Prévalence et Facteurs Associés à la Neuropathie Périphérique chez le Patient Infecté par l’Hépatite Virale C

Callixte Kuate-Tegueu, Ruffin Fotso kamdem, Daniel Gams massi, Jacques Doumbe, Paul Chimi Mbonda, Yannick Fogoum Fogang, Adamou Nsangou, Clémentine Sipoffo Kamdem

Abstract


RÉSUMÉ
Introduction. L’infection par le virus de l’Hépatite C est reconnue comme un problème majeur de santé publique au Cameroun où sa prévalence est estimée à 13.8%. Les manifestations extra-hépatiques comprenant entre autres le syndrome de Sjrögen et la neuropathie périphérique sont fréquentes pouvant survenir chez 40 à 75% des patients infectés. Objectif. Déterminer la prévalence et les facteurs associés à la neuropathie chez le patient infecté par l’hépatite virale C à Douala. Méthodes. Il s’agissait d’une étude transversale descriptive qui s’est déroulée du 25 Janvier au 31 mai 2018 dans le service de consultations externes de l’Hôpital Laquintinie de Douala. Étaient inclus tous les patients de plus de 18 ans ayant une sérologie anticorps anti HVC positive alors qu’étaient exclus tous ceux présentant des comorbidités telles que le diabète, le VIH, l’utilisation des médicaments neurotoxiques. Résultats. Soixante patients ont été inclus parmi les 86 recrutés, d’âge moyen 57,48 ± 12,11 ans et 65% de sexe féminin. La prévalence de la neuropathie périphérique était de 28.3%. La neuropathie périphérique était symptomatique dans 52,9% des cas et les facteurs associés à la neuropathie après une analyse univariée étaient un âge supérieur à 65 ans (p=0,017), l’infection par le génotype 1 (p=0,017) et le génotype 2 (p=0,016). Conclusion. La neuropathie liée à l’hépatite virale C est fréquente dans la ville de Douala touchant près du 1/3 des personnes infectées. Il est important de rechercher systématiquement les signes de neuropathie chez les sujets infectés par le VHC.

ABSTRACT
Introduction. Hepatitis C virus (HCV) infection is recognized as a major public health problem in Cameroon where its prevalence is estimated at 13.8%. Although many studies have reported various types of peripheral neuropathy such as polyneuropathy, multiple mononeuropathy, and Guillain-Barre syndrome in patients with chronic HCV infection in Western countries, there are only a few studies describing an association between HCV infection and neuropathy in Cameroon. Objectives. The aim of this study was to assess the prevalence of peripheral neuropathy and associated factors in patients with chronic HCV infection. Methods. A cross sectional study was carried out from the 25th January to May 31st 2018 at the outpatient unit at the Douala Laquintinie Hospital. Were included all the patients aged 18 years and older with a positive HVC serology test. Clinical neuropathy was diagnosed when symptoms and signs of peripheral sensory or motor involvement were present (AAN criteria). Results. Were recruited 86 patients of average age 58.7 ± 10.9 years with 66.3% of female sex. Clinical sign of peripheral neuropathy was observed in 17 out of 60 patients (28.3%) after exclusion of 26 patients with associated comorbidities. Polyneuropathy (88.2%) was the commonest type of neuropathy and the neuropathy was symptomatic in 52.9% of cases. Factors associated with peripheral neuropathy was: age older than 65 years (p= 0.017), infection by the genotype 1(p =0.05) and genotype 2(p = 0.016). Conclusion. These findings suggest that peripheral neuropathy is common in patients with chronic HCV infection in Douala. It is important to systematically look at signs of neuropathy in HCV infected subjects.

Keywords


Hépatite C, neuropathie périphérique, prévalence, facteurs associés, Cameroun

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