Service de médecine A, centre hospitalier de Libreville, Gabon
- Mots-clés : hepatitis B, hepatitis C, hepatitis co-infection, interferon, Gabon
- DOI : 10.1684/mst.2012.0032
- Page(s) : 101-2
- Année de parution : 2012
Introduction: Viral hepatitis remains a major public health problem in the sub-Saharan region. Diagnosis is often made at an advanced stage after a long period with few or no symptoms. Late diagnosis impedes optimal management. Materials and methods: All patients treated for documented chronic hepatitis B or C from January 2001 to December 2009 were identified and the cost of their treatment was estimated. Data examined included socioeconomic information, circumstances surrounding diagnosis, cost of work-up, cost of curative treatment (pegylated interferon + ribavirin for hepatitis C and lamivudine for hepatitis B), and overall cost of support.
Results: The study included 146 patients (65 women, 81 men) with a mean age of 34 years. Hepatitis was type B in 89 patients, type C in 51, and type B/C coinfection in 6 patients. The estimated cost of work-up was 483 USD for type B and 507 USD for type C. The cost of curative treatment was 1569 USD for type B and 7842 USD for type C. The estimated cost of support was 407 USD. The total cost of management was 2459 USD for type B and 8757 USD for type C. Only 9 patients received optimal treatment, and it resulted in curing 3 of the 4 with hepatitis B and 4 of the 5 with hepatitis C. During treatment, progression to cirrhosis occurred in two patients, one with hepatitis B and one with hepatitis C. Conclusion: Financial constraints frequently prevent patients in Gabon with hepatitis B and C from receiving optimal care. The creation of a national healthcare system in 2008 may lead to cost reductions and improve management of this disease in a predominantly young population.