title: [Socioeconomic aspects and management of chronic hepatitis B and C in Libreville, Gabon].
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.forename: R
authors.initials: R
authors.lastname: Bignoumba Ibouili
authors.forename: J
authors.initials: J
authors.lastname: Iba Ba
authors.forename: P E
authors.initials: PE
authors.lastname: Itoudi Bignoumba
authors.forename: L
authors.initials: L
authors.lastname: Missounga
authors.forename: A G
authors.initials: AG
authors.lastname: Eyi Nguema
authors.forename: L
authors.initials: L
authors.lastname: Pemba
authors.forename: S
authors.initials: S
authors.lastname: Coniquet
authors.forename: J B
authors.initials: JB
authors.lastname: Moussavou Kombila
authors.forename: J B
authors.initials: JB
authors.lastname: Boguikouma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005681:Gabon; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult