Hepatitis C virus infects humans world-wide. The virus genome varies greatly and it has several genotypes. HCV infection is highly prevalent in Central Africa and Cameroon. Initial studies on the genetic variability of HCV showed infection with HCV genotypes 1, 2, and 4. We have now sequenced the NS5b and E2 regions of 156 HCV isolates collected from patients presenting for diagnosis in Yaounde and used the data to describe the distribution of HCV genotypes and subtypes in patients with hepatitis in Cameroon. Genotype 1 was more frequent than Genotypes 4 and 2. Genotypes 1 and 4 were highly heterogeneous, containing many subtypes described previously (1b, 1c, 1e, 1h, 1l, 4f, 4t, 4p, 4k) and unsubtyped groups. There was a systematic phylogenetic concordance between NS5b and E2 sequence clustering. The Genotype 2 sequences did not vary. Neither subject age nor gender influenced HCV distribution. HCV Genotypes 1 and 4 are very heterogeneous in Cameroon, perhaps due to ancient infections. The homogeneity of HCV Genotype 2 indicates its more recent introduction from western Africa.

Antibodies to the hepatitis delta virus (HDV) were found in 17.6% of 233 hepatitis B virus surface antigenpositive subjects in Cameroon. Phylogenetic analyses showed the presence of HDV-1, HDV-5, HDV-6, and HDV-7 genotypes. These results enrich the limited data on HDV prevalence and molecular diversity in Cameroon.Hepatitis delta virus (HDV) is associated with hepatitis B virus (HBV) infection and is frequently related to more severe disease than that due to the underlying HBV monoinfection (5, 10). HDV infection has a worldwide distribution, but its frequency varies greatly throughout different geographic regions. It is highly endemic in the Middle East, in the Mediterranean area, in the Amazonian region, and in several African countries (3). Genomic analysis of HDV isolates from different regions of the world reported at least eight phylogenetically distinct genotypes with dissimilar geographic distributions. Apart from HDV genotype 1 (HDV-1), which is ubiquitous, each virus clade is geographically localized: HDV-2 is found in Japan, Taiwan, and Russia; HDV-4 is found in Taiwan and Japan; HDV-3 is found in the Amazonian region; and HDV-5, HDV-6, HDV-7, and HDV-8 are found in Africa (6). The role of these HDV genotypes is not yet well determined, but some studies have suggested an association between the severity of disease and infection with different HDV genotypes (4, 8). The two studies conducted 2 decades ago on HDV infection in Cameroon have reported the prevalence of antibodies against HDV (HDV-Ab) of 6.5% and 27.3%, respectively (9, 12). In spite of this high prevalence, no data on HDV genotype diversity in Cameroon are available. Therefore, in the present study, we investigated the current HDV seroprevalence and the genotype diversity in Cameroonian patients with chronic HBV infection.This study was performed on plasma samples from 233 hepatitis B virus surface antigen (HBsAg) carriers (mean age, 34.5 years; 79 women and 154 men) seen at two medical care centers in Yaounde, Cameroon, from May 2008 to May 2009. As recommended by the Cameroonian Society of Gastroenterology, in addition to the HBV DNA quantification and the assessment of biochemical liver enzyme, HDV screening should be part of the screening of HBsAg carriers, considering the endemicity of this infection in Central Africa. The analyses included in HDV screening are HDV antibody (HDV-Ab) and HDV RNA quantification for HDV-Ab-positive patients. During the medical consultation, HBsAg carriers were screened for HDV infection and were asked to participate in this study. For carriers who agreed to participate, written informed consent was obtained for HDV genotyping, since this analysis is not part of the original protocol in a routine workup of liver disease.The presence of HDV-Ab was determined by the Murex anti-delta assay (Abbott, Wiesbaden, Germany), and HBV DNA viral load was determined by the Abbott RealTime HBV quantification kit (Abbott Molecular Inc., Rungis, France) according to the manufacturer's protocol. During routine workup of th...

Data were examined from a day-to-day clinical practice in Yaounde, Cameroon to evaluate the efficacy and safety of peginterferon alfa-2a and ribavirin in treatment-naive Cameroonian patients with chronic hepatitis C. Ninety adults with chronic hepatitis C (mean age, 53 +/- 8 years; 79% males; 37.8% genotype 1; 23.3% genotype 2; and 38.9% genotype 4) were given at least 12 weeks of combination therapy between February 2003 and August 2007. Of these, 54 completed the treatment and the 24-week follow up. Subsequently, 18 continued treatment and 18 (20%) discontinued the treatment, 6 (6.7%) due to adverse effects. An intention-to-treat analysis showed that 38 (52.8%) had an end-of-treatment virologic response and 34 (47.2%) had a sustained virologic response. Sustained virologic response were significantly higher among patients with hepatitis C virus (HCV) genotype 2 (83.4%) than in those with genotype 1 (31%) or genotype 4 (42.3%) (P < 0.05). Non HCV-2 genotype, pretreatment fibrosis score >2, HCV RNA level >8.0 x 10(5) IU/ml and a non-virologic response at 12 weeks of treatment were associated with poor sustained virologic response (P < 0.05). Thus, HCV can be treated in a Sub-Saharan African country. It indicates that Cameroonian HCV-1 and -4 patients have a poorer sustained virologic response than the published results for Western and Middle-East countries. Virus subtype may influence the treatment outcome, since there is a great genetic diversity within Cameroonian HCV-1 and -4 genotypes.

Introduction: In order to identify the modes of investigation and the results of the assessment of rectal bleeding in the Cameroonian adult, we retrospectively analysed the records of 287 patients aged above 20 years diagnosed with rectal bleeding with the aim to know the prescription patterns according to age, the diagnostic performance of tests and the results. Methodology: Between the 1 st of January 2009 and the 30 th of June 2010, we examined patients at the University Teaching Hospital and the "La Cathédrale" Medical Centre in Yaounde. Age, sex, endoscopic tests and results were evaluated. Results: 287 protocols met our selection criteria, sex ratio (M/F) 2.4/1, median age 46 years interquartile range [36, 55]. Normal tests were 57 (19.2%). Main lesions: haemorrhoids (42.4% CI95 36.7 -48.3), colorectal cancer (10.8% CI95 7.5 -14.9), anal fissure (8.8% CI95 5.8 -12.6) and colorectal polyps (8.4% CI95 5.5 -12.2). The prevalence of significant lesions (polyps and cancer) recorded 7% for those under age 40. 20.5% in those were between 40 -50 years, and 28.9% for those over 50 years. For anoscopies, 44.4% were under 40 years, 39.3% of cases of sigmoidoscopy affected those between 40 -50 years and colonoscopy affected 54% of those over 50 years. For the diagnostic yield, 26.2% had a significant lesion for flexible sigmoidoscopy and only 16.7% and 1.6% for colonoscopy and anoscopy respectively. Conclusion: The study shows that anoscopy and sigmoidoscopy are the main initial tests conducted in Cameroon in the assessment of rectal bleeding in adults of less than 50 years and they are quite sufficient. Haemorrhoids and colorectal cancer are the main pathologies.

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