Abstract
BackgroundChronic hepatitis C infection is a major public health concern, with a high burden in Sub-Saharan Africa. There is growing evidence that chronic hepatitis C virus (HCV) infection causes neurological complications. This study aimed at assessing the prevalence and factors associated with neurological manifestations in chronic hepatitis C patients.MethodsThrough a cross-sectional design, a semi-structured questionnaire was used to collect data from consecutive chronic HCV infected patients attending the outpatient gastroenterology unit of the Douala General Hospital (DGH). Data collection was by interview, patient record review (including HCV RNA quantification, HCV genotyping and the assessment of liver fibrosis and necroinflammatory activity), clinical examination complemented by 3 tools; Neuropathic pain diagnostic questionnaire, Brief peripheral neuropathy screen and mini mental state examination score. Data were analysed using Statistical package for social sciences version 20 for windows.ResultsOf the 121 chronic hepatitis C patients (51.2% males) recruited, 54.5% (95% Confidence interval: 46.3%, 62.8%) had at least one neurological manifestation, with peripheral nervous system manifestations being more common (50.4%). Age ≥ 55 years (Adjusted Odds Ratio: 4.82, 95%CI: 1.02–18.81, p = 0.02), longer duration of illness (AOR: 1.012, 95%CI: 1.00–1.02, p = 0.01) and high viral load (AOR: 3.40, 95% CI: 1.20–9.64, p = 0.02) were significantly associated with neurological manifestations. Peripheral neuropathy was the most common neurological manifestation (49.6%), presenting mainly as sensory neuropathy (47.9%). Age ≥ 55 years (AOR: 6.25, 95%CI: 1.33–29.08, p = 0.02) and longer duration of illness (AOR: 1.01, 1.00–1.02, p = 0.01) were significantly associated with peripheral neuropathy.ConclusionOver half of the patients with chronic hepatitis C attending the DGH have a neurological manifestation, mainly presenting as sensory peripheral neuropathy. Routine screening of chronic hepatitis C patients for peripheral neuropathy is therefore necessary, with prime focus on those with older age and longer duration of illness.
Highlights
Hepatitis C is a major public health problem affecting greater than 185 million people worldwide [1]
This study aimed at assessing the prevalence and factors associated with neurological manifestations in chronic hepatitis C patients
Data collection was by interview, patient record review, clinical examination complemented by 3 tools; Neuropathic pain diagnostic questionnaire, Brief peripheral neuropathy screen and mini mental state examination score
Summary
Hepatitis C is a major public health problem affecting greater than 185 million people worldwide [1]. In Cameroon varying reports of hepatitis C seroprevalence exist, with country estimates of up to 13%, second only to Egypt with the highest estimated seroprevalence (17%) in the continent and in the world [5]. Amongst those infected with HCV, 55–80% become chronically infected, but most may remain asymptomatic until complications set in [7]. Amongst the EHMs, neurological manifestations are estimated to occurring in up to 50% of HCV infected patients [9,10,11]. This study aimed at assessing the prevalence and factors associated with neurological manifestations in chronic hepatitis C patients
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