{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:43:28Z","timestamp":1781073808803,"version":"3.54.1"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Zanzibar, a low\u2010resource semiautonomous region of Tanzania, has an estimated prevalence of hepatitis B virus (HBV) infections of 3.6%. To assess the feasibility of care and treatment, a 5\u2010year hepatitis B demonstration project was implemented in Zanzibar during January 2017\u2013December 2021, following the 2015 WHO HBV care and treatment guidelines. Participants included adults (aged\u2009\u2265\u200918\u2009years) who tested positive for HBV surface antigen and tested negative for HIV and hepatitis C antibody. Participants were examined for clinical signs of liver disease and testing was conducted at baseline to assess treatment eligibility and every 6\u201312\u2009months thereafter. Tenofovir disoproxil fumarate (TDF) was provided at no cost to treatment\u2010eligible participants. Clinical and laboratory data were analysed to assess improvement in proximal disease outcomes. Among 596 participants enrolled, the median age was 32\u2009years (IQR 26\u201339) and 365 (61%) were male. Of those enrolled, 268 (45%) returned for \u2265\u20091 follow\u2010up visit, with a median of 511\u2009days of follow\u2010up. Overall, 58 patients initiated treatment: 15 met treatment criteria based on liver cirrhosis alone; 13 by APRI &gt;\u20091.5; among those with HBV DNA results, six met criteria based on HBV DNA levels and ALT activity; 24 met \u2265\u20092 criteria. Significant decreases in ALT activities, APRI scores and HBV DNA levels were observed among those treated. This hepatitis B care and treatment programme was demonstrated to be feasible in a low\u2010resource setting. Despite challenges, testing and linkage to care is critical to decrease the global burden of hepatitis B.<\/jats:p>","DOI":"10.1111\/jvh.14051","type":"journal-article","created":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T14:39:22Z","timestamp":1734791962000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hepatitis B Care and Treatment in Zanzibar, Tanzania: A Demonstration Project Following 2015 <scp>WHO<\/scp> Treatment Guidelines, 2017\u20132021"],"prefix":"10.1111","volume":"32","author":[{"given":"Sanaa S.","family":"Said","sequence":"first","affiliation":[{"name":"The State University of Zanzibar  Zanzibar Tanzania"},{"name":"Mnazi Mmoja Hospital  Zanzibar Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5772-7046","authenticated-orcid":false,"given":"Shaun","family":"Shadaker","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"McMahon","sequence":"additional","affiliation":[{"name":"Arctic Investigations Program Centers for Disease Control and Prevention  Anchorage Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige A.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff A.","family":"Beckett","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleem","family":"Kamili","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M.","family":"Harris","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,21]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"WHO \u201cGlobal Progress Report on HIV Viral Hepatitis and Sexually Transmitted Infections \u201d (2021) https:\/\/www.who.int\/publications\/i\/item\/9789240027077."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4239646"},{"key":"e_1_2_9_4_1","unstructured":"RAD\u2010AID \u201cTanzania Population \u201d (2022) https:\/\/rad\u2010aid.org\/wp\u2010content\/uploads\/Zanzibar_CR.pdf."},{"key":"e_1_2_9_5_1","volume-title":"Tanzania HIV Impact Survey (THIS) 2016\u20132017: Final Report","author":"Tanzania Commission for AIDS (TACAIDS) 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in Pregnancy \u201d accessed September 28 2023 https:\/\/www.who.int\/publications\/i\/item\/978\u201092\u20104\u2010000270\u20108."},{"key":"e_1_2_9_13_1","unstructured":"WHO \u201cGlobal Guidance on Criteria and Processes for Validation: Elimination of Mother\u2010to\u2010Child Transmission of HIV Syphilis and Hepatitis B Virus \u201d accessed September 28 2023 https:\/\/www.who.int\/publications\/i\/item\/9789240039360."},{"key":"e_1_2_9_14_1","unstructured":"WHO \u201cImplementation Guide for Vaccination of Health Workers \u201d accessed September 28 2023 https:\/\/www.who.int\/publications\/i\/item\/9789240052154."},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20\u20100521"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010023\u201003082\u20104"}],"container-title":["Journal of Viral 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