Hepatitis C Continuum of Care in a Treatment Center in Sub-Saharan Africa

Autor: Ivo Ditah, Georges B. Nko’Ayissi, Dominique Noah Noah, Agnes Malongue, Olivier Donfack-Sontsa, B Aude Eyenga, T Sylvie Taku, Servais Albert Fiacre Bagnaka Eloumou, Henry Namme Luma
Rok vydání: 2018
Předmět:
Zdroj: Journal of Clinical and Experimental Hepatology. 8:335-341
ISSN: 0973-6883
Popis: Background Hepatitis C virus (HCV) infection is a major public health challenge in Cameroon with over three million people infected. Government efforts to improve care and treatment are unsatisfactory and need to be assessed. We aimed at studying the several steps along the HCV continuum of care in one of two hepatitis treatment centers in Cameroon. Methods We undertook a retrospective chart review of anti-HCV positive individuals, who attended the Douala general hospital between 2008 and 2015. We defined the HCV treatment cascade as follows: step 1—HCV RNA testing, step 2—complete pre-therapeutic evaluation (genotyping and liver fibrosis markers), step 3—initiation of treatment, step 4—treatment completion, and step 5—sustained virological response (SRV). Each successive step in the HCV care continuum was dependent on passing through the previous step. Results The mean age of the 669 anti-HCV antibody positive individuals was 57 (sd: ±13) years. Females were 52.8% of the study population. 410 (61.3%) were tested for HCV RNA. Three hundred and sixty-six (54.7%) were confirmed to have viral replication (HCV RNA positive). One hundred and eighty (26.9%) did a complete pre-therapeutic evaluation (both HCV genotyping and liver fibrosis assessment included). Eighty-one (12.1%) initiated treatment with pegylated interferon/ribavirin. Seventy-two (10.8%) completed treatment and 44 (6.6%) had SVR. Sociodemographic characteristics including age, gender, marital status, having medical insurance, and profession were associated with attaining later steps in the care cascade. Conclusion This study shows that HCV continuum of care and treatment is less optimal at the Douala general hospital and is highly impacted by socio-economic factors. Continued efforts are needed to improve HCV care.
Databáze: OpenAIRE