Viral hepatitis as a differential diagnosis of yellow fever suspected cases in Cameroon: Prevalence and molecular characterization.

OBJECTIVES

The aim of this study was to determine the prevalence and genetic diversity of viral hepatitis among clinical cases of acute febrile jaundice initially suspected to be yellow fever (YF).

METHODS

We conducted a prospective cross-sectional study on YF-negative suspected samples collected between September 2024 and January 2025. The pentaplex polymerase chain reaction assay was used to detect five hepatotropic viruses. All detected viruses were genotyped, sequenced, and phylogenetically analyzed.

RESULTS

Among the 404 participants tested, viral hepatitis was diagnosed in 107 (26.5%; 95% confidence interval [CI]: 22.4-31.0%). The proportions were: hepatitis A virus (HAV) 70.1% (75/107), hepatitis B virus (HBV) 23.4% (25/107), hepatitis C virus (HCV) 3.7% (4/107), and hepatitis E virus (HEV) 2.8% (3/107). No sample was positive for hepatitis D virus, and no dual viral infections were detected. HAV was most common in patients under 15 years of age, while HBV was most common in patients aged over 15. The genotypes identified were HAV-IB and HAV-IIA, HBV-A and E, HCV-1 and HCV-4, and HEV-4.

CONCLUSIONS

Our study shows that viral hepatitis plays a key role in acute febrile jaundice cases, which are often attributed to the YF virus in Cameroon.