against HBV. Improving the prognosis and quality of care in these patients depends on finding solutions to these problems and applying the recommendations for the management of HIV/HBV co-infection.

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  1. Service d’hépato-gastroentérologie, CHU de Yopougon, Abidjan Côte-d’Ivoire, UFR des sciences médicales d’Abidjan, Université de Cocody, Abidjan, Côte-d’Ivoire

    K. A. Attia

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  1. K. A. Attia
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Correspondence to K. A. Attia.

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Attia, K.A. Co-infection VIH-VHB au sud du Sahara : données épidémiologiques, cliniques et thérapeutiques. J Afr Hepato Gastroenterol 1, 51–53 (2007). https://doi.org/10.1007/s12157-007-0011-z

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  • DOI: https://doi.org/10.1007/s12157-007-0011-z

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