Endoscopic mucosal phenotypes and endoscopic Sydney system gastritis assessment in relation to Helicobacter pylori infection and upper digestive clinical signs: A 2-year study among patients with gastroduodenal disorders in Cameroon.

Background and Aim: Helicobacter pylori represents the major pathogen in the pathophysiology of diverse gastrointestinal conditions. This study sought to determine the endoscopic aspect of the gastric mucosa in relation to H. pylori infection in Cameroon. Methods: This study was conducted in three reference health facilities in Cameroon from October 2020 to October 2022. The study enrolled 494 consecutive volunteer dyspeptic patients attending to the gastroenterology department of the selected health facilities. A description of the aspect of gastric mucosa of all participants was performed during endoscopy examination, and biopsies were collected for H. pylori detection using rapid urease tests. Results: Gastritis, ulcerated lesions, duodenitis, esophagitis, normal mucosa aspect, bulbitis, and gastric neoplastic lesions were found in 40.1, 22.3, 10.9, 10.3, 9.7, 6.3, and 0.40% of biopsy samples, respectively. Erythematous/exudative (45.9%) and enterogastric reflux (12.2%) were the main gastritis types recorded. H. pylori was present in 58.1, 46.3, 87.1, 66.7, and 61.8% in gastritis, duodenitis, bulbitis, esophagitis, and ulcerated lesions, respectively. A positive relationship was noticed between the presence of H. pylori and gastritis (1.037 [0.720-1.493]; P = 0.845), bulbitis (4.237 [1.602-11.235]; P = 0.004), esophagitis (1.515 [0.822-2.793]; P = 0.183), ulcerated lesions (1.233 [0.798-1.904]; P = 0.345), erythematous/exudative gastritis (1.354 [0.768-2.389]; P = 0.295), and enterogastric reflux gastritis (1.159 [0.492-2.733]; P = 0.736). Conclusion: Gastritis and erythematous/exudative gastritis are the most frequent gastrointestinal pathophysiology conditions in dyspeptic patient in our milieu. H. pylori infection is responsible for 94.8% of the gastrointestinal pathophysiology conditions with bulbitis as the condition is significantly associated with this bacterium infection.

Helicobacter pylori infection-A risk factor for lipid peroxidation and superoxide dismutase over-activity: A cross-sectional study among patients with dyspepsia in Cameroon.

Background and Aim: There is an intimate relationship between oxidative stress and inflammation. Helicobacter pylori (H. pylori) infection leads to gastritis in almost all the hosts. So, we hypothesize that gastritis in H. pylori infection may be described as the accumulation of continuous oxidative damage. Methods: The study was conducted from October 2020 to October 2021 at three reference health facilities in Cameroon. A total of 266 participants (131 males and 135 females) ranging from 15 to 88 years old with 48.28 ± 17.29 years as mean age were enrolled. Each participant gave a written informed consent and ethical committees approved the protocol. Biopsies samples were collected for H. pylori detection using histological examination and rapid urease test. Malondialdehyde (MDA) and glutathione (GSH) content, and catalase (CAT) and superoxide dismutase (SOD) activities were evaluated in serum as biomarkers of oxidative stress. Results: Helicobacter pylori was detected in 71.80% of our sample population. Low income level was associated with higher GSH level (P = 0.0249) and having family history of gastric cancer to higher SOD activity (P = 0.0156). A significant higher MDA content (P < 0.0001) and SOD activity (P = 0.0235) was recorded among infected individuals compared with noninfected ones. A significantly higher MDA content and SOD activity was recorded among smokers (P = 0.0461) and participants older than 50 years old (P = 0.0491) with H. pylori positivity. Conclusion: Our findings showed that H. pylori infection is associated with overproduction of reactive oxygen species and oxidative stress. The presence of this pathogen in elderly individuals or in smokers increased their risk for oxidative stress.

Involvement of CD95 and ligand in CD4+ T-cell and CD8+ T-cell depletion and hepatic cytolysis in patients with chronic viral hepatitis B.

BACKGROUND: Chronic viral hepatitis B (HBV) is characterised by progressive hepatocyte destruction and T-cell depletion. The mechanisms of the CD95-CD95 ligand (CD95L) signalling pathway during this chronic disease and the cirrhotic process remains unclear. OBJECTIVE: We evaluated the involvement of the CD95-CD95L receptor-ligand system in T-cell depletion and hepatic cytolysis in patients with chronic HBV. METHODS: This was a cross-sectional study conducted from September to December 2018 at the Yaoundé General Hospital, Cameroon. Four mL of whole blood was collected and analysed. The CD95 and CD95L levels, as well as the CD4+ T-cell and CD8+ T-cell counts, were performed by enzyme-linked immunosorbent assay and flow cytometry. RESULTS: Of the 130 HBV-positive patients, 36 (27.7%) were cirrhotic and 94 (72.3%) were non-cirrhotic. The cirrhotic patients had significantly elevated CD95 (p < 0.001) and CD95L (p = 0.001) plasma levels, compared with non-cirrhotic patients. The CD4/CD8 ratios were lower in cirrhotic patients, compared to non-cirrhotic patients (p < 0.001). There were statistically significant correlations between CD95 level and CD4+ T-cell counts, between CD95 level and CD8+ T-cell counts, between CD95 level and the CD4/CD8 ratio, between CD95 level and fibrosis score, and between CD95L level and fibrosis score. CONCLUSION: CD95 and CD95L could be involved in T-cell depletion and hepatic cytolysis during the pathogenesis of chronic HBV and could potentially be used as biomarkers for immunological and hepatic monitoring in patients with chronic HBV.

Epidemiology of hepatitis C: related hepatocellular carcinoma in Cameroon.

INTRODUCTION: 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). CONCLUSION: 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.