{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:52:17Z","timestamp":1791910337215,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,12]],"date-time":"2023-02-12T00:00:00Z","timestamp":1676160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Despite a high prevalence, there are few successful models for de\u2010centralizing diagnosis and treatment of chronic hepatitis B virus (HBV) infection among rural communities in Sub\u2010Saharan Africa. We report baseline characteristics and 1\u2009year retention outcomes for patients enrolled in a HBV clinic integrated within chronic disease services in a rural district hospital in Sierra Leone. We conducted a retrospective cohort study of patients with HBV infection enrolled between 30 April 2019 and 30 April 2021. Patients were eligible for 1\u2009year follow\u2010up if enrolled before 28 February 2020. Treatment eligibility at baseline was defined as cirrhosis (diagnosed by clinical criteria of decompensated cirrhosis, ultrasonographic findings or aspartate\u2010aminotransferase\u2010to\u2010platelet ratio &gt;2) or co\u2010infection with HIV or HCV. Retention in care was defined as a documented follow\u2010up visit at least 1\u2009year after enrolment. We enrolled 623 individuals in care, median age of 30\u2009years (IQR 23\u201340). Of 617 patients with available data, 97 (15.7%) had cirrhosis. Treatment was indicated among 113 (18.3%) patients and initiated among 74 (65.5%). Of 39 patients eligible for 1\u2009year follow\u2010up on treatment at baseline, 20 (51.3%) were retained at 1\u2009year, among whom 12 (60.0%) had documented viral suppression. Among the 232 patients not initiated on treatment eligible for 1\u2009year follow\u2010up, 75 (32.3%) were retained at 1\u2009year.<\/jats:p><jats:p>Although further interventions are required to improve outcomes, our findings demonstrated feasibility of retention and treatment of patients with HBV infection in a rural district in Sub\u2010Saharan Africa, when integrated with other chronic disease services.<\/jats:p>","DOI":"10.1111\/jvh.13812","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T07:59:37Z","timestamp":1675670377000},"page":"455-462","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Challenges of hepatitis B treatment in rural <scp>Sub\u2010Saharan<\/scp> Africa: Treatment initiation and outcomes from a public <scp>hospital\u2010based<\/scp> clinic in Kono, Sierra Leone"],"prefix":"10.1111","volume":"30","author":[{"given":"Emmanuel T.","family":"Nyama","sequence":"first","affiliation":[{"name":"Partners In Health  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4077-3476","authenticated-orcid":false,"given":"Lao\u2010Tzu","family":"Allan\u2010Blitz","sequence":"additional","affiliation":[{"name":"Division of Global Health Equity: Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Department of Pediatrics Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remy","family":"Bitwayiki","sequence":"additional","affiliation":[{"name":"Partners In Health  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Swaray","sequence":"additional","affiliation":[{"name":"Partners In Health  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Williams","family":"Lebbie","sequence":"additional","affiliation":[{"name":"Partners In Health  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lavalie","sequence":"additional","affiliation":[{"name":"Ministry of Health and Sanitation  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mhango","sequence":"additional","affiliation":[{"name":"Partners In Health  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Global Health Equity: Department of Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Pati\u00f1o","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Partners In Health  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61412-X"},{"key":"e_1_2_11_3_1","volume-title":"Global Hepatitis Report, 2017","author":"World Health Organization","year":"2017"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30295-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i42.11941"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1129-z"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-10-191"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2217\/fvl.13.11"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2019.04.002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25050"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13247"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/trv044"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2018.1474097"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2549-8"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-018-1229-x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4013-4"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00134-0"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(16)30130-9"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-08-0303"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.19-0477"},{"key":"e_1_2_11_21_1","unstructured":"World Health Organization.Hepatitis Scorecard for the WHO Africa Region Implementing the hepatitis elimination strategy.2019. 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