Simplification of viral hepatitis screening and diagnosis

Most of sub-Saharan African countries are suffering from severe restriction in health care resources and many infected people with viral hepatitis live in rural areas far from the central medical centers. To scale up and decentralize screening, clinical assessment and treatment services in low and middle income countries, it is essential to develop simple and validated diagnostic tests that are feasible and affordable in these contexts. The PROLIFICA group aims to fill this gap. For several years, our group has been working on the development and validation of simplified diagnostic tools:

I Chronic hepatitis B

1. We have developed and implemented a HBV in-house PCR at low cost (Ghosh et al. J Viral Hep 2016)
2. Transient elastography (Fibroscan) using portable machine in the field is accurate to screen patients for significant liver fibrosis and cirrhosis  (Lemoine et al Gut 2016)
3. We developed the new score the gammaglutamyl transferase to platelet ratio (GPR) (Lemoine et al Gut 2016)
4. We developed a score called TREAT-B, free of HBV DNA measurement to identify HBV-infected patients in need of treatment in Africa- This is the first score like this in Africa (Shimakawa et al. J hepatol 2018), see below picture.

II Chronic hepatitis C

1. We validated the clinical utility of using HCV core antigen using dry blood spots (DBS) to identify viraemic patients in East Africa (Mohamed et al. J Int AIDS society 2017).
2. We also validated the performance of the Xpert technology from finger prick in people who inject drugs in Tanzania (analysis under progress).

 Figure: The new developed TREAT-B score.