Prevalence and Determinants of Kidney Markers among Subjects with Hepatitis C Virus Infection

Introduction: Hepatitis C virus (HCV) infection is a worldwide public health problem with multisystemic involvements including kidneys. We assessed the prevalence and determinants of kidney markers among HCV infected subjects. Methods: A cross-sectional study was conducted from March to July 2017 in two referral centers in Yaoundé. Sociodemographic, clinical and paraclinical data were collected from patient’s records. Renal involvement was evaluated using estimated glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease’s (MDRD) equation, urine dipstick and albumin/creatinine ratio (ACR). An eGFR < 60 and between 60 - 89 mL/min/1.73 m2 was defined as low and reduced respectively. Albuminuria was defined by an ACR > 30 mg/g and divided into A1 (<30 mg/g), A2 (30 - 300 mg/g) and A3 (>300 mg/g). Results: We included 65 (41.5% males) HCV infected patients with a mean age of 56.8 ± 10.5 years. HCV infection was diagnosed for more than 5 years in 54 (83.1%) patients. HCV viral load and genotype were available in 40 (61.5%) patients;viral load was high (>5.9 logs/mL) in 20 (50%) of them and genotypes 4 (40%), 1 (32.5%) and 2 (27.5%) were found in this population. The mean eGFR was 112.9 ± 31.9 mL/min/1.73 m2 with 14 (21.5%) and 4 (6.2%) patients having reduced and low eGFR respectively. Albuminuria (80%), leukocyturia (24.6%) and hematuria (4.6%) were the observed dipstick abnormalities. Median albuminuria (IQR) was 542.4 (238.7 - 961.5) mg/g, with 7 (11%), 12 (18%) and 46 (71%) patients in A1, A2 and A3 respectively. Reduced/low eGFR and albuminuria were observed in 58 (89.2%) patients while low eGFR and albuminuria were found in 55 (84.6%) patients. Advanced age, female gender, HCV genotype 1 and 4, and albuminuria (all p < 0.03) were associated with eGFR reduction. Conclusion: Renal abnormalities are common in HCV infected patients leading by proteinuria and decreased eGFR. Known risk factors of kidney diseases, HCV genotype 1 and 4 and albuminuria were associated with eGFR reduction in our setting.

Evaluation of Oxidative Status of Patients with Gout Attack in a Cameroonian Urban Hospital

Background: Gout is the leading cause of microcrystalline arthritis worldwide and the most common cause of arthritis in adult men. The prevalence of cardiovascular disease, type II diabetes and metabolic syndrome is high among gout patients;one of the current hypotheses that may explain this relationship is based on oxidative stress;however, few studies have sought to investigate this relationship. Objective: The aim of this study was to determine the oxidative status of patients with gout attack. Methods: We conducted a case-control study over a 4 months period at the Rheumatology service of the Yaoundé Central Hospital. Cases were patients with an acute gout attack and controls were healthy subjects matched for sex and age. We evaluated uricemia, serum levels of Superoxide Dismutase (SOD), Glutathione Peroxidase (GPx), Catalase and Malondialdehyde (MDA). Oxidative stress was defined by an increase in MDA and/or a decrease in SOD, Catalase and GPx. Statistical analysis was performed by the S.P.S.S. 21.0 software. The Student’s T-test was used to compare means;the significance threshold was 0.05. Results: Sixty subjects were recruited of which 30 with an acute gout attack and 30 healthy subjects. The mean ages of the cases and controls were respectively 58 ± 8 years and 57.6 ± 8 years. Uricemia was statistically higher in cases (81 ± 20 mg/L) compared to controls (47 ± 11 mg/L) (p < 0.001). MDA levels were higher among cases (1.37 ± 0.46 mmol/L) compared to controls (1.14 ± 0.39 mmol/L) (p < 0.05). There was no significant difference in serum levels of catalase, SOD and GPx between cases and controls. Conclusion: Patients with gout attack have an elevated serum level of malondialdehyde but their oxidative status seems similar to that of normal individuals.