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    ABSTRACT: The purpose of this study was to identify risk factors for hepatitis C virus (HCV) infection in a rural village in the Nile Delta with a high prevalence of antibodies to HCV (anti-HCV). One half of the village households were systematically selected, tested for anti-HCV, and interviewed: 973 of 3,999 (24.3%) subjects were anti-HCV-positive (reflecting prior HCV infection but not necessarily current liver disease), with nearly equal prevalence among males and females. Anti-HCV prevalence increased sharply with age among both males and females, from 9.3% in those 20 years of age and younger to >50% in those older than 35, suggesting a cohort effect with reduced transmission in recent years. Multivariate regression was used to estimate independent effects of risk factors on seropositivity. Among those over 20 years of age, the following risk factors were significantly associated with seropositivity: age (P < .001); male gender (odds ratio [OR] = 2.5, 95% CI = 1.3-4.7); marriage (OR = 4.1, 2.4-6.9); anti-schistosomiasis injection treatment (OR = 2.0, 1.3-2.9); blood transfusion (OR = 1.8, 1.1-2.9), invasive medical procedure (surgery, catheterization, endoscopy, and/or dialysis) (OR = 1.5, 1.1-1.9); receipt of injections from “informal” health care provider (OR = 1.3, 1.0-1.6); and cesarean section or abortion (OR = 1.4, 1.0-1.9). Exposures not significantly related to anti-HCV positivity in adults included: history of, or active infection with, Schistosoma mansoni, sutures or abscess drainage, goza smoking in a group, and shaving by community barbers. Among those 20 years old or younger, no risk factors were clearly associated with anti-HCV positivity; however, circumcision for boys by informal health care providers was marginally associated with anti-HCV (OR = 1.7, 1.0-3.0). Prevention programs focused primarily on culturally influenced risks in rural Egyptian communities are being implemented and evaluated.
    Hepatology 12/2000; 33(1):248 - 253. · 12.00 Impact Factor
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    ABSTRACT: Hepatitis C virus (HCV), a major cause of chronic liv- er disease, is highly prevalent in Egypt. The morpho- logical criteria for diagnosis of HCV in liver tissue are suggestive, while the definite diagnosis relies on direct de- tection of HCV RNA. We attempted at localizing HCV gnomic RNA in for- malin fixed paraffin embedded liver tissue sections using the reverse transcription polymerase chain reaction in situ hybridization technique (RT in situ - PCR) versus standard in situ hybridization (ISH). Liver biopsies from 43 patients with clinical and his- tological evidence suggestive of HCV infection were in- cluded. PCR amplified viral complimentary DNA (cDNA) was detected in liver hepatocytes by in situ hybridization with a biotin labeled probe, in 32 cases, 32/43 (74.4%). The signal was seen as strong perinuclear reaction with occasional cytoplasmic reaction. From the 32 tissues found positive for HCV by RT in situ PCR, only 9 were positive using standard in situ hybridization, 9/32 (28.1%), with a weaker signal obtained. The present study recommends applying RT in situ PCR as a sensitive method for the confident diagnosis of HCV in liver biopsies that might help to assess morpho- logic criteria. The objective diagnosis of HCV by RT in situ PCR could limit therapeutic lines to positive cases.
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    ABSTRACT: The epidemiological and molecular characteristics of hepatitis C virus (HCV) infection in the general population have been poorly investigated in Africa. The aim of this study was to determine the prevalence, genotype distribution and epidemic history of HCV in the Gabonese general population. A total of 4042 sera collected from adults in 220 villages in all nine administrative areas of the country were screened for antibodies to HCV. HCV NS5B region sequencing was performed for molecular characterization and population genetic analyses. Of 4042 tested sera, 455 (11.2%) were positive. The seroprevalence of HCV varied significantly by administrative area, with the highest rate in Ogooué-Lolo province (20.4%) and the lowest in Ogooué-Maritine province (3.7%). History of parenteral injections, past hospital admission and age over 55 years were independent risk factors for HCV infection (p<0.0001). Phylogenetic analyses showed that 91.9% of the strains were genotype 4 (HCV-4), 5.7% genotype 1 and 2.2% genotype 2. HCV-4 strains were highly heterogeneous, with more than eight subtypes; subtype 4e predominated (57.3%). Coalescence analyses indicated that subtype 4e was the oldest, with an estimated most recent common ancestor of 1702 [95% CI, 1418-1884]. The epidemic profile indicated that it spread exponentially during the first part of the 20th century, probably by iatrogenic transmission. These results confirm the endemicity of HCV subtype 4e in Gabon and show that its spread is due to a cohort effect, with previous, possibly iatrogenic events. More extensive epidemiological studies are needed to better characterize the route of transmission and the dissemination of HCV in Gabon.
    PLoS ONE 01/2012; 7(8):e42002. · 3.53 Impact Factor