Liver Disease and Treatment Needs of Asymptomatic Persons Living With Hepatitis B in Senegal.

The prevalence of active hepatitis B among asymptomatic persons remains unclear in Africa. Of 1206 newly diagnosed persons in Senegal, 12.3% had significant fibrosis and 31.3% had hepatitis B virus (HBV) DNA levels >2000 IU/mL. Overall, 128 (12.9%) were eligible for antiviral therapy. Generalized HBV screening allowed the identification of a large population requiring HBV care.

Hepatitis B-related hepatocellular carcinoma in a 36-year-old pregnant woman: prognosis and management dilemma.

Management of chronic hepatitis B infection complicated by hepatocellular carcinoma (HCC) in pregnancy poses a treatment dilemma as the pregnancy accelerates disease progression and narrows the diagnostic tools and therapeutic choices. Studies have reported higher maternal and fetal losses. We share our experience with a 36-year-old pregnant woman who presented at 35 weeks' gestation with a large painful nodular liver and significant weight loss. She tested HBsAg-positive and had both clinical and laboratory features of severe liver decompensation. The abdominal ultrasound rightly described HCC on a cirrhotic background. The fetus was delivered by cesarean section but the mother died soon after.

[An unusual cause of jaundice]. / Une cause inhabituelle d'ictère.

Hepatic impairment is common during hyperthyroidism. It is most often asymptomatic. Hyperthyroidism revealed by jaundice has been rarely described in the literature. We here report the case of a 52-year old patient in Dakar (Senegal) presenting with jaundice associated with pruritus. Laboratory tests showed elevated alanine aminotransferases (1.1 N), aspartate aminotransferase(1.5 N), alkaline phosphatases (3 N), gamma glutamyl transferases (1.3 N) and bilirubinemia (22 N). Abdominal ultrasound was normal. A toxic or drug-related cause, bile duct obstruction, viral or autoimmune hepatitis as well as primary biliary cholangitis were excluded. The dosage of thyroid hormones showed elevated free T4, 24 ng/dL (9-20 ng/dL) and undetectable plasma TSH less than 0.01µUI/mL (0,35-4,94 IU/mL). TSH receptor antibodies were positive 7.04 IU/L (n < 1.75 IU/L). Thyroid ultrasound objectified diffuse homogeneous hypervascular goiter. The diagnosis of hepatic impairment secondary to Graves-Basedow disease without cardiac dysfunction was retained. Clinical outcome and laboratory test results were favorable under carbimazole. Jaundice can be an indicator of hyperthyroidism. An investivation of clinical signs and laboratory parameters for hyperthyroidism is essential in patients with unexplained jaundice.

[Viral Hepatitis B: clinical, paraclinical and evolutionary features within the Hepatogastroenterology Department at the Aristide Le Dantec Hospital: about 728 cases]. / Hépatite virale B: aspects cliniques, paracliniques et évolutifs dans le service d'Hépato Gastroentérologie de l'Hôpital Aristide Le Dantec: à propos de 728 cas.

Viral Hepatitis B is a major public health problem in sub-Saharan Africa accounting for approximately 65 million of chronic carriers and 56.000 deaths per year. Our study aims to investigate the epidemiological paraclinical, therapeutic and evolutionary features of viral hepatitis B in patients followed up in our Department and to describe their serological profiles. We conducted a retrospective, longitudinal study in the Hepatogastroenterology Department at the Aristide Le Dantec Hospital in Dakar from 2010 to 2014. We included all HBsAg positive patients followed up on an ambulatory basis or hospitalized. We collected data from 728 medical records of patients infected with Hepatitis B virus: 7 cases of acute hepatitis, 442 cases of chronic infections, 161 cases of cirrhosis and 118 cases of hepatocellular carcinoma. The average age of patients was 33 years [14 - 83 years] with a sex ratio of 2.2. The circumstances in which it was diagnosed included systematic screening (26.2%), right hypochondrium pain (23%) and donation of blood (18.6%). Fifty nine were Hepatitis B virus mono-infected and had chronic active hepatitis. Inactive carriers were 118. Serological status was undetermined in 252 patients due to clinical examination inadequacy related to economic constraints. Antiviral Hepatitis B treatment wasn't performed in 58 patients. Patients' virologic and biochemical response after 120 weeks of treatment with Tenofovir was 85% and 100% respectively. Hepatitis B virus is a major cause of liver disease in Senegal.