HEPAT-B
HEPAT-B : a French national prospective cohort of patients with chronic hepatitis B virus (HBV) infection
Main objective: To document the clinical and biological events and experiences of patients with chronic infection or hepatitis B, with or without long-term treatment.
Social sciences objectives:
- To document the experiences and difficulties encountered by people living with chronic hepatitis B, from screening to care, in order to better meet their needs and provide recommendations for adapting health service activities to this population,
- Identify psychosocial (quality of life, mental health), behavioral and socioeconomic factors associated with liver disease progression (in relation to chronic hepatitis B severity and comorbidities) and retention in care.
- Identify ways of reducing stigmatization and facilitating empowerment of the groups most concerned (immigrants, the elderly).
Project period
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Main investigator
CARRAT Fabrice (UMR-S 1136 CLEPIVIR Institut Pierre Louis Epidémiologie et Santé Publique)
SESSTIM member(s) of the project:
Non-SESSTIM member(s) of the project
CARRAT Fabrice (UMR-S 1136 CLEPIVIR Institut Pierre Louis Epidémiologie et Santé Publique); BOURLIÈRE Marc (Hépato-Gastroentérologie Hôpital Saint Joseph); PARLATI Lucia (Pôle d'Hépato-gastroentérologie Hôpital Cochin); ZOULIM Fabien (Inserm U1052 Centre de Recherche en Cancérologie de Lyon (CRCL) Physiopathologie des hépatites B et C et nouvelles stratégies antivirales Centre Léon Bérard); MARADAN Gwenaelle Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur (ORS PACA)
Sponsors:
ANRS-MIE
Partners:
UMR-S 1136 CLEPIVIR Institut Pierre Louis Epidémiologie et Santé Publique; Hôpital Saint Joseph Marseille; Pôle d'Hépato-gastroentérologie Hôpital Cochin; Inserm U1052 Centre de Recherche en Cancérologie de Lyon (CRCL) Physiopathologie des hépatites B et C et nouvelles stratégies antivirales Centre Léon Bérard; Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur (ORS PACA)
Research topics:
Research question:
In 2019, according to the WHO, around 296 million people worldwide were living with the hepatitis B virus (HBV), and this infection causes more than 820,000 deaths a year from cirrhosis and hepatocellular carcinoma (HCC). In France in 2016, 136,000 people were living with HBV, and 7% of cirrhosis and 10% of HCC were HBV-related. The risk of HCC varies according to disease stage, viral replication and host immune response. For patients with HBeAg+ viral infection, this risk is poorly assessed due to the absence of long-term longitudinal studies. Furthermore, the impact of extra-hepatic comorbidities on the risk of HCC is poorly assessed in existing cohorts. In the ANRS CO22 HEPATHER cohort, we have shown that age, male sex, metabolic syndrome, alcohol consumption and B viral load have a direct effect on the occurrence of advanced liver fibrosis, which in turn predicts the occurrence of HCC. The risk of HCC was significantly lower in patients with sustained loss of HBsAg with or without HBs seroconversion, defining functional cure. Spontaneous HBsAg loss is a rare event in the natural history of HBV (around 1% per year), and the factors associated with this loss remain poorly understood. The role of ethnicity, genotypes and other viral or host factors (including genetic) remains to be determined.
Method:
Multicenter observational study with prospective data collection and constitution of biological collections of patients with or having had hepatitis B. Patients included in the study will come from the ANRS CO22 Hepather cohort, with a median follow-up of 6 years.
Social sciences component :
- a quantitative component with a socio-behavioral questionnaire conducted by telephone with the participants
- a qualitative component with individual interviews to better describe the experience of living with hepatitis B among certain groups of people (the elderly and immigrants)
Research prospects:
the perspectives for the social sciences component are to identify psychosocial, behavioral and socio-economic factors that will enable us to pinpoint patients at greatest risk of clinical progression or non-compliance with treatment and follow-up, and thanks to the mixed (qualitative and quantitative) approach, to identify the needs and expectations of people living with hepatitis B in order to improve their experience of the disease and their care, and to propose interventions to inform and adapt the activities of medical services and public health players.
