Promoting Antiviral Access and Adherence in the Expansion of Hepatitis B Prevention Programs: Insights From the Democratic Republic of Congo

J Pediatric Infect Dis Soc. 2024 Nov 21;13(Supplement_5):S148-S152. doi: 10.1093/jpids/piae081.

Abstract

Hepatitis B virus (HBV) antiviral administration and adherence are essential to reach the World Health Organization's 2030 hepatitis elimination goals. As HBV treatment guidelines are now simplified and expanded, adherence to treatment will be critical, but challenges to adherence are poorly studied. After introducing tenofovir disoproxil fumarate (TDF) monotherapy to expectant mothers with high-risk HBV in Kinshasa, DRC, we conducted semi-structured interviews to understand medication adherence behaviors, to complement pill counts and measurement of TDF metabolite levels. Key facilitators of adherence identified included trust in healthcare workers, a better understanding of HBV, and family support. Identified barriers included fear of stigma and low health literacy. Knowledge about HBV disease remains low, underscoring the importance of ongoing education of clinic staff and patients alike.

Keywords: Africa; DRC; adherence; hepatitis B virus; prevention of vertical transmission; tenofovir disoproxil fumarate.

MeSH terms

  • Adult
  • Antiviral Agents* / therapeutic use
  • Democratic Republic of the Congo
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Hepatitis B virus / drug effects
  • Hepatitis B* / drug therapy
  • Hepatitis B* / prevention & control
  • Humans
  • Medication Adherence*
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / prevention & control
  • Social Stigma
  • Tenofovir* / therapeutic use
  • Young Adult

Substances

  • Antiviral Agents
  • Tenofovir