Time for “Test and Treat” in Prevention of Mother-to-Child Transmission Programs in Low- and Middle-Income Countries

2010 ◽  
Vol 55 (3) ◽  
pp. 287-289 ◽  
Author(s):  
Maria Zolfo ◽  
Anja De Weggheleire ◽  
Erik Schouten ◽  
Lutgarde Lynen
Keyword(s):  
Mother To Child Transmission ◽  
Child Transmission ◽  
Middle Income ◽  
Test And Treat ◽  
Middle Income Countries ◽  
Mother To Child ◽  
Low And Middle Income

scholarly journals Elimination of Viral Hepatitis in Low and Middle-Income Countries: Epidemiological Research Gaps

2021 ◽  
Author(s):  
Antoine Jaquet ◽  
Guy Muula ◽  
Didier K. Ekouevi ◽  
Gilles Wandeler
Keyword(s):  
Viral Hepatitis ◽  
Treatment Outcomes ◽  
Chronic Viral Hepatitis ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Research Gaps ◽  
Middle Income ◽  
Middle Income Countries ◽  
Testing Strategies ◽  
Mother To Child

Abstract Purpose of Review The purpose of our review was to summarize current recommendations on testing strategies, antiviral therapy eligibility and monitoring, and prevention of mother-to-child transmission of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and to highlight major research gaps in low and middle-income countries (LMIC), with a particular focus on sub-Saharan Africa (SSA). Recent Findings While data on the prevalence of HBV and HCV infections in LMIC are increasing, current knowledge on liver-related complications as well as on treatment outcomes remains limited. Furthermore, very little information is available on the feasibility and cost-effectiveness of large-scale testing and management strategies in high-prevalence settings. The availability of policy-relevant data is particularly scarce in SSA, which accounts for a significant part of the global burden of chronic viral hepatitis. Summary Current recommendations on the management and monitoring of chronic viral hepatitis rely mainly on data from high-income settings. The global elimination of viral hepatitis will only be achieved if prevention, testing, and treatment strategies tailored to specific LMIC are implemented. In order to inform scalable and cost-effective interventions, dedicated research initiatives have to be undertaken. Future studies will have to include the evaluation of innovative testing strategies, the validation of simplified methods to diagnose liver cirrhosis and hepatocellular carcinoma, and the monitoring of long-term treatment outcomes and toxicity. In addition, national plans to achieve the elimination of HBV mother-to-child transmission are urgently needed, including effective ways to test pregnant women, treat those who are eligible, and ensure birth dose vaccination is given to all newborns.

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