Almost 1 in 3 people in the world have been infected with hepatitis B virus (HBV) and currently an estimated 257 million people are infected for life. Chronic hepatitis B can lead to cirrhosis, liver failure or liver cancer (hepatocellular carcinoma). About 700,000 people die each year (i.e almost 2,000 persons per day) from chronic hepatitis B-related complications.
Without a scale-up of effective interventions, HBV will lead to 11.8 million deaths by 2030. These deaths will mainly occur in Asia and Africa, which bear the highest burden of HBV epidemic. In 2016, the United Nations General Assembly and the World Health Organization (WHO) incorporated viral hepatitis elimination in the 2030 agenda for sustainable development. Africa, which accounts for about 80 million HBV-infected people at risk of serious hepatic complications, has been identified as a priority region for research on hepatitis B due to the high burden of hepatitis B and the absence of guidelines adapted to the local setting.
PROLIFICA started in November 2011 in The Gambia and Senegal, West Africa (WATCH-B study), with the support of Imperial College London, the Medical Research Council Gambia (MRCG) unit at the London School of Hygiene and Tropical Medicine, The University Cheikh Anta Diop in Dakar, INSERM France and the international agency for research on cancer (IARC). PROLIFICA is a unique research platform in Sub-Saharan Africa and has generated high quality data that have been used by the WHO to develop guidelines and reports on viral hepatitis B in Africa. Between December 2011 and January 2014 within the PROLIFICA project we screened around 16,000 subjects for HBV in Gambia and Senegal (prevalence around 10%) and 2,108 HBV-infected patients in The Gambia (n=1,192) and Senegal (n=916) had a comprehensive liver assessment using high quality reference tests (e.g HBV DNA, liver biopsy or Fibroscan). To date 283 patients have been treated with Tenofovir Disoproxil Fumarate (TDF) for more than 5 years whilst 1,825 patients have not been treated since they did not fulfill the current international treatment criteria. Treatment is currently provided by Gileas US company. PROLIFICA has therefore generated two cohorts of patients with chronic hepatitis B. We are following these patients in order to assess the rate of liver disease progression in HBV-infected individuals exposed to the African environment (MATCH-B study).