Publications
139 results found
Abellona MRU, Mark P, Ladep N, et al., 2018, Elucidating Serum and Urinary Hepatocellular Carcinoma Diagnostic Biomarker Panels: Insight from the United Kingdom and West Africa, Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases (AASLD) / Liver Meeting, Publisher: WILEY, Pages: 37A-38A, ISSN: 0270-9139
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- Citations: 1
Maurice J, Tsochatzis E, Nelson M, et al., 2018, Diagnostic accuracy of non-invasive markers of fibrosis in HIV mono-infected patients with histologically confirmed NAFLD, 4th Joint Conference of the British HIV Association (BHIVA) with the British Association for Sexual Health and HIV (BASHH), Publisher: WILEY, Pages: S75-S76, ISSN: 1464-2662
Lemoine M, Cooke GS, 2018, The Egyptian hepatitis C programme: a model of HCV treatment intervention?, Journal of Hepatology, Vol: 68, Pages: 638-639, ISSN: 0168-8278
Maurice J, Kelleher P, Nelson M, et al., 2018, NAFLD in HIV mono-infection is a consequence of insulin resistance but not bacterial translocation, International Liver Congress (ILC), Publisher: ELSEVIER SCIENCE BV, Pages: S358-S358, ISSN: 0168-8278
Lemoine M, Mohamed Z, Chevaliez S, et al., 2018, Role of hepatitis C virus core antigen assay in hepatitis C care in Africa, LANCET GASTROENTEROLOGY & HEPATOLOGY, Vol: 3, Pages: 223-224, ISSN: 2468-1253
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- Citations: 2
Garvey L, Atzori S, Williamson M, et al., 2018, A cross-sectional study to investigate spleen stiffness via acoustic radiation force impulse (arfi) elastography in HIV-infected patients with non cirrhotic portal hypertension, Publisher: WILEY, Pages: S71-S72, ISSN: 1464-2662
Ndow G, Cohen D, Shimakawa Y, et al., 2018, Occult Hepatitis B infection is frequent and a risk factor of advanced liver disease in The Gambia, West Africa, International Liver Congress (ILC), Publisher: ELSEVIER SCIENCE BV, Pages: S485-S486, ISSN: 0168-8278
Abellona U, Mark DP, Oleribe O, et al., 2018, Towards elucidating a universal panel of diagnostic biomarkers for early hepatocellular carcinoma, International Liver Congress (ILC), Publisher: ELSEVIER SCIENCE BV, Pages: S433-S433, ISSN: 0168-8278
Boyer S, Baudoin M, Nishimwe M, et al., 2018, Cost-effectiveness of Sofosbuvir-based hepatitis C regimens in Central and West Africa (ANRS 12342), International Liver Congress (ILC), Publisher: ELSEVIER SCIENCE BV, Pages: S184-S185, ISSN: 0168-8278
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Boyer S, Baudoin M, Nishimwe M, et al., 2018, Long-term effectiveness of Sofosbuvir-based hepatitis C regimens in Central and West Africa (ANRS 12342), International Liver Congress (ILC), Publisher: ELSEVIER SCIENCE BV, Pages: S183-S184, ISSN: 0168-8278
Shimakawa Y, Seck A, Nayagam S, et al., 2018, Screening strategies to prevent mother-to-child transmission of hepatitis B in sub-Saharan Africa, LANCET GASTROENTEROLOGY & HEPATOLOGY, Vol: 3, Pages: 222-223, ISSN: 2468-1253
Oleribe OO, Salako BL, Akpalu A, et al., 2018, Public private partnership in in-service training of physicians: the millennium development goal 6-partnership for African clinical training (M-PACT) approach, PAN AFRICAN MEDICAL JOURNAL, Vol: 29, ISSN: 1937-8688
Introduction: in-service training of healthcare workers is essential for improving healthcare services and outcome. Methods: the Millennium Development Goal (MDG) 6 Partnership for African Clinical Training (M-PACT) program was an innovative in-service training approach designed and implemented by the Royal College of Physicians (RCP) and West African College of Physicians (WACP) with funding from Eco Bank Foundation. The goal was to develop sustainable capacity to tackle MDG 6 targets in West Africa through better postgraduate medical education. Five training centres were establised: Nigeria (Abuja, Ibadan), Ghana (Accra), Senegal (Dakar) and Sierra Leone (Freetown) for training 681 physicians from across West Africa. A curriculum jointly designed by the RCP-WACP team was used to deliver biannual 5-day training courses over a 3-year period. Results: of 602 trained in clinical medicine, 358 (59.5%) were males and 535 (88.9%) were from hosting countries. 472 (78.4%) of participants received travel bursaries to participate, while 318 (52.8%) were residents in Internal Medicine in the respective institutions. Accra had the highest number of participants (29.7%) followed by Ibadan, (28.7%), Dakar, (24.9%), Abuja, (11.0%) and Freetown, (5.6%). Pre-course clinical knowledge scores ranged from 35.1% in the Freetown Course to 63.8% in Accra Course 1; whereas post-course scores ranged from 50.5% in the Freetown course to 73.8% in Accra course 1. Conclusion: M-PACT made a positive impact to quality and outcome of healthcare services in the region and is a model for continued improvement for healthcare outcomes, e.g malaria, HIV and TB incidence and mortality in West Africa.
Nayagam S, Sicuri E, Lemoine M, et al., 2017, Economic evaluations of HBV testing and treatment strategies and applicability to low and middle-income countries, BMC Infectious Diseases, Vol: 17, Pages: 107-116, ISSN: 1471-2334
Background: Many people living with chronic HBV infection remain undiagnosed until later stages of disease.Increasing testing and treatment rates form part of the strategy to respond to the WHO goal of eliminating viralhepatitis as a public health threat by 2030. However, achieving these ambitious targets is dependent on findingeffective and cost-effective methods of scale up strategies. The aim of this study was to undertake a narrativereview of the literature on economic evaluations of testing and treatment for HBV infection, to help inform thedevelopment of the 2017 WHO Hepatitis Testing Guidelines.Methods: We undertook a focussed literature review for economic evaluations on testing for HBV accompanied byantiviral treatment. The search was carried out in Pubmed and included only articles published after 2000 and writtenin English. We narratively synthesise the results and discuss the key drivers of cost-effectiveness and their applicabilityto low and middle-income countries (LMICs).Results: Nine published studies were included in this review, only one of which was performed in a low or middleincomesetting in West Africa. Eight studies were performed in high-income settings, seven among high risk groupsand one among the general population. The studies were heterogeneous in many respects including the populationand testing strategy under consideration, model structure and baselines parameters, willingness to pay thresholds andoutcome measures used. However, most studies found HBV testing and treatment to be cost-effective, even at lowHBsAg prevalence levels.Conclusions: Currently economic evaluations of HBV testing and treatment strategies in LMICs is lacking, thereforelimiting the ability to provide formal recommendations on the basis of cost-effectiveness alone. Further implementationresearch is needed in order to help guide national policy planning.
Mohamed Z, Mbwambo J, Shimakawa Y, et al., 2017, Clinical utility of HCV core antigen detection and quantification using serum samples and dried blood spots in people who inject drugs in Dar-es-Salaam, Tanzania, Journal of the International AIDS Society, Vol: 20, ISSN: 1758-2652
Introduction: A lack of access to hepatitis C virus (HCV) diagnostics is a significant barrier to achieving the World HealthOrganization 2030 global elimination goal. HCV core antigen (HCVcAg) quantification and dried blood spot (DBS) areappealing alternatives to conventional HCV serology and nucleic acid testing (NAT) for resource-constraint settings, particu-larly in difficult-to-reach populations. We assessed the accuracy of serum and DBS HCVcAg testing in people who inject drugsin Tanzania using HCV NAT as a reference.Method: Between May and July 2015, consecutive HCV-seropositive patients enrolled in the local opioid substitutiontreatment centre were invited to participate in the study. All had HCV RNA detection (Roche Molecular Systems,Pleasanton, CA, USA), genotyping (NS5B gene phylogenetic analysis) and HCVcAg on blood samples and DBS (Architectassay; Abbott Diagnostics, Chicago, IL, USA).Results: Out of 153 HCV-seropositive individuals, 65 (42.5%) and 15 (9.8%) were co-infected with HIV (41 (63%) were on anti-retroviral therapy (ARVs)) and hepatitis B respectively. In total, 116 were viraemic, median viral load of 5.7 (Interquartilerange (IQR); 4.0–6.3) log iU/ml (75 (68.2%) were genotype 1a, 35 (31.8%) genotype 4a). The median alanine transaminase(ALT) (iU/l), aspartate transaminase (AST) (iU/l) and gamma-glutamyl transferase (GGT) (iU/l) were 35 (IQR; 23–51), 46 (32–57) and 69 (35–151) respectively. For the quantification of HCV RNA, serum HCVcAg had a sensitivity at 99.1% and aspecificity at 94.1%, with an area under the receiver operating curve (AUROC) at 0.99 (95% CI 0.98–1.00). DBS HCVcAg had asensitivity of 76.1% and a specificity of 97.3%, with an AUROC of 0.87 (95% CI 0.83–0.92). HCVcAg performance did not differby HIV co-infection or HCV genotype.Conclusions: Our study suggests that HCVcAg testing in serum is an excellent alternative to HCV polymerase chain reaction inAfrica. Although HCVcAg detection and quanti
Lemoine M, Lacombe K, Bastard JP, et al., 2017, Metabolic syndrome and obesity are the cornerstones of liver fibrosis in HIV-monoinfected patients, AIDS, Vol: 31, Pages: 1955-1964, ISSN: 0269-9370
Background: Metabolic syndrome (MetS) and nonalcoholic fatty liver disease have become a common finding in HIV-infected patients. However, the severity, risk factors and pathogenesis of liver fibrosis in this population have been poorly documented.Objectives: To assess the impact of MetS on liver fibrosis and analyze the association between MetS, liver fibrosis and markers of adipose tissue and macrophage activation.Methods: In a matched cohort of HIV-1-monoinfected patients with and without MetS, after exclusion of other causes of liver disease, we assessed liver stiffness measurement and measured levels of serum adipokines, homeostasis model assessment index and soluble CD163 (sCD163) and CD14 as markers of fat, insulin resistance and macrophage/monocyte activation, respectively.Results: A total of 468 HIV-monoinfected individuals were enrolled; 405 (203 with MetS/202 without MetS) were analyzed. Patients with MetS were older and 49% had insulin resistance. The prevalence of significant liver fibrosis (≥F2) was higher in patients with MetS [25.1%, 95% confidence interval (19.3–31.2)] compared with those without MetS [7.9%, (4.6–12.5), P < 0.0001]. In multivariable analysis, obesity [odds ratio: 3.9 (95% CI 2.1–7.1)] and homeostasis model assessment [1.1 (1.06–1.2)] were independent factors of significant fibrosis and remained associated after adjustment on MetS. Serum levels of adipokines and sCD163 were significantly associated with the degree of liver fibrosis. When adjusted on MetS, leptin and sCD163 remained strongly associated with fibrosis/cirrhosis, whereas HIV parameters and antiretroviral therapy were not.Conclusion: In HIV-monoinfected patients, MetS is an important risk factor of liver fibrosis. Adipose tissue and macrophage activation might be key players in the development of liver fibrosis but the exact mechanisms need to be elucidated.
Oleribe OO, Kirby K, Oladipo O, et al., 2017, The Millennium Development goal 6 Partnership for African Clinical Training (M-PACT) Clinical Course: a six months' post training impact survey, Annals of Medical and Health Sciences Research, Vol: 7, Pages: 284-288, ISSN: 2141-9248
Context: The Royal College of Physicians of London and the West African College of Physicians have a long history of collaboration with a focus on postgraduate education. The Millennium Development Goal 6 Partnership for African Clinical Training (M-PACT) Clinical Course project was undertaken to improve the theoretical and practical knowledge base in the pertinent diseases of the Millennium Developments Goals (MDG 6): Tuberculosis, HIV/AIDS, Malaria, and medical leadership. Aim: To assess the impact of the training on everyday practice of the participants at least six months’ post training. Material and methods: A cross-sectional descriptive survey was used to execute this study between April to May 2016. A self-administered questionnaire was used for this study. Questionnaires were distributed using SurveyMonkey®. Data were analyzed using SurveyMonkey® Analysis Tool and Microsoft Excel Sheet. Results: A total of 73 trainees from six different courses responded to the survey. Majority (76.06%) of all respondents were from tertiary facilities. The survey revealed a positive influence on the clinical practice of participants, on prescription patterns, diagnostic approaches, and case findings in the community. A number of new concepts such as “Doctors as Leaders” were learned by the participants with over 80% of respondents desiring further trainings in leadership. Conclusion: The M-PACT courses had changed the knowledge base of the participants with more confident diagnosis, management and prescribing reported as a result. We suggest that this format for postgraduate teaching is important not only in West Africa, but throughout sub-Saharan Africa.
Maurice JB, Patel A, Scott AJ, et al., 2017, Prevalence and risk factors of nonalcoholic fatty liver disease in HIV-monoinfection, AIDS, Vol: 31, Pages: 1621-1632, ISSN: 0269-9370
Shimakawa Y, Pourette D, Bainilago L, et al., 2017, Improving communication about viral hepatitis in Africa, LANCET INFECTIOUS DISEASES, Vol: 17, Pages: 688-689, ISSN: 1473-3099
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Lemoine M, Lacombe K, Bastard J-P, et al., 2017, Metabolic syndrome and obesity are the cornerstones of liver fibrosis in HIV-monoinfected patients: results of the METAFIB study, Publisher: JOHN WILEY & SONS LTD, Pages: 14-15
Ndow G, Gore ML, Shimakawa Y, et al., 2017, Hepatitis B testing and treatment in HIV patients in The Gambia - compliance with international guidelines and clinical outcomes, PLOS One, Vol: 12, ISSN: 1932-6203
BackgroundCompliance with WHO guidelines on HBV screening and treatment in HIV-coinfected patients is often challenging in resource limited countries and has been poorly assessed in sub-Saharan Africa.MethodsBetween 2015 and 2016, we assessed physician’s compliance with WHO guidelines on HIV-HBV coinfection in the largest HIV clinic in The Gambia, and the hepatic outcomes in HIV-HBV coinfected patients as compared to randomly selected HIV-monoinfected controls.Results870 HIV-infected patients regularly seen in this clinic agreed to participate in our study. Only 187 (21.5%, 95% CI 18.8–24.3) had previously been screened for HBsAg, 23 (12.3%, 95% CI 8.0–17.9) were positive of whom none had liver assessment and only 6 (26.1%) had received Tenofovir. Our HBV testing intervention was accepted by all participants and found 94/870 (10.8%, 95% CI 8.8–13.1) positive, 78 of whom underwent full liver assessment along with 40 HBsAg-negative controls. At the time of liver assessment, 61/78 (78.2%) HIV-HBV coinfected patients received ART with 7 (11.5%) on Tenofovir and 54 (88.5%) on Lamivudine alone. HIV-HBV coinfected patients had higher APRI score compared to controls (0.58 vs 0.42, p = 0.002). HBV DNA was detectable in 52/53 (98.1%) coinfected patients with 14/53 (26.4%) having HBV DNA >20,000 IU/L. 10/12 (83.3%) had at least one detectable 3TC-associated HBV resistance, which tended to be associated with increase in liver fibrosis after adjusting for age and sex (p = 0.05).ConclusionsCompliance with HBV testing and treatment guidelines is poor in this Gambian HIV programme putting coinfected patients at risk of liver complications. However, the excellent uptake of HBV screening and linkage to care in our study suggests feasible improvements.
Shimakawa Y, Lemoine M, 2017, Early age at diagnosis of hepatocellular carcinoma in sub-Saharan Africa., Lancet Gastroenterology and Hepatology, Vol: 2, Pages: 393-393, ISSN: 2468-1253
Shimakawa Y, Njie R, Vray M, et al., 2017, Development and validation of a simple score to select HBV-infected patients for antiviral therapy in Africa, International Liver Congress / 52nd Annual Meeting of the European-Association-for-the-Study-of-the-Liver, Publisher: ELSEVIER SCIENCE BV, Pages: S686-S686, ISSN: 0168-8278
Maurice J, Judge R, Baldry M, et al., 2017, NAFLD in HIV is associated with age and metabolic factors but not HIV-specific parameters in a prospectively characterised cohort, Publisher: WILEY, Pages: 41-42, ISSN: 1464-2662
Castera-Guy J, Rubbo P-A, Kania D, et al., 2017, Semi-quantitative real-time PCR: A useful approach to identify persons with low replicative chronic hepatitis B, JOURNAL OF VIROLOGICAL METHODS, Vol: 244, Pages: 1-3, ISSN: 0166-0934
Mohamed Z, Mbwambo J, Rwegasha J, et al., 2017, High prevalence of chronic hepatitis C in injecting drug users in Tanzania, East Africa: a neglected burden of disease, International Liver Congress / 52nd Annual Meeting of the European-Association-for-the-Study-of-the-Liver, Publisher: ELSEVIER SCIENCE BV, Pages: S416-S416, ISSN: 0168-8278
Lemoine M, Lacombe K, Bastard J-P, et al., 2017, Metabolic syndrome and obesity are the cornerstones of liver fibrosis in HIV-monoinfected patients, International Liver Congress / 52nd Annual Meeting of the European-Association-for-the-Study-of-the-Liver, Publisher: ELSEVIER SCIENCE BV, Pages: S424-S425, ISSN: 0168-8278
Lemoine M, 2016, Semi-quantitative real-time PCR: A useful approach to identify persons with low replicative chronic hepatitis B., Journal of Virological Methods
Nayagam S, Conteh L, Sicuri E, et al., 2016, Community-based screening and treatment for chronic hepatitis B in sub-Saharan Africa - Authors' reply., Lancet Global Health, Vol: 5, Pages: e35-e35, ISSN: 2214-109X
Shimakawa Y, Lemoine M, Njai HF, et al., 2016, Natural history of chronic HBV infection in West Africa: a longitudinal population-based study from The Gambia, Gut, Vol: 65, Pages: 2007-2016, ISSN: 0017-5749
Background The natural history of chronic HBV infection in sub-Saharan Africa is unknown. Data are required to inform WHO guidelines that are currently based on studies in Europe and Asia.Methods Between 1974 and 2008, serosurveys were repeated in two Gambian villages, and an open cohort of treatment-naive chronic HBV carriers was recruited. Participants were followed to estimate the rates of hepatitis B e (HBeAg) and surface antigen (HBsAg) clearance and incidence of hepatocellular carcinoma (HCC). In 2012–2013, a comprehensive liver assessment was conducted to estimate the prevalence of severe liver disease.Results 405 chronic carriers (95% genotype E), recruited at a median age of 10.8 years, were followed for a median length of 28.4 years. Annually, 7.4% (95% CI 6.3% to 8.8%) cleared HBeAg and 1.0% (0.8% to 1.2%) cleared HBsAg. The incidence of HCC was 55.5/100 000 carrier-years (95% CI 24.9 to 123.5). In the 2012–2013 survey (n=301), 5.5% (95% CI 3.4% to 9.0%) had significant liver fibrosis. HBV genotype A (versus E), chronic aflatoxin B1 exposure and an HBsAg-positive mother, a proxy for mother-to-infant transmission, were risk factors for liver fibrosis. A small proportion (16.0%) of chronic carriers were infected via mother-to-infant transmission; however, this population represented a large proportion (63.0%) of the cases requiring antiviral therapy.Conclusions The incidence of HCC among chronic HBV carriers in West Africa was higher than that in Europe but lower than rates in East Asia. High risk of severe liver disease among the few who are infected by their mothers underlines the importance of interrupting perinatal transmission in sub-Saharan Africa.
Ghosh S, Sow A, Guillot C, et al., 2016, Implementation of an in-house quantitative real-time polymerase chain reaction method for Hepatitis B virus quantification in West African countries, JOURNAL OF VIRAL HEPATITIS, Vol: 23, Pages: 897-904, ISSN: 1352-0504
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