Kponou Mathieu Bienvenu TOBOSSI^1,, Mamatchi MELILA², Lochina FETEKE³, Mlatovi DEGBE², Bawou Toussaint BANAKINAO², Haziz SINA¹

Background: Chronic hepatitis B (HBV) infection is a major public health issue in sub-Saharan Africa, frequently leading to severe clinical complications like cirrhosis and hepatocellular carcinoma. While diet is a known modulator of liver health, its specific role in the progression of HBV in the Togolese context is poorly documented. This study aimed to identify dietary risk factors associated with the onset or worsening of clinical complications in patients with chronic hepatitis B. Methods: A retrospective case-control study was conducted at a specialized hepatitis care facility in Lomé, Togo. We enrolled 212 HBsAg-positive adults, comprising 106 "cases" with at least one documented HBV-related clinical complication and 106 age- and sex-matched "controls" without such complications. Dietary habits preceding the onset of complications were assessed using a standardized questionnaire. Multivariate logistic regression was used to analyze the association between food consumption frequency and clinical outcomes, adjusting for potential confounders. Results: The frequent consumption of several food categories was significantly associated with an increased risk of clinical complications (p < 0.05). These included alcoholic beverages, high-lipid foods (fried items, certain sauces), high-carbohydrate foods (fermented pastes, refined sugar), red meat, and bouillon cubes. Conversely, a regular intake of leafy green vegetable-based sauces was found to be significantly associated with a lower risk of complications. Conclusion: Our findings suggest that a dietary pattern characterized by the high-frequency consumption of pro-inflammatory, high-energy foods is a significant risk factor for the progression of chronic hepatitis B in the Togolese setting. These results underscore the urgent need to integrate medical nutrition therapy and patient education into the standard of care to mitigate the risk of severe liver disease.

Hepatitis of viral origin B, dietary determinants of risk, clinical complications, nutrition, Togo