However, the lack of national Hepatitis C screening and treatment guidelines is reflected by a diversity in diagnostic and treatment protocols across care providers, resulting in unnecessary costs and possible sub-optimal clinical outcomes. WHO and The Ministry of Public Health of Cameroon have made the fight against viral hepatitis their focus through vast treatment programs for hepatitis B/C and that have now been progressively made accessible to all social layer at low cost. In Cameroun, hepatitis C is endemic and the prevalence of HCV varies widely between 1 and 23.9% depending on the study population. In contrast to HBV, there is no prophylactic HCV vaccine. In fact, for HCV infection, 80% of high-income countries are not on track to meet HCV elimination targets by 2030, and 67% will not meet elimination targets even if they were given an additional 20 years. In 2016, World Health Assembly has adopted the Global Health Sector Strategy (GHSS) on viral hepatitis to eliminate hepatitis by 2030 However, available evidence demonstrates that global viral hepatitis elimination by 2030 is highly unlikely especially in Low and middle income countries where rates of hepatitis B and C diagnosis are very low, averaging 8 and 18%, respectively. In 2019, approximately 290,000 people died from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma. Globally, the World Health Organization (WHO) estimates that an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year. Chronic hepatitis C is one of the main causes of cirrhosis and primary liver cancer. This virus causes acute hepatitis that evolves in majority (85%) into chronic hepatitis. Hepatitis C is a liver inflammation caused by a hepatitis C virus (HCV). Hence, in the absence of nuclei acid testing, ALT/AST are relevant sentinel markers to screen HCVAb carriers who require monitoring/care for HCV-associated hepatocellular carcinoma in RLS. Interestingly, HCVAb carriage is associated with abnormal liver levels of enzyme (ALT/AST), especially among the elderly populations. In this rural health facility, HCVAb is highly endemic and the burden of liver impairment is concerning. After excluding positive cases for HBsAg and/or HIVAb, liver function tests (ALT/AST) were performed on eligible participants (HBsAg and HIVAb negative) and outcomes were compared according to HCVAb status with p 50 years compared to younger ones, p = 0.0001. Following a consecutive sampling, consenting individuals were tested for anti-HCV antibodies, hepatitis B surface antigen (HBsAg) and HIV antibodies (HIVAb) as per the national guidelines. MethodsĪ facility-based observational study was conducted from July-August 2021 among individuals attending the “St Monique” Health Center at Ottou, a rural community of Yaounde,Cameroon. We herein determine the association between anti-HCV positivity and liver impairment in an African RLS. This warrants context-specific strategies for appropriate management of liver impairment in RLS. This sounds more challenging for hepatitis C virus (HCV) given that antibody (HCVAb) sero-positivity still lacks wide access to HCV RNA molecular testing. The Viral hepatitis elimination by 2030 is uncertain in resource-limited settings (RLS), due to high burdens and poor diagnostic coverage.
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