Authors: Mathurin Pierre Kowo, Marthe Gharante Ntep Eboko, Gabin Ulrich Kenfack, Antonin WilsonNdjitoyap Ndam, Serge Tchamgoué, Marthe Pélagie Alogo A Nwatsock, Paul Talla, Isabelle DangBabagna, Michele Tagni Sartre, Christian Tzeuton6, Oudou Njoya, Magloire Biwolé Sida, FirminAnkouane Andoulo.
Background: The recent introduction of direct acting antivirals (DAAs) in Cameroon represents an important step in the treatment of chronic hepatitis C which till recently was pegylated interferon based. However, there is still a number of patients who fail DAA-based regimens. The aim of this study was to identify factors associated with these failures in patients treated for chronic HCV in Cameroon.
Methods: We consecutively included patients infected with HCV from six treatment centers in Cameroon. All patients treated with DAAs and having a documented viral load 12 weeks after completion of treatment were included. Factors associated with treatment failure were sought using Pearson’s Chi-square test and logistic regression.
Results: We included 272 patients with mean age of 63.4 ±8.8 years. Genotype 1 was the most frequent (43.8%) followed by genotype 4 (31.6%) and genotype 2 (23.5%). In 3 patients (1.2%) there were combined genotypes (G1/G4 in 1 patient and G1/G2 in 2 patients). A high viral load (>800.000 UI/ml) was found in 176 patients (68%) and148 patients (58%) had severe fibrosis or cirrhosis. Patients with prior exposure to anti-HCV treatment represented
20.2% and treatment failure rate was 25% (68/272). Factors associated with treatment failure were prior exposureto anti-HCV medication and severe ibrosis or cirrhosis.
Conclusion: Oral direct acting antiviral agents have revolutionized the treatment of hepatitis C. However, a number of patients still present failure to this treatment. In Cameroon factors found to be associated to treatment failure were severe fibrosis or cirrhosis and prior exposure to anti-HCV treatment.
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