Incidence of Elevated Aminotransferases Levels among Patients Presenting with Hepatitis Syndrome in the Northwest Region of Cameroon

Abstract

Hepatitis B (HB) and Hepatitis C (HC) are a leading cause of liver enzyme elevations in patients (LEE). This study aimed to estimate the prevalence of LEE among patients with hepatitis syndrome. This study enrolled 192 participants presenting with signs and symptoms of hepatitis in the Northwest Region of Cameroon from August 2015 to May 2016. Venous blood samples were collected for the diagnosis of HBV and HCV. Enzymatic measurement of ALT and AST was done using a biochemical analyzer. ALT and AST were categorised using standardized toxicity grade on upper limit of normal.The age ranged of the patients was 2-98years with a mean(SD) age of 41.42(±18.04). Of the 192 patients 97(50.5%) were female, HBV and HCV prevalences were 100(52.1%) and 0(0.0%) respectively. The prevalences of HBV were insignificantly (p=>0.05) higher in female 54(56.8%) and in the age range<30years 31(58.5%). ALT and AST activities showed significant (p <0.05) higher values 76.9±10.6 and 106.7±14.4, respectively in HBV positive than in HBV negative individuals. The prevalence of elevated ALT and AST enzymes were 68(35.4%) and 85(44.3%) respectively. Age and gender-wise prevalances showed high prevalence in >50years and in male. Elevated and significant transaminase activities were found in HBV positive compared to negative subjects. Alcoholic liver disease was common in HBV negative patients while chronic liver disease was higher among HBV positive patients (P =0.012). Elevated ALT and AST levels are common in both HBV positive and HBV negative subjects indicating multifactorial causes. As such effective management of hepatotoxicity requires accurate diagnosis. Materials and Methods Study design, site and populationThis study was carried out in the Northwest region of Cameroon from August 2015 to May 2016. It was a hospital based crosssectional study which enrolled participants who presented with signs and symptoms of hepatitis in the outpatient department of Mezam Polyclinic and Regional Hospitals. The exclusion criteria were participants who refused to be part of the study, patients who were known to be seropositive for HBV or HCV and those with known HIV positive status. Sample size was calculated based on Raosoft online calculator using the level of significance of 0.05 and power of 80% assuming that the expected prevalence is 10%.[17] A total of 192 patients of both sexes exceeded the minimum required sample size of 97. Ethical considerationEthical clearance was obtained from the institution ethical review boards. Clients above 18 years and guardians of children 18 years and below were verbally consented. The aims of the study and procedure to be taken were explained to them and their confidentiality ensured prior to sample collection. Laboratory procedureAfter venous blood collection, samples were allowed to clot and centrifuged at 3000 rmp for 3mins. HBV and HCV were diagnosed using HBV and HCV Diaspot strips (Jakarta, Indonesia) which detect HBsAg or HCV respectively from the patient serum. ALT and AST were measure enzymatic...

Identifying Possible Hepatic Fibrosis of Hepatitis B Origin Using Non-invasive Markers: A Case-control Study in the South West Region of Cameroon

“…-p) = A measure of variability (similar to standard deviation) P 1 =Proportion of controls with elevated ALT: 21.7%[24] P 2 =Proportion of HBV infected cases with elevated ALT…”