Medical Virology

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Browsing Medical Virology by Author "Andersson, Monique"

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    Hepatitis B virus infection as a neglected tropical disease
    (Public Library of Science, 2017-10-05) O'Hara, Geraldine A.; McNaughton, Anna L.; Maponga, Tongai; Jooste, Pieter; Ocama, Ponsiano; Chileng, Roma; Mokaya, Jolynne; Liyayi, Mitchell I.; Wachira, Tabitha; Gikungi, David M.; Burbridge, Lela; O'Donnel, Denise; Akiror, Connie S.; Sloan, Derek; Torimiro, Judith; Yindom, Louis Marie; Walton, Robert; Andersson, Monique; Marsh, Kevin; Newton, Robert; Matthews, Philippa C.
    ENGLISH ABSTRACT: The Global Hepatitis Health Sector Strategy is aiming for “elimination of viral hepatitis as a public health threat” by 2030 [1], while enhanced elimination efforts for hepatitis are also promoted under the broader remit of global Sustainable Development Goals (SDGs) [2]. This is an enormous challenge for hepatitis B virus (HBV) given the estimated global burden of 260 million chronic carriers, of whom the majority are unaware of their infection [3] (Fig 1). We here present HBV within the framework for neglected tropical diseases (NTDs) [4] in order to highlight the ways in which HBV meets NTD criteria and to discuss the ways in which the NTD management paradigm could be used to strengthen a unified global approach to HBV elimination [5]. The major burden of morbidity and mortality from HBV is now borne by tropical and subtropical countries [6]. Many African populations epitomize specific vulnerability to HBV [7], so we here focus particular attention on Africa, both through focus on the existing published literature and through presentation of a unique data set of opinion and experience (see S1 Supporting Information). However, the themes we represent are transferable to other low- and middle-income settings and are relevant on the global stage.
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    Modelling cost-effectiveness of tenofovir for prevention of mother to child transmission of hepatitis B virus (HBV) infection in South Africa
    (BMC (part of Springer Nature), 2019-06-26) Mokaya, Jolynne; Burn, Edward A. O.; Tamandjou Tchuem, Cynthia; Goedhals, Dominique; Barnes, Eleanor J.; Andersson, Monique; Pinedo-Villanueva, Rafael; Matthews, Philippa C.
    Background: International sustainable development goals for the elimination of viral hepatitis as a public health problem by 2030 highlight the need to optimize strategies for prevention, diagnosis and treatment of hepatitis B virus (HBV) infection. An important priority for Africa is to have affordable, accessible and sustainable prevention of mother to child transmission (PMTCT) programmes, delivering screening and treatment for antenatal women and implementing timely administration of HBV vaccine for their babies. Methods: We developed a decision-analytic model simulating 10,000 singleton pregnancies to assess the costeffectiveness of three possible strategies for deployment of tenofovir in pregnancy, in combination with routine infant vaccination: S1: no screening nor antiviral therapy; S2: screening and antiviral prophylaxis for all women who test HBsAg-positive; S3: screening for HBsAg, followed by HBeAg testing and antiviral prophylaxis for women who are HBsAg-positive and HBeAg-positive. Our outcome was cost per infant HBV infection avoided and the analysis followed a healthcare perspective. Results: Based on 10,000 pregnancies, S1 predicts 45 infants would be HBV-infected at six months of age, compared to 21 and 28 infants in S2 and S3, respectively. Relative to S1, S2 had an incremental cost of $3940 per infection avoided. S3 led to more infections and higher costs. Conclusion: Given the long-term health burden for individuals and economic burden for society associated with chronic HBV infection, screening pregnant women and providing tenofovir for all who test HBsAg+ may be a costeffective strategy for South Africa and other low/middle income settings.