Cameroon Baptist Convention Health Board Chronic Hepatitis B Cohort Study
Cameroon Baptist Convention Health Board Chronic Hepatitis B Cohort Study
The natural history and response to therapy of chronic hepatitis B infection in West Africa
 are currently poorly understood. In this study, employees of the Cameroon Baptist Convention
 Health Board (CBCHB) and spouses who are found to be hepatitis B positive on screening will
 be offered enrollment. Disease monitoring and treatment will be provided following current
 WHO guidelines. Clinical data will be prospectively recorded for 5 years, and bio-specimens
 will be frozen for future analysis.
Chronic hepatitis B (CHB) is common in Cameroon, and hepatitis B-related hepatocellular
 carcinoma is a leading cause of cancer death throughout West and Central Africa. Little is
 known about the natural history of CHB in sub-Saharan Africa and the long term response to
 antiviral therapy. The study hypothesis is that these can be determined by prospective
 follow-up of a population-based cohort.

 Aims, purpose, or objectives:

 1. To determine the characteristics of a population of asymptomatic Cameroonian adults who
 work for the Cameroon Baptist Convention Health Board (CBCHB) who have chronic hepatitis
 B infection.

 2. To determine the phase of infection into which these Hepatitis B carriers fall.

 3. To determine the incidence and risk factors for cirrhosis, decompensated cirrhosis, and
 hepatocellular carcinoma in this cohort over time.

 4. To offer treatment according to a standardized protocol, and to determine the outcome of
 treatment.

 5. To archive serum samples from patients for potential future studies of specific markers
 associated with hepatitis B and liver disease outcomes.

 Methods: Adult employees of the Cameroon Baptist Convention Health Board (CBCHB) and their
 spouses who are known to be positive for hepatitis B surface antigen (HBsAg+) will be offered
 the enrollment in a cohort study for CHB. Following enrollment, their stage of disease will
 be determined using clinical, laboratory and imaging studies. Patients will then be followed
 at regular intervals for 5 years. Antiviral therapy will be offered to patients who qualify
 according to current World Health Organization guidelines.

 Significance: This protocol will prospectively determine the scope of CHB-related illness in
 an initially asymptomatic, population-based cohort and the outcomes of current WHO treatment
 guidelines in this African cohort.
Inclusion Criteria:

 -  Age at least 18yrs.

 -  CBCHB employee or spouse of an employee.

 -  Able to provide written informed consent.

 -  Willing to comply with follow-up visits.

 Exclusion Criteria:

 -  None