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The aim of this study was to determine the prevalence of six viruses, from two families of the order Bunyavirales, in the general population of central Tunisia. Sera collected from 377 asymptomatic blood donors were serologically assayed for Rift Valley fever virus (RVFV), Crimean–Congo hemorrhagic fever virus (CCHFV), and four sandfly-borne phleboviruses: Toscana virus (TOSV), sandfly fever Naples virus (SFNV), sandfly fever Sicilian virus (SFSV), and sandfly fever Cyprus virus (SFCV). Of the 377 subjects enrolled in this study, 17.3% were IgG positive for at least one of the viruses tested. The most frequently detected antibodies were against TOSV (13.3%), followed by SFCV (2.9%), RVFV (1.9%), SFSV (1.3%), and SFNV (1.1%). Only one sample was IgG positive for CCHFV. Dual reactivity was observed in nine cases: SFSV + SFCV in three cases (0.8%) and TOSV + SFNV, TOSV + SFCV, and TOSV + RVFV in two cases (0.5%) each. 15.9% of donors were IgG positive against sandfly-borne phleboviruses. Among the 65 donors IgG positive for phleboviruses, 50.8% were from rural areas compared to 12.3% from urban areas (p < 0.001); 92.3% had animals in their living quarters (p = 0.009); and 70.8% lived in the vicinity of stagnant water (p = 0.062). Seroprevalence was significantly higher among donors living with chronic diseases (p = 0.039). Furthermore, the seroprevalence of phleboviruses was higher in Kairouan, the central governorate, than in the two coastal governorates: Monastir and Sousse, with 33.4%, 24.2%, and 14.9%, respectively. The presence of antibodies in the general population needs further investigation to better assess the extent of these viruses. Only TOSV was known to have an extensive circulation in Tunisia and in North Africa. Continued surveillance and interventions are necessary to detect the emergence of all arboviruses and to prevent further transmission.

Background Anti-viral therapy is not routinely recommended for chronic hepatitis B virus (HBV) infection, in patients who have persistently elevated serum HBV DNA level (>2000 IU/mL), normal alanine aminotransferase (ALAT) and without significant liver fibrosis, defining the indeterminate phase. The objective of the study is to identify the factors associated with the progression of liver fibrosis in chronic HBV infected patients in the indeterminate phase. Methods This is cross-sectional study, conducted in Infectious Disease and Hepato-gastroenterology departments of Farhat Hached university hospital, between January 2008 and January 2022. We have included the Ag HBs (+) patients initially not treated, presenting at the time of the initial evaluation: a viral load> 2,000 IU/L for at least six months, normal ALAT ( Results In total, 97 patients were included, with a median age of 32.9± 9.1 years, and a female predominance (sex ratio M/F=0.64). Progression of fibrosis was observed in 16 patients (16.5%) with a mean delay of 70.9±41.1 months. In the univariate analysis, factors associated with progression of fibrosis were the presence of comorbidities (p=0.001), the high initial viral load (p=0.004), the appearance of cytolysis (p=0.001) and the increase in viral load (p=0.002), during follow-up. The AUROC of the initial viral load was 0.664 (95%CI: 0.500-0.820). An intial viral load at 8090 UI/l was associated with the progression of fibrosis with a sensibility of 70.3% and specificity of 63%. Conclusion Factors associated with progression of fibrosis in the indeterminate phase of chronic HBV infection were the presence of comorbidities, and changes of ALAT during follow-up. This leads us to consider extending the therapeutic indications to this group of patients.