title: Challenges in the management of chronic HBV infection in West Africa: The clinician's perspective.
abstract: BACKGROUND
  Hepatitis B infection has become a public health issue in recent years. Approximately 350 million of the world's population are chronically infected reaching endemic proportions in West Africa. Guidelines for treatment are continuously improving but are becoming more complex.
  
  
  OBJECTIVE
  To determine the challenges hepatologists experience in the management of patients with chronic hepatitis B.
  
  
  METHODS
  This was a cross-sectional descriptive study conducted among hepatologists in West Africa during a regional hepatitis conference in 2013.
  
  
  RESULTS
  Forty-six hepatologists completed the questionnaire. When evaluating a patient for chronic hepatitis B, the preferred investigations were: LFT (100%); abdominal ultrasound (93.5%); HBeAg (93.5%); HBV DNA (78%); HBsAg measure (22%); HBV genotype (15.2%); and liver biopsy (34.8%). Most had their patients on nucleoside/nucleotide analogue but follow-up visits after 1 year were problematic.
  
  
  CONCLUSIONS
  The majority of hepatologists had good intentions regarding the evaluation of their patients, but only a small percentage of patients are properly investigated.
authors.affiliation: Consultant Gastroenterologist/Lecturer, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria ucsuizes@yahoo.co.uk.
authors.forename: Uchenna C
authors.initials: UC
authors.lastname: Okonkwo
authors.affiliation: Chief Consultant Gastroenterologist/Reader, Department of Internal Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Onyekwere
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D003430:Cross-Sectional Studies; D019468:Disease Management; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D011795:Surveys and Questionnaires
chemical_list: D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens
keywords: Chronic HBV infection; West Africa; challenges