{"id":9133,"date":"2025-11-19T03:17:00","date_gmt":"2025-11-19T03:17:00","guid":{"rendered":"https:\/\/cdafound.org\/?p=9133"},"modified":"2026-05-29T03:43:42","modified_gmt":"2026-05-29T03:43:42","slug":"modelling-micro-elimination-third-trimester-tenofovir-prophylaxis-for-perinatal-transmission-of-hepatitis-b-in-the-remote-dolpa-district-of-nepal","status":"publish","type":"post","link":"https:\/\/cdafound.org\/fr\/modelling-micro-elimination-third-trimester-tenofovir-prophylaxis-for-perinatal-transmission-of-hepatitis-b-in-the-remote-dolpa-district-of-nepal\/","title":{"rendered":"Mod\u00e9lisation de la micro-\u00e9limination\u00a0: prophylaxie par t\u00e9nofovir au troisi\u00e8me trimestre de grossesse pour la transmission p\u00e9rinatale de l\u2019h\u00e9patite B dans le district isol\u00e9 de Dolpa, au N\u00e9pal"},"content":{"rendered":"

La pr\u00e9valence de l'h\u00e9patite B (VHB) est tr\u00e8s \u00e9lev\u00e9e chez les femmes enceintes du district de Dolpa, au N\u00e9pal, une r\u00e9gion caract\u00e9ris\u00e9e par son isolement g\u00e9ographique et une faible couverture vaccinale. \u00c0 l'aide d'une mod\u00e9lisation math\u00e9matique, nous avons \u00e9valu\u00e9 l'impact de la prophylaxie par t\u00e9nofovir disoproxil fumarate (TDF) au troisi\u00e8me trimestre de grossesse sur la charge virale du VHB et estim\u00e9 le temps n\u00e9cessaire \u00e0 son \u00e9limination \u00e0 Dolpa. Nous avons d\u00e9velopp\u00e9 un mod\u00e8le math\u00e9matique pour \u00e9valuer l'impact de la prophylaxie par TDF sur l'\u00e9limination du VHB selon quatre sc\u00e9narios\u00a0: couverture vaccinale de base 50% (sc\u00e9nario I), TDF 50% et couverture vaccinale de base (sc\u00e9nario II), TDF 90% et vaccination de base (sc\u00e9nario III) et TDF 90%, dose \u00e0 la naissance et couverture vaccinale 95% (sc\u00e9nario IV). Nous avons estim\u00e9 l'impact de la prophylaxie par TDF sur la morbidit\u00e9 et la mortalit\u00e9 li\u00e9es au VHB et projet\u00e9 le temps n\u00e9cessaire \u00e0 son \u00e9limination dans le district. Notre mod\u00e8le sugg\u00e8re que l'\u00e9limination du VHB est improbable \u00e0 Dolpa d'ici 2100 avec les interventions de base. L'extension de la couverture vaccinale par le TDF \u00e0 la dose 90%, associ\u00e9e \u00e0 la vaccination de base, r\u00e9duit significativement la pr\u00e9valence du VHB et la mortalit\u00e9 qui y est li\u00e9e, rendant son \u00e9limination possible en moins de 60 ans. La mise en \u0153uvre de la dose 90% de TDF, conjugu\u00e9e \u00e0 la vaccination \u00e0 la naissance et \u00e0 la couverture vaccinale infantile contre le VHB (dose 95%), pourrait acc\u00e9l\u00e9rer l'\u00e9limination du VHB (pr\u00e9valence du VHB \u2264 0,1% chez les enfants de moins de 5 ans) et permettre d'atteindre cet objectif d'ici 2045. Dans les zones g\u00e9ographiquement difficiles d'acc\u00e8s, une approche de micro-\u00e9limination utilisant le TDF au troisi\u00e8me trimestre de grossesse constitue une strat\u00e9gie efficace et \u00e9quitable pour lutter contre le VHB. Cette approche est susceptible de r\u00e9duire consid\u00e9rablement la charge du VHB et la mortalit\u00e9 qui y est li\u00e9e, m\u00eame avant d'atteindre l'\u00e9limination compl\u00e8te, tout en r\u00e9pondant \u00e0 certaines difficult\u00e9s li\u00e9es \u00e0 l'immunoprophylaxie.<\/p>\n\n

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Hepatitis B (HBV) prevalence is very high in pregnant women in the Dolpa district of Nepal, a region characterised by a remote geographic landscape and low vaccination coverage. Using mathematical modelling, we evaluated the impact of third-trimester tenofovir disoproxil fumarate (TDF) prophylaxis on HBV burden and estimated the time required to achieve HBV elimination in […]<\/p>\n","protected":false},"author":939,"featured_media":3193,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[9],"tags":[31,21,12,2686,2687],"publication-author":[2681,80,97,92,2682,2685,2683,2684],"class_list":["post-9133","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-publication","tag-elimination","tag-hbv","tag-modelling","tag-mother-to-child-transmission","tag-tenofovir-prophylaxis","publication-author-belaynew-taye","publication-author-devin-razavi-shearer","publication-author-homie-razavi","publication-author-ivane-gamkrelidze","publication-author-patricia-valery","publication-author-paul-clark","publication-author-shrestha-ananta","publication-author-sudhamshu-kc"],"acf":[],"_links":{"self":[{"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/posts\/9133","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/users\/939"}],"replies":[{"embeddable":true,"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/comments?post=9133"}],"version-history":[{"count":2,"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/posts\/9133\/revisions"}],"predecessor-version":[{"id":9138,"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/posts\/9133\/revisions\/9138"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/media\/3193"}],"wp:attachment":[{"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/media?parent=9133"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/categories?post=9133"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/tags?post=9133"},{"taxonomy":"publication-author","embeddable":true,"href":"https:\/\/cdafound.org\/fr\/wp-json\/wp\/v2\/publication-author?post=9133"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}