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Experiences from local CHB programs are needed to inform treatment guidelines and policies on the continent. Here, we present 5-year results from one of the first large-scale CHB treatment programs in sub-Saharan Africa.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Adults with CHB were enrolled in a pilot treatment program in Addis Ababa, Ethiopia, in 2015. Liver enzymes, viral markers, and transient elastography were assessed at baseline and thereafter at 6-month intervals. Tenofovir disoproxil fumarate was initiated based on the European Association for the Study of the Liver (EASL) criteria, with some modifications. Survival analysis was performed using the Kaplan\u2013Meier method.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 1303 patients were included in the program, of whom 291 (22.3%) started antiviral therapy within the initial 5\u00a0years of follow-up. Among patients on treatment, estimated 5-year hepatocellular carcinoma-free survival was 99.0% in patients without cirrhosis at baseline, compared to 88.8% in patients with compensated cirrhosis, and 54.2% in patients with decompensated cirrhosis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The risk of death was significantly higher in patients with decompensated cirrhosis at baseline (adjusted hazard ratio 44.6, 95% confidence interval 6.1\u2013328.1) and in patients older than 40\u00a0years (adjusted hazard ratio 3.7, 95% confidence interval 1.6\u20138.5). Liver stiffness declined significantly after treatment initiation; the median change from baseline after 1, 3, and 5\u00a0years of treatment was\u2009\u2212\u20094.0\u00a0kPa,\u2009\u2212\u20095.2\u00a0kPa, and\u2009\u2212\u20095.6\u00a0kPa, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This pilot program demonstrates the long-term benefits of CHB therapy in a resource-limited setting. The high mortality in patients with cirrhosis underscores the need for earlier detection of CHB and timely initiation of antiviral treatment in sub-Saharan Africa.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>The study was registered at ClinicalTrials.gov (NCT02344498) on January 26, 2015.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12916-023-03082-4","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T16:02:04Z","timestamp":1696003324000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Five-year results of a treatment program for chronic hepatitis B in Ethiopia"],"prefix":"10.1186","volume":"21","author":[{"given":"Hailemichael","family":"Desalegn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stian Magnus Staurung","family":"Orlien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Aberra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyerusalem","family":"Mamo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sine","family":"Grude","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Hommersand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nega","family":"Berhe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svein Gunnar","family":"Gundersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5966-7166","authenticated-orcid":false,"given":"Asgeir","family":"Johannessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"3082_CR1","unstructured":"WHO. 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