Publications by authors named "Damien Cohen"

Introduction: Chronic infection with hepatitis B virus (HBV) is a leading cause of morbidity and death, especially in sub-Saharan Africa (SSA), where approximately 60 million adults are infected. More than 90% of these patients are unaware of their HBV status.

Areas Covered: Scaling-up of HBV screening programs in SSA are essential to increase diagnosis, linkage to care, and access to treatment, and will ultimately reduce HBV disease burden to achieve WHO hepatitis elimination targets.

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Article Synopsis
  • Prevalence of occult hepatitis B infection (OBI) in Africa is not well-researched, prompting a study comparing HBsAg-negative individuals with and without advanced liver disease.
  • The study found a significantly higher prevalence of OBI among patients with advanced liver disease (18.3%) compared to healthy controls (9.4%), indicating a strong association with increased risk of liver complications.
  • The findings suggest that OBI is common and presents a distinct risk for liver disease in The Gambia, highlighting the need for systematic screening in HBsAg-negative liver disease patients and potentially better outcomes from infant hepatitis B vaccination.
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Hepatitis B virus (HBV) contains a 3.2 kb DNA genome and causes acute and chronic hepatitis. HBV infection is a global health problem, with 350 million chronically infected people at increased risk of developing liver disease and hepatocellular carcinoma (HCC).

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Hepatitis B virus (HBV) classification comprises up to 10 genotypes with specific geographical distribution worldwide, further subdivided into 40 subgenotypes, which have different impacts on liver disease outcome. Though extensively studied, the classification of subgenotype A sequences remains ambiguous. This study aimed to characterize HBV isolates from West African patients and propose a more advanced classification of subgenotype A.

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The clinical utility of quantifying hepatitis B surface antigen (qHBsAg) levels in African subjects with chronic hepatitis B virus (HBV) infection has been poorly documented. From a multicentre cohort of 944 HBV-infected African patients, we aimed to assess whether qHBsAg alone can accurately identify i) those in a HBeAg-negative chronic HBV infection phase at low risk of liver disease progression and ii) those in need of antiviral therapy according to the 2017 EASL guidelines. We analysed 770 HBV mono-infected treatment-naïve patients, mainly males (61%) from West Africa (92%), median age 35 years (IQR: 30-44), median HBV DNA: 95.

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Background: A promising avenue for cancer treatment is exacerbating the deregulation of the DNA repair machinery that would normally protect the genome. To address the applicability of poly(ADP-ribose) polymerase (PARP) inhibitors (PARPi) combined with radiotherapy for the treatment of hepatocellular carcinoma (HCC) two approaches were used: firstly, the in vitro sensitivity to the PARPi Veliparib and Talazoparib +/- radiation exposure was determined in liver cell lines and the impact of the HBV X protein (HBx) that deregulates cellular DNA damage repair via SMC5/6 degradation was investigated. Secondly, PARP expression profiles and DNA damage levels using the surrogate marker gammaH2AX were assessed in a panel of control liver vs HCC tissues.

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Background & Aims: Although HBV is a major cause of death in Africa, its genetic variability has been poorly documented. This study aimed to address whether HBV genotype and surface gene variants are associated with HBV-related liver disease in The Gambia.

Methods: We conducted a case-control study nested in the Prevention of Liver Fibrosis and Cancer in Africa programme.

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Article Synopsis
  • Sub-Saharan Africa has a significant number of children co-infected with HIV and HBV, and this study focused on identifying and analyzing these cases in Senegal.
  • Out of 613 children studied, 4.1% were found to be co-infected, with a median age of 13; many were also experiencing complications from treatment.
  • A high percentage of these co-infected children showed resistance to HIV treatments, with over half facing virologic failure and a majority having persistent HBV viremia, highlighting the need for better targeted therapies.
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Despite the existence of an effective vaccine, HBV infects 257 million people worldwide and is the cause of the majority of HCC. With an annual mortality rate of 887 000 patients in 2015, this cancer is the second deadliest. Low-income countries such as ones in sub-Saharan Africa are the most at risk due to the limited access to healthcare.

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Background: To eliminate hepatitis B virus (HBV) infection, it is essential to scale up testing and treatment. However, conventional tools to assess treatment eligibility, particularly nucleic acid testing (NAT) to quantify HBV DNA, are hardly available and affordable in resource-limited countries. We therefore assessed the performance of a novel immunoassay, hepatitis B core-related antigen (HBcrAg), as an inexpensive (US$ <15/assay) alternative to NAT to diagnose clinically important HBV DNA thresholds (≥2000, ≥20 000, and ≥200 000 IU/mL) and to select patients for antiviral therapy in Africa.

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