Treatment of Hepatitis B in Resource-limited Settings - a Pilot Program in East Africa

NCT ID: NCT02344498

Last Updated: 2024-11-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

7350 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-01-31

Study Completion Date

2026-12-31

Brief Summary

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Viral hepatitis kills nearly one million people each year, even though effective treatment exists. The aim of this study is to establish a treatment protocol for hepatitis B, which is simple and cheap enough to be implemented in resource-limited settings.

Detailed Description

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Chronic viral hepatitis is a major health problem globally. Each year nearly one million deaths are attributable to either hepatitis B or C. In Ethiopia 5-10% of the general population are infected with hepatitis B. Oral antiviral treatment of hepatitis B exists, but high costs and advanced laboratory requirements have been barriers to offer such treatment in resource-limited settings, resembling the situation in treatment of HIV/AIDS a decade ago.

The present study will investigate a simplified approach to hepatitis B treatment in resource-limited settings, inspired by the recent success of HIV treatment in such settings. The critical research question is how to identify patients with expected benefit of treatment in the absence of advanced laboratory support. A WHO expert panel recently suggested treatment criteria for use in settings without advanced laboratory facilities, but these criteria have not yet been tested out in real life. The present study will build on and develop the WHO approach to treatment of hepatitis B, aiming to develop a treatment protocol that can be feasible in other resource-limited countries. The potential public health benefit for poor people in low- and middle-income countries is substantial.

Conditions

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Hepatitis B

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Urban

HBV patients in Addis Abeba. Eligible patients treated with tenofovir disoproxil fumarate 245 mg OD.

Tenofovir disoproxil

Intervention Type DRUG

Rural

HBV patients in Adama, Afar, Jigjiga and Jimma. Eligible patients treated with tenofovir disoproxil fumarate 245 mg OD.

Tenofovir disoproxil

Intervention Type DRUG

Interventions

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Tenofovir disoproxil

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Consenting adults (≥18 years) residing in Ethiopia who are HBsAg positive

Exclusion Criteria

* Children \<18 years, other terminal disease (cancer etc.)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Addis Ababa University

OTHER

Sponsor Role collaborator

The Research Council of Norway

OTHER

Sponsor Role collaborator

University of Agder

OTHER

Sponsor Role collaborator

South-Eastern Norway Regional Health Authority, Norway

UNKNOWN

Sponsor Role collaborator

St. Paul's Hospital Millennium Medical College, Ethiopia

OTHER

Sponsor Role collaborator

Haramaya University,Ethiopia

UNKNOWN

Sponsor Role collaborator

Oslo University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Asgeir Johannessen

Researcher / project manager

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Asgeir Johannessen, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Oslo University Hospital

Nega Berhe, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Addis Abeba University

Locations

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St Paul Hospital Millennium Medical College

Addis Ababa, Addis Abeba, Ethiopia

Site Status

Countries

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Ethiopia

References

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Rossvoll L, Desalegn H, Gudissa FG, Birhanu D, Hussen A, Cheneke W, Jeylan A, Debela EA, Yusuf M, Sugule A, Berhanu N, Gudina EK, Orlien SM, Stockdale AJ, Berhe N, Johannessen A. Treatment of chronic hepatitis B in Ethiopia: 1-year results from a real-life, multicentre, prospective cohort study. Lancet Glob Health. 2025 Nov;13(11):e1914-e1923. doi: 10.1016/S2214-109X(25)00309-2.

Reference Type DERIVED
PMID: 41109262 (View on PubMed)

Desalegn H, Orlien SMS, Aberra H, Mamo E, Grude S, Hommersand K, Berhe N, Gundersen SG, Johannessen A. Five-year results of a treatment program for chronic hepatitis B in Ethiopia. BMC Med. 2023 Sep 29;21(1):373. doi: 10.1186/s12916-023-03082-4.

Reference Type DERIVED
PMID: 37775742 (View on PubMed)

Desalegn H, Aberra H, Berhe N, Medhin G, Mekasha B, Gundersen SG, Johannessen A. Predictors of mortality in patients under treatment for chronic hepatitis B in Ethiopia: a prospective cohort study. BMC Gastroenterol. 2019 May 15;19(1):74. doi: 10.1186/s12876-019-0993-1.

Reference Type DERIVED
PMID: 31092203 (View on PubMed)

Aberra H, Desalegn H, Berhe N, Mekasha B, Medhin G, Gundersen SG, Johannessen A. The WHO guidelines for chronic hepatitis B fail to detect half of the patients in need of treatment in Ethiopia. J Hepatol. 2019 Jun;70(6):1065-1071. doi: 10.1016/j.jhep.2019.01.037. Epub 2019 Mar 28.

Reference Type DERIVED
PMID: 30929749 (View on PubMed)

Desalegn H, Aberra H, Berhe N, Mekasha B, Stene-Johansen K, Krarup H, Pereira AP, Gundersen SG, Johannessen A. Treatment of chronic hepatitis B in sub-Saharan Africa: 1-year results of a pilot program in Ethiopia. BMC Med. 2018 Dec 17;16(1):234. doi: 10.1186/s12916-018-1229-x.

Reference Type DERIVED
PMID: 30554571 (View on PubMed)

Aberra H, Gordien E, Desalegn H, Berhe N, Medhin G, Mekasha B, Gundersen SG, Gerber A, Stene-Johansen K, Overbo J, Johannessen A. Hepatitis delta virus infection in a large cohort of chronic hepatitis B patients in Ethiopia. Liver Int. 2018 Jun;38(6):1000-1009. doi: 10.1111/liv.13607. Epub 2017 Oct 20.

Reference Type DERIVED
PMID: 28980394 (View on PubMed)

Aberra H, Desalegn H, Berhe N, Medhin G, Stene-Johansen K, Gundersen SG, Johannessen A. Early experiences from one of the first treatment programs for chronic hepatitis B in sub-Saharan Africa. BMC Infect Dis. 2017 Jun 19;17(1):438. doi: 10.1186/s12879-017-2549-8.

Reference Type DERIVED
PMID: 28629395 (View on PubMed)

Desalegn H, Aberra H, Berhe N, Gundersen SG, Johannessen A. Are non-invasive fibrosis markers for chronic hepatitis B reliable in sub-Saharan Africa? Liver Int. 2017 Oct;37(10):1461-1467. doi: 10.1111/liv.13393. Epub 2017 Mar 23.

Reference Type DERIVED
PMID: 28222249 (View on PubMed)

Other Identifiers

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2014/1146

Identifier Type: -

Identifier Source: org_study_id

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