Hepatitis C Virus Infection in Hemodialysis in Cameroon: Prevalence and Incidence

Hemodialysis (HD) is the world's most prevalent kidney replacement therapy for end-stage renal disease patients. Hepatitis C virus infection (HCV) is highly prevalent in patients undergoing HD. There are no reports of the epidemiology of HCV viremia and HCV incidence rate based on prospective studies in HD units in Cameroon. This study evaluated the prevalence and incidence rate of HCV based on anti-HCV antibody (Ab) and HCV-RNA detection.

We conducted a controlled prospective study in three hemodialysis centers in Cameroon, from October 2021 to January 2023. The HEXAGON HCV rapid kit was used to detect anti-HCV Ab, and HCV-RNA was searched using the Xpert® HCV Viral Load technology. We performed a Wilcoxon test and the chi-square or Fisher exact test in statistical analyses.

A total of 205 HD patients were enrolled with a mean age of 47.7 ±14.5 years and median hemodialysis duration of 36 months (IQR: 12-72). Anti-HCV Ab was positive in 59 patients, giving a prevalence of 28.8% (95% CI: 22.7-35.5). This Anti-HCV Ab infection was mainly found in patients with a relatively long period of HD (P = 0,00002). Of the 59 anti-HCV Ab-positive patients, HCV-RNA was detected in 42, with the HCV active infection prevalence of 71.2% (95% CI: 57.9-82.2). A high viral load (HCV RNA > 800,000 UL/ml) was detected in 31% (95% CI: 17.6-47.1). A total of 125 patients with a negative status at the start of the study (M0) were prospectively followed up. After seven months (M7), 15 [12%; 95% CI: 06.9-19.)] became HCV positive, with an incidence rate of 20.6 cases per 100 patients-years.

There is a high prevalence of HCV infection and HCV incidence rate in this study. Strategies aimed at decreasing HCV infection in HD centers in Cameroon are urgently needed.