Hepatitis C Virus Infection in African Patients with Liver Cirrhosis or Primary Hepatocellular Carcinoma

Abstract

We have studied the prevalence of hepatitis C virus (HCV) infection in Rwandan patients with histologically proven liver cirrhosis (LC) or primary hepatocellular carcinoma (HCC). Anti-HCV antibodies were determined by using a second-generation test, with a line immunoassay for structural and non-structural antigens as confirmation. Seventy-nine patients with LC, 26 with HCC, and 54 voluntary blood donors as controls were evaluated. Anti-HCV antibodies were more prevalent in LC patients (48%) and in HCC patients (38%) than in the controls (17%; difference, p = 0.0001 and p = 0.03, respectively). Eighty-four per cent of LC patients and 54% of HCC patients were HBsAg-negative. The prevalence of anti-HCV antibodies was significantly higher for LC and HCC patients who had been in contact with HBV but who had no persistent HBV infection (p < 0.05). We conclude that HCV infection is common in Rwanda and is linked to LC and HCC.

Human immunodeficiency virus and hepatitis C co-infection in sub-Saharan West Africa

“…48 In The Gambia it is reported that an HCV prevalence of 3% is found among an apparently healthy population. 49 In Sierra Leone, prevalence of 2% among children aged 6-12 year with identifiable specific risk factors is reported.13 Among blood donors, prevalences of 17%, 1.4%, 1.8%, 12.3%, and 0.9% have been reported in Rwanda, 45 Benin, 50 Kenya, 51 Nigeria 52 and Ghana, 53 respectively. Distribution of HCV is related to socio-economic status, which gives rise to considerable geographic and temporal variation in its incidence and prevalence.…”

“…In many sub-Saharan countries, data on HCV incidence or distribution are limited 44,45 and this has made it difficult for the tropical features of the disease to be fully understood. 46 In the early 1990s in Africa, prevalence of HCV was low and stable; however, this was based on selected evidence 47 and increased access to diagnostic facilities in some countries 4,12,43 does not support this assertion.…”

Cancer in Rwanda

“…Infection with hepatitis B and C is common in Rwanda and presumably accounts for much of the high frequency of liver cancer (Gascon et al, 1988;Mets et al, 1993). Cervical cancer is associated with the sexually transmitted human papillomavirus infection, and the proportion who give or receive money for sex is high, as is the proportion of men who report having a regular sexual partner other than their wife.…”

Traditional phytotherapy remedies used in Southern Rwanda for the treatment of liver diseases

“…Africa (Mets et al, 1993;Dasnoy et al, 1997;Thomas et al, 2011). In Rwanda, estimates from the University Hospital of Butare indicate that viral hepatitis and its complications, cirrhosis and hepatic carcinoma, represent 80% of all liver pathologies, the ninth most common cause of morbidity (Musemakweli, 1999).…”