Epidemiological, Clinical Aspects, Risk Factors and Paraclinques and Therapeutics of Chronic Viral Hepatitis C at the Donka National Hospital Chu Conakry

Introduction: Viral hepatitis C is a real public health problem worldwide due to its complications, notably cirrhosis and hepatocellular carcinoma. Patients and Method: This was a descriptive cross-sectional study including all patients followed in our outpatient department in the period from January 1, 2022 to March 30, 2024, i.e. 27 months. This work aimed to study the epidemiological, clinical and paraclinical aspects of patients carrying HCV and followed in our department. Results: Of the 2242 patients followed, 83 patients had positive anti-HCV antibodies, i.e. a prevalence of 3.70%; 46 were men (55.7%) and 37 women (44.3%), for a sex ratio of 1.25. The average age was 46 years with a range of 22 to 80 years. The main risk factors were: dental care 43.37%, surgery 24.09%, blood transfusion and/or its derivatives 12.04%, circumcision and/or excision 100%. The main circumstances of discovery of viral hepatitis C were: physical asthenia (43.37%), cytolysis and jaundice in 36.14%, during voluntary screening in 14.46% and donation of blood in 6.02% of cases; 56% of our patients had a viral load (HCV RNA) less than 50,000 IU/ml and 44% had a viremia greater than 50,000 IU/ml. Abdominal ultrasound was normal in 80% of cases, hepatic steatosis in 10% of cases. The assessment of fibrosis by Fibroscan showed absence of fibrosis or minimal fibrosis (F0F1) in 36.14% (n=30), moderate fibrosis (F2) in 30.12% (n=25); severe fibrosis (F3) in 21.69% (n=18) and cirrhosis (F4) in 12.05% (n=10). Conclusion: The prevalence of HCV infection is very high in this study, the treatment borne by patients in our poor countries remains too expensive, only prevention remains an option. Therapeutically, all our patients (100%) were placed on SOFOSBUVIR 400mg and VELPATASVIR 100mg (SOFOVELPA). Ribavirin added in four of our cirrhotic patients. Sustained virological response (SVR) was achieved in 80 of our patients. HCV RNA was undetectable in all 77 patients after twelve weeks of treatment with SOFOVELPA, undetectable in 3 patients after 24 weeks of treatment with SOFOVELPA + RIBAVIRIN. The three HCC patients died during treatment in the third month; fourth month and eighth month. SVR was 100% in patients who completed their treatment.