A recent study has explored the outcomes for adults with chronic hepatitis B (HBV) in Gambia who are not eligible for antiviral treatment, shedding light on the low risk of severe liver complications in this group.
Chronic HBV affects roughly 300 million people globally, but current guidelines only recommend treatment for a small percentage, leaving most people without access to antiviral therapy.
The research, conducted through the PROLIFICA cohort study, analyzed over 800 untreated individuals with chronic HBV in Gambia. It found that these patients had a low risk of death or progression to liver cancer over a six-year period, compared to the general Gambian population. Key factors linked to mortality in these individuals included existing liver disease, high blood pressure, and co-infection with hepatitis C.
Lead researcher Dr. Gibril Ndow noted that the findings raise questions about the necessity of expanding HBV treatment in Africa, as most untreated patients had stable conditions. Although 7% of participants showed signs of disease progression, none developed liver cancer or advanced cirrhosis. Viral load at diagnosis was identified as the main predictor of disease progression.
Senior author Professor Maud Lemoine emphasized the need for affordable viral load testing in Africa to help identify patients at higher risk. The study’s findings contribute to the ongoing debate on HBV treatment criteria in low-resource settings, highlighting the importance of long-term research to refine guidelines for chronic hepatitis B management in Africa.
This research marks an important step in understanding how chronic hepatitis B affects untreated populations and could guide future healthcare policies aimed at prioritizing those most at risk of serious liver disease.
