{"id":2683,"date":"2025-10-15T13:51:14","date_gmt":"2025-10-15T11:51:14","guid":{"rendered":"https:\/\/angh.net\/abstracts\/?p=2683"},"modified":"2025-10-15T13:51:16","modified_gmt":"2025-10-15T11:51:16","slug":"connaissances-attitudes-et-pratiques-des-medecins-dafrique-subsaharienne-francophone-relatives-a-lhepatite-b-delta","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/connaissances-attitudes-et-pratiques-des-medecins-dafrique-subsaharienne-francophone-relatives-a-lhepatite-b-delta\/","title":{"rendered":"Connaissances, attitudes et pratiques des m\u00e9decins d\u2019Afrique subsaharienne francophone relatives \u00e0 l\u2019h\u00e9patite B \u2013 Delta"},"content":{"rendered":"

2025<\/b><\/p>\n

AR Kpossou (1), JR. Ngele Efole (2,3), H.T. Zougmore (2), C. Mbendi (3), R. Sombi\u00e9 (4), D. Ouattara (4), F. Nguimtsa Tenefo (5), S. Eloumou (5), MA. Ntsama (5), LM Lawson-Ananissoh (6), H. Kissi (7), S. Doffou (7), I Ngo (7), A. Mongo Onkouo (8), J. Mimiesse (8), K. Diallo (9), D. Diallo (8), NM. Mutumwinka (2), R. Ntagirabiri (10), K. Doumbia (11), H. Sow (11), M. Gueye (12), I. Diallo (12), E. Bokana (12), A.M. Moussa (13), E.P. Itoudi (14), HZ. Elhadji Lamine (15), S. M. Camengo Police (16), G.M. Hassan (17), C. Ntirenga (18), E. Batumike (3), G. Fantognon (2), J. Sehonou (1), V. Loustaud-Ratti (19), T. Asselah (20), P. Pulwermacher (2), JF.D. Cadranel (2) (auteur pr\u00e9sentant le r\u00e9sum\u00e9). <\/em>

H\u00e9patologie <\/b> – 05\/05\/2025 – Communication orale<\/p>\n

Introduction : L\u2019h\u00e9patite B-Delta (HBD) est pr\u00e9valente dans de nombreux pays d\u2019Afrique subsaharienne. Cependant, nous ne disposons pas de donn\u00e9es \u00e9manant des m\u00e9decins exer\u00e7ant dans ces pays sur leurs modalit\u00e9s de prise en charge de l\u2019HBD. L\u2019objectif de cette \u00e9tude \u00e9tait d\u2019\u00e9valuer les connaissances, attitudes et pratiques des m\u00e9decins exer\u00e7ant dans les formations sanitaires d\u2019Afrique subsaharienne francophone, en ce qui concerne le diagnostic de l\u2019HBD et les modalit\u00e9s de traitement.<\/p>\n

Mat\u00e9riels et m\u00e9thodes : L\u2019outil d\u2019enqu\u00eate \u00e9tait un questionnaire Google Forms a \u00e9t\u00e9 envoy\u00e9 aux H\u00e9pato-gastroent\u00e9rologues (HGE), m\u00e9decins g\u00e9n\u00e9ralistes (MG), internistes (INT), infectiologues (INF), s\u00e9niors (S) ou juniors (J) de d\u00e9but mai \u00e0 fin septembre 2024 des pays d\u2019Afrique subsaharienne francophone. Etaient \u00e9valu\u00e9s : l\u2019\u00e2ge, le genre, l\u2019exp\u00e9rience de l\u2019op\u00e9rateur, le type d\u2019activit\u00e9 (lib\u00e9rale, Centre hospitalier universitaire -CHU-, H\u00f4pital g\u00e9n\u00e9ral -HG- ou m\u00e9decin junior -MJ-), la sp\u00e9cialit\u00e9 (HGE, MG, INT, INF), les modalit\u00e9s du d\u00e9pistage de l\u2019h\u00e9patite BD en fonction du statut antig\u00e8ne HBs, l\u2019utilisation des marqueurs virologiques, l\u2019\u00e9valuation de la fibrose h\u00e9patique, les indications et les modalit\u00e9s du traitement, les crit\u00e8res d\u2019\u00e9valuation du traitement, l\u2019\u00e9valuation de la fibrose apr\u00e8s traitement et les modalit\u00e9s du d\u00e9pistage du carcinome h\u00e9pato-cellulaire. Les comparaisons entre groupes ont \u00e9t\u00e9 test\u00e9es par test T de Welsh et par le test du Qui2 au seuil de significavit\u00e9 de 5 %.<\/p>\n

R\u00e9sultats : En tout, 248 r\u00e9pondants (Rs) issus de 17 pays, d\u2019\u00e2ge moyen 37,1 \u00b1 8,1 ans, 61,7% d\u2019hommes, ayant une activit\u00e9 lib\u00e9rale (12,5 %), hospitali\u00e8re en CHU (50,8%), ou en h\u00f4pital g\u00e9n\u00e9ral (21,8%), ou en statut de m\u00e9decin junior (14,9%) ont r\u00e9pondu \u00e0 l\u2019enqu\u00eate. Selon les sp\u00e9cialit\u00e9s, il y avait 66,5% d\u2019HGE, 21,0% de MG, 10,1% d\u2019INT et 2,4% d\u2019INF. Le nombre moyen de patients B-D suivis \u00e9tait de 6, sans diff\u00e9rence selon le type d\u2019activit\u00e9 (p= 0,765). La recherche d\u2019une infection delta chez tous les patients antig\u00e8ne HBs \u00e9tait r\u00e9alis\u00e9e par 71,8% des Rs. Chez les patients mono-infect\u00e9s au VHC, 82,3% des Rs ne prescrivaient pas la recherche du VHD. En cas d\u2019h\u00e9patite aigu\u00eb Ag HBs positif, 56,9 % recherchaient une HBD. Des Rs, 97,5% connaissaient le test \u00e0 prescrire pour le d\u00e9pistage du VHD qui est l\u2019anticorps anti-VHD. La recherche de l\u2019ARN du virus Delta pour affirmer la r\u00e9plication virale \u00e9tait utilis\u00e9e par 91,5% des Rs. Pour la r\u00e9alisation de la charge virale, 37,5% envoyaient au laboratoire national de r\u00e9f\u00e9rence, 10,1% dans un autre laboratoire local, 46,4% dans un laboratoire \u00e0 l\u2019\u00e9tranger et 6,05% dans le laboratoire de leur centre d\u2019exercice.
\nL\u2019\u00e9valuation de la fibrose se faisait par Fibroscan\u00ae pour 68,6 % des Rs et la ponction biopsie du foie pour 12,9 % des Rs. Un traitement \u00e9tait propos\u00e9 chez les patients \u00e0 fibrose > F2 dans 23,8 % des cas quel que soit le niveau de transaminases et chez tous les patients par 57,7 % des Rs. Les Rs proposaient un traitement par interf\u00e9ron p\u00e9gyl\u00e9 dans 39,9 % des cas, bulevirtide dans 21,8% des cas, interf\u00e9ron + bul\u00e9virtide dans 49,2% et bul\u00e9virtide + analogue dans 48,8%. Des Rs, 52,0% r\u00e9f\u00e9raient leurs patients \u00e0 un autre coll\u00e8gue de CHU. Le traitement \u00e9tait \u00e0 la charge du patient selon 76,2% des Rs.
\nParmi les crit\u00e8res d\u2019efficacit\u00e9 du traitement, une diminution ou normalisation des transaminases \u00e9tait retenue par 81,9 % des Rs, une diminution de la fibrose pour 62,9% des Rs, l\u2019annulation de la r\u00e9plication selon 76,6% et une diminution de la r\u00e9plication selon 82,3%, une n\u00e9gativation de l\u2019ARN et normalisation des transaminases selon 76,6% des Rs. En outre, 47,6 % des Rs d\u00e9finissaient la r\u00e9ponse virologique par une annulation ou une diminution de 2 log de la r\u00e9plication virale et une RVP par une disparition de l\u2019ARN apr\u00e8s 12 mois (39,9 %) ou 24 mois (17,3 %) avec activit\u00e9 des transaminases normales. Enfin, 62,9 % des r\u00e9pondants \u00e9valuaient la diminution de la fibrose apr\u00e8s traitement ; 78,6% des Rs d\u00e9pistaient le CHC en cas de cirrhose, 79,8 % en cas de F3 et 79,0% si ant\u00e9c\u00e9dent familial d\u2019h\u00e9patocarcinome.<\/p>\n

Conclusion : Les r\u00e9sultats de cette enqu\u00eate montrent une certaine m\u00e9connaissance de l\u2019HBD par les m\u00e9decins d\u2019Afrique subsaharienne francophone, li\u00e9e en partie \u00e0 des difficult\u00e9s d\u2019obtenir la charge virale Delta et des probl\u00e8mes d\u2019acc\u00e8s au traitement par bul\u00e9virtide. De fait, les modalit\u00e9s du diagnostic et la n\u00e9cessit\u00e9 du d\u00e9pistage syst\u00e9matique d\u2019une infection BD chez tous les patients antig\u00e8ne HBs doivent \u00eatre rappel\u00e9s par les soci\u00e9t\u00e9s savantes. De m\u00eame, l\u2019acc\u00e8s \u00e0 la charge virale et au traitement de l\u2019HBD devrait \u00eatre am\u00e9lior\u00e9 par les autorit\u00e9s en charge de la sant\u00e9 de ces pays.<\/p>\n

Remerciements
\nMadame Christelle LEGRAND, Groupe hospitalier Public du Sud de l\u2019Oise, Creil
\nSoci\u00e9t\u00e9 Africaine d\u2019H\u00e9pato-gastroent\u00e9rologie (SAHGE)
\nTous les participants \u00e0 l\u2019enqu\u00eate.<\/p>\n","protected":false},"excerpt":{"rendered":"

2025 AR Kpossou (1), JR. Ngele Efole (2,3), H.T. Zougmore (2), C. Mbendi (3), R. Sombi\u00e9 (4), D. Ouattara (4), F. Nguimtsa Tenefo (5), S. Eloumou (5), MA. Ntsama (5), LM Lawson-Ananissoh (6), H. Kissi (7), S. Doffou (7), I Ngo (7), A. Mongo Onkouo (8), J. Mimiesse (8), K. Diallo (9), D. Diallo (8), […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[49],"class_list":["post-2683","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-49"],"yoast_head":"\nConnaissances, attitudes et pratiques des m\u00e9decins d\u2019Afrique subsaharienne francophone relatives \u00e0 l\u2019h\u00e9patite B \u2013 Delta - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/connaissances-attitudes-et-pratiques-des-medecins-dafrique-subsaharienne-francophone-relatives-a-lhepatite-b-delta\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Connaissances, attitudes et pratiques des m\u00e9decins d\u2019Afrique subsaharienne francophone relatives \u00e0 l\u2019h\u00e9patite B \u2013 Delta - 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