PROLIFICA: a story of West African clinical and research collaborations to target hepatitis B-related hepatocellular carcinoma in West Africa

Hepatitis B virus (HBV) infection is highly endemic in sub-Saharan Africa, where the lifetime risk of HBV infection is over 60% and more than 8% of the population remains chronic HBV carriers. Furthermore, this area has one of the highest HBV-related liver cancer rates in the world,1 being the most common cancer in men and third most common in women.2,3 HBV infection therefore represents a significant global threat to health in the African continent.Though most countries in sub-Saharan Africa have established HBV vaccination programs for infants through the WHO and Global Vaccine Alliance (GAVI)-sponsored Expanded Program of Immunization, HBV vaccine coverage remains incomplete.4 Furthermore, the current recommendation from World Health Organisation African division (WHO-AFRO) for birth dose HBV vaccination to prevent maternal-child transmission and early horizontal transmission of HBV has not been widely implemented.5 This is a critical issue in Africa, as more than 90% of children infected with HBV early in life progress to become chronic carriers of HBV, with the attendant risks of HBV-related liver disease, liver cancer and death.6,7Severe limitations in healthcare infrastructure, availability of diagnostics and treatment mean that currently West Africa is ill-equipped to manage the exponentially increasing burden of disease relating to the HBV epidemic. Greater knowledge of the determinants of hepatocellular carcinoma (HCC) development and cost-effective point-of-care diagnostic tests for HBV-related liver disease, and HCC are significant unmet needs in West Africa.Since 1973, HBV research has been conducted …