title: Epidemiology of hepatitis C: related hepatocellular carcinoma in Cameroon.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is a global public health problem. Hepatitis C virus (HCV) infection accounts for close to 24% of HCC in developing countries especially when associated with cirrhosis. There exists no vaccine against HCV to prevent the occurrence of HCV-related HCC. A sound knowledge of the epidemiology and prevention of the initial infection is vital. The aim of our study was to determine the epidemiologic profile of HCV-related HCC in Cameroon to improve its' management.
  
  
  METHODS
  It was a prospective study of histologically proven HCV-related HCC seen in two University Centers in Yaounde, Cameroon from March 2012 to January 2013. Demographic data (age, gender), alcohol abuse (>80g/day), presence of cirrhosis, tobacco abuse and parenteral exposition were analyzed.
  
  
  RESULTS
  Twenty-six patients with histologically proven HCV-related HCC were included (18 men (69.2%) and 8 women (30.8%); mean age +/- SD, 61.46+/-10.18 years). A total of 22 (84.6%) patients had a parenteral exposition, 02 (7.7%) patients were alcoholics and 06 (23.1%) patients were smokers. The proportion of patients with cirrhosis was 69.2% against 30.8% cirrhosis-free. Patients with cirrhosis were relatively younger than those cirrhosis-free (mean age +/- SD, 59.05+/-10.05 years vs 66.87+/- 8.72 years, p=0.06). HCV-related HCC was more prevalent in 60 years and above patients (53.8%, 95%CI: 33.4-73.4). The relative risk of HCC among alcoholics patients was high (RR: 1.5, 95%CI: 1.13-1.99, p<0.05).
  
  
  CONCLUSIONS
  In Cameroon, HCV-related HCC is more prevalent among age older than 60 years, a finding which is relatively less to that found in western countries, male gender is twice more at risk than female gender and cirrhosis frequency is less compared to that observed elsewhere. HCV and alcohol play a synergistic role in the occurrence of HCC in our environment.
authors.affiliation: Yaounde University Hospital Center, Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Firmin Ankouane
authors.initials: FA
authors.lastname: Andoulo
authors.affiliation: Yaounde Central Hospital, Department of internal medicine and specialties, Faculty of medicine and pharmaceuticals sciences, University of Douala, Douala, Cameroon.
authors.forename: Dominique Noah
authors.initials: DN
authors.lastname: Noah
authors.affiliation: Yaounde University Hospital Center, Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Roger
authors.initials: R
authors.lastname: Djapa
authors.affiliation: Yaounde University Hospital Center, Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Mathurin
authors.initials: M
authors.lastname: Kowo
authors.affiliation: Yaounde General Hospital, Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Paul
authors.initials: P
authors.lastname: Talla
authors.affiliation: Yaounde Central Hospital, Department of Radiology, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Edith Hell
authors.initials: EH
authors.lastname: Medjo
authors.affiliation: Yaounde University Hospital Center, Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Isidore Kamsi
authors.initials: IK
authors.lastname: Djomkam
authors.affiliation: Yaounde University Hospital Center, Department of surgery and specialties, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Bernadette Ngo
authors.initials: BN
authors.lastname: Nonga
authors.affiliation: Yaounde University Hospital Center, Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Oudou
authors.initials: O
authors.lastname: Njoya
authors.affiliation: Yaounde General Hospital, Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde I, Yaoundé, Cameroon.
authors.forename: Elie Claude Ndjitoyap
authors.initials: EC
authors.lastname: Ndam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002163:Cameroon / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000821:virology; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000453:epidemiology
keywords: Cameroon; Hepatocellular carcinoma; alcohol; cirrhosis; developing countries; epidemiology; hepatitis C; parenteral exposition