Anamnestic Findings and Alanine Aminotransferase Predict Accurately Chronic HBs Antigen Carriers among Black Africans in Côte d’Ivoire (West Africa)
Clinical Medicine Research
Volume 3, Issue 2, March 2014, Pages: 12-16
Received: Jan. 4, 2014; Published: Feb. 20, 2014
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Authors
Alassan K. Mahassadi, Programme national de lutte contre les hépatites virales en Côte d’Ivoire (PNLHV); Service d’hépato-gastroentérologie, CHU de Yopougon
Emile Allah-Kouadio, Programme national de lutte contre les hépatites virales en Côte d’Ivoire (PNLHV); Service d’hépato-gastroentérologie, CHU de Cocody
Constant Assi, Programme national de lutte contre les hépatites virales en Côte d’Ivoire (PNLHV); Service d’hépato-gastroentérologie, CHU de Cocody
Fulgence M. Y. Bathaix, Programme national de lutte contre les hépatites virales en Côte d’Ivoire (PNLHV); Service d’hépato-gastroentérologie, CHU de Yopougon
Ahmad Coulibaly, Programme national de lutte contre les hépatites virales en Côte d’Ivoire (PNLHV); Service d’hépato-gastroentérologie, CHU de Cocody
Hortense Hovi, Dispensaire du groupe de presse « Fraternité Matin »
Mathieu B. Camara, Service d’hépato-gastroentérologie, CHU de Cocody
Thérèse Y. Ndri, Service d’hépato-gastroentérologie, CHU de Yopougon
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Abstract
Background: The high burden of viral hepatitis B (HBV) remains a challenge in Côte d’Ivoire where patients are mostly seen in hospital at the end stage of the disease. Aim: This cross sectional study is aimed at assessing the usefulness of anamnestic findings, clinical and biological factors in predicting chronic hepatitis B surface antigen (HBsAg) carriers in clinical practice. Patients and methods: The study was conducted in 230 workers (median age: 39 years, female: 20%) of government press enterprise (GPE) in 2010. Socio-demographic, clinical and biological parameters were collected. Chronic HBsAg carrier was defined as serum HBsAg positivity after 2 assessments within 6 months interval. Diagnostic accuracy of predictive factors was determined by multivariate logistic regression. Results: The prevalence of chronic HBsAg was 12.6% [95%CI: 8.61-17.60]. Chronic HBsAg carriers frequently expressed a history of hepatitis (13.8 vs 2.5%, p=0.003), or jaundice (37.9 vs 14.3, p=0.003), had slightly high level of AST (33 vs 25.5 IU/L, p=.004) and ALT (31.5 vs 22, p=<0.0001) compared to non-carriers. In multivariate analysis, age (OR: 0.93, p=0.03), history of hepatitis (OR=8.18, p=0.005), unsafe injection with boiled syringe (OR: 3.41, p=0.03), and ALT (OR=1.03, p=0.002) were predictive factors of chronic HBsAg carriers. The model yielded an AUROC of 0.793±0.06. With a cut-off <0.125, the model allowed predicting chronic HBsAg carrier with a sensitivity and negative predictive value of 78.6 and 96.1% respectively. Among 28 chronic HBsAg carriers 22(78.6%) were correctly predicted and 6(21.4%) were false negative. With a cut-off >0.5, the model showed a specificity, positive and negative predictive values of 99, 66.7 and 88.9% respectively. The model correctly classified 192(99%) workers as non-chronic HBsAg carriers and 2(1%) were misclassified. Conclusion: This study suggests that age, history of hepatitis, unsafe injection with boiled syringe combined with ALT could be used to predict chronic HBsAg carrier in Côte d’Ivoire and other endemic areas in Africa.
Keywords
HBs Antigen, ALT, Hepatitis B, Sub-Saharan Africa
To cite this article
Alassan K. Mahassadi, Emile Allah-Kouadio, Constant Assi, Fulgence M. Y. Bathaix, Ahmad Coulibaly, Hortense Hovi, Mathieu B. Camara, Thérèse Y. Ndri, Anamnestic Findings and Alanine Aminotransferase Predict Accurately Chronic HBs Antigen Carriers among Black Africans in Côte d’Ivoire (West Africa), Clinical Medicine Research. Vol. 3, No. 2, 2014, pp. 12-16. doi: 10.11648/j.cmr.20140302.11
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