clove and Hepatitis-C

Our work aimed to assess the efficacy and safety of direct-acting antiviral drugs in the treatment of hepatitis C in Madagascar.. This retrospective clinical study was carried out from March 2018 to February 2020 in the hepato-gastro-enterology department of the University Hospital Center Joseph Raseta de Befelatanana.. A total of 35 patients were included, out of which 24 received sofosbuvir/ledipasvir ± ribavirin, 10 sofosbuvir/ribavirin and one sofosbuvir/velpatasvir. Thirty-three patients were naïve to the treatment and 2 patients were initially treated with the sofosbuvir/ledipasvir combination. The sustained virologic response was 94% (33/35) in the general population, 23/25 in cirrhotic patients and 10/10 in non-cirrhotic patients. The sustained virologic response was 22/24 for sofosbuvir/ledipasvir ± ribavirin, 10/10 for sofosbuvir/ribavirin and 1/1 for sofosbuvir/velpatasvir. Adverse effects were observed in 13 patients, mainly asthenia and insomnia.. The small number of patients with hepatitis C treatments and their limited financial resources are the main limits of this survey.. Direct-acting antivirals are effective and characterized by good tolerance in these Malagasy hepatitis C patients.

Topics: Antiviral Agents; Drug Therapy, Combination; Genotype; Hepacivirus; Hepatitis C; Hepatitis C, Chronic; Hospitals, Teaching; Humans; Madagascar; Retrospective Studies; Ribavirin; Sofosbuvir

Due to anemia and maternal, childhood and infancy diseases, blood transfusion is one of the most important medical cares given in sub-Saharan Africa, including Madagascar. World Health Organization encourages worldwide countries to maximize transfusion security. Until now, there was no data within a large population of blood donors. Therefore, the aim of this study was to assess the prevalence and time trends of hepatitis C virus (HCV) among all first-time blood donors coming into the National Centre of Transfusion Supply in Antananarivo.. This retrospective study was conducted at the National Centre of Transfusion Supply in Antananarivo from 2003 to May 2009. We looked up to all recorded results of systematic screening of blood donor candidates and we took data about all first-time blood donors, including age and gender. Forty-seven thousand five hundred and ten of 47,636 first-time blood donors were retained, the others were excluded due to lack of some data.. The mean age of our donors was 33.3 years (35.8 for male, and 32.6 for female; P<<0.05). Eighty percent were male (38,225/47,510). HCV prevalence was 0.65% during the period of study and HCV positive donor candidates were older than HCV negative (mean age: 39.1 vs. 33.2; P<<0.05). It was in fact stable from 2003 to 2007, and then decreased. HCV prevalence was higher in women than in men (0.9 vs. 0.6; P<0.05), and it increased by age (P<0.05).. Our study found a low prevalence of HCV among blood donors compared to many countries in Africa.

Topics: Adult; Blood Donors; Blood Safety; Donor Selection; Female; Hepacivirus; Hepatitis C; Hepatitis C Antibodies; Humans; Madagascar; Male; Mass Screening; Middle Aged; Reagent Kits, Diagnostic; Retrospective Studies; Seroepidemiologic Studies; Urban Population; Young Adult

The risk factors for the transmission of HCV vary substantially between countries and geographic regions. The overall prevalence in south and east Africa region has been estimated to be 1.6% but limited information about the epidemiology of HCV infection in Madagascar is available. A cross-sectional survey for hepatitis C antibodies was conducted in 2,169 subjects of the general population of Antananarivo to determine seroprevalence of hepatitis C and associated risk factors.. The overall seroprevalence was 1.2% (25/2,169). The prevalence did not differ significantly according to gender but it increased with age (Chi2 tendency test, p < 10-5). The variable history of hospitalization, previous therapeutic injections, dental treatment, intravenous drug use, and abnormal ALT and AST were statistically significantly related with the presence of HCV antibodies. No relationship with past history of blood transfusion was observed.. HCV prevalence in Madagascar seems to be similar to that in most other east African countries. Age appears to be an important risk factor. Iatrogenic causes of HCV transmission need to be further evaluated because all HCV cases had a history of receiving therapeutic injections and data suggested a cumulative effect in relation with therapeutic injections.

Topics: Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Cross-Sectional Studies; Female; Genotype; Hepacivirus; Hepatitis C; Hepatitis C Antibodies; Humans; Logistic Models; Madagascar; Male; Middle Aged; Risk Factors; Seroepidemiologic Studies; Urban Health

The prevalence of hepatitis C virus (HCV) genotypes in Madagascar is not well known. Serum samples were obtained from 2,169 individuals selected by random sampling in the population living in Antananarivo city. Using HCV antibody test (Monolisa anti-HCV Plus version 2), 36 (1.7%) of the 2,169 samples were positive. The presence of HCV RNA was determined by using reverse transcription polymerase chain reaction amplifying the 5'-untranslated region (UTR): HCV RNA was detected in 17 of the 36 HCV antibodies positive samples. The genotype was determined using BLAST tool with another 5'-UTR fragment. The phylogenetic analysis of the polymerase (NS5b) and envelope (E1/E2) fragment sequences showed a low level of diversity compared to the high diversity in other African countries: subtype 1b (nine cases, 52.9%) and genotype 2 (eight cases, 47.1%) including subtype 2b (six cases), subtype 2k (one case), and one unclassified subtype. BLAST search with the 5'-UTR fragment sequence of this unclassified subtype identified that strain as subtype 2a.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Genotype; Hepacivirus; Hepatitis C; Humans; Madagascar; Male; Middle Aged; Phylogeny; Population Surveillance; RNA, Viral

The achievement of a sera collection representative for the general population > or = 1 year in 1994 allowed the assessment of the seroprevalence of Hepatitis C virus infection (HCV) in Antananarivo and Toamasina provinces which represent 45% of the total population of Madagascar. The overall sero-prevalence was 1.2% among the 921 tested sera. The prevalence was not significantly different according to sex, but it increased according to the age. The absence of positive children was an argument in consideration of the low importance of mother-to-infant transmission in the epidemiology of HCV. A significant relationship was observed with past history of blood transfusion. This point is a well established idea that reminds the interest of the detection of positive individuals for anti-HCV antibodies. The seroprevalence observed in our study could be considered as moderate. It is close to the values recorded in Europe or in Japan, and much lower than those observed in Equatorial Africa.

Topics: Adolescent; Adult; Age Distribution; Child; Child, Preschool; Female; Hepatitis C; Humans; Infant; Madagascar; Male; Middle Aged; Population Surveillance; Prevalence; Seroepidemiologic Studies; Sex Distribution; Transfusion Reaction

Hepatocellular carcinoma (HCC) etiology and incidence in Madagascar are not well established. The work presented here is the first documented study on HCC in Madagascar. The study was undertaken at the Centre Hospitalier de Soavinandriana, Antananarivo, from October 1995 to October 1996. Hepatocellular carcinoma was reported in 19 out of 22 patients with liver tumor included in the study. In 6 cases, patients developed post alcoholic cirrhosis HCC. Hepatitis B virus markers were detected in 48% of cases (13/19). The HBs Ag was detected in 42% of cases (8/19) in association with HBe Ag in 16% of cases (3/19), and hepatitis C virus antibodies in 11% of cases (2/18). In 3 cases, the etiology remained unknown. Hepatocellular carcinoma appeared the most frequent liver cancer, mainly due to post-hepatitis B cirrhosis. The introduction of hepatitis B vaccine in EPI (Expanded Program of Immunization) is recommended in order to reduce the percentage of hepatitis B virus carriers in the malagasy population and furthermore the incidence of HCC.

Topics: Adolescent; Adult; Age Distribution; Aged; Biopsy, Needle; Carcinoma, Hepatocellular; Child; Child, Preschool; Female; Hepatitis B; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis C; Hepatitis C Antibodies; Humans; Liver Neoplasms; Madagascar; Male; Middle Aged; Seroepidemiologic Studies; Sex Distribution

The first serological survey of hepatitis A, B and C virus infection was carried out in Madagascar during 1993 in two rural villages (653 sera) of the middle-west. This study shows a high frequency of positivity of hepatitis A virus markers (94.9%). Hepatitis A is acquired in early childhood. The data show the high frequency of positivity of hepatitis B (HBV) markers: in the two villages 72.5% and 89.8% have one marker, and seroprevalence of HBs antigene is 18.9% and 30.5%. Hepatitis B also is acquired in early childhood. The data show that not only hepatitis A and B but also hepatitis C is highly prevalent (2.2% and 5.8%). There was an increase in HCV antibody prevalence with age.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Hepacivirus; Hepatitis A; Hepatitis Antibodies; Hepatitis B; Hepatitis B Antibodies; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis C; Hepatovirus; Humans; Infant; Madagascar; Male; Rural Population