Intrafamilial transmission of hepatitis C in Egypt

National Hepatology & Tropical Medicine Research Institute, Cairo, Egypt.
Hepatology (Impact Factor: 11.06). 09/2005; 42(3):683-7. DOI: 10.1002/hep.20811
Source: PubMed


The incidence of hepatitis C (HCV) infection and associated risk factors were prospectively assessed in a cohort of 6,734 Egyptians from 2 rural villages who were negative for antibodies to HCV (anti-HCV). Initial and follow-up sera were tested for anti-HCV by enzyme immunoassay (EIA), and possible incident cases were confirmed by using the microparticle enzyme immunoassay (MEIA) and tested for HCV RNA. All follow-up serum samples converting from negative to positive without detectable HCV-RNA were further tested by recombinant immunoblot assay. Over an average of 1.6 years, asymptomatic anti-HCV seroconversion occurred in 33 people (3.1/1,000 person-years [PY]), including 28 (6.8/1,000 PY) in the Nile Delta village (AES), where prevalence was 24% and 5 (0.8/1,000 PY) in the Upper Egypt village (baseline prevalence of 9%). The strongest predictor of incident HCV was having an anti-HCV-positive family member. Among those that did, incidence was 5.8/1,000 PY, compared (P < .001) with 1.0/1,000 PY; 27 of 33 incident cases had an anti-HCV-positive family member. Parenteral exposures increased the risk of HCV but were not statistically significant; 67% of seroconverters were younger than 20 years of age, and the highest incidence rate (14.1/1,000 PY) was in children younger than 10 who were living in AES households with an anti-HCV-positive parent. In conclusion, young children would especially benefit from measures reducing exposures or preventing infection with HCV.

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    • "The total number of HCV infections reported here will be lower than those reported elsewhere since this analysis focuses on estimating the number of viraemic cases in the population after taking into account all age groups, mortality, new infections and cured patients. There is still evidence of high levels of ongoing HCV transmission [20] [21] [22] [23] with high HCV prevalence observed among young individuals [24] [25]. Table 1 shows that an estimated 168,000 new infections occurred in 2013, of which 102,000 went on to have chronic hepatitis C (CHC). "

    Full-text · Article · Jun 2014 · Arab Journal of Gastroenterology
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    • "Egypt suffers from the world’s highest prevalence of HCV infection - up to 24% in rural areas [9] - and intra-familial spread of HCV has been documented as one of the most important routes of transmission [11,12] leading to the current estimated burden of 10 million infected Egyptians. Added to this burden is the widespread use of pesticides as well as diets that are contaminated by aflatoxin B1 in rural areas, where over half of the Egyptian population resides and agriculture is the predominant occupation. "
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    ABSTRACT: Background Hepatocellular carcinoma (HCC), one of the most fatal types of malignancy, is increasing worldwide, and particularly in Egypt where there is a confluence of its contributing factors, including high prevalence of hepatitis C virus (HCV) infection, widespread use of pesticides, and diets that are contaminated by aflatoxin B1 (AFB1) in rural areas. We investigated knowledge, attitudes, and prevention practices related to HCV infection and pesticides use in rural Egypt, where over half of the population resides and agriculture is the predominant occupation. Methods From two rural villages we recruited 67 residents aged 18–80 years, who completed a 40-item survey that included questions about demographics, knowledge of and protective measures relevant to pesticides use in the home and in agriculture, awareness and perceptions of HCV infection and its treatment and prevention. Results Among the 67 study participants, gender distribution was equal, the mean age was 47.2, and one third never attended school. More than 50% reported using pesticides at home, but fewer reported having some knowledge about its health effects. Twelve participants were agricultural workers, and 11 of them applied pesticides in the field and knew about their toxicity; however only one person was correctly using the appropriate protective equipment. Among all the participants, 52 did not know what causes HCV infection, and 42 of those who knew it was a virus mentioned incorrect modes of transmission; and 30 did not know the disease manifestations. Conclusion In rural Egypt, there is a significant lack of knowledge of HCV infection and its transmission mode and limited use of protective measures against pesticides despite familiarity with these chemicals.
    Full-text · Article · May 2014 · BMC Public Health
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    • "This elevated risk of incident of HCV of family members could be due to sharing of implements such as razors or toothbrushes or due to sexual transmission between family members [14] [15]. Alternatively, the elevated risk may be due to shared risk factors (such as the family members all attending a particular health practitioner) rather than being caused by direct transmission between family members [13]. To disentangle these relationships it would be useful to know how HCV is patterned within families. "
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    ABSTRACT: Objective. To identify the risk factors for HCV infection within married couples in Egypt. Methods. In 2008 Egypt conducted its first nationally representative survey of HCV prevalence. 11126 of the 12780 individuals aged 15–59 year who were sampled agreed to participate and provided information via a questionnaire about demographic and behavioural characteristics and blood for HCV antibody and RNA analysis. We assessed the risk factors for HCV infection in a subsample of 5182 married individuals via multivariate logistic regression. Results. Overall HCV antibody prevalence in the married couples was 18.2% (95% CI, 16.8–19.6). HCV antibody prevalence was higher in the husbands (23.7%) than the wives (12.1%; P < 0.001 ). Having a spouse who was infected with HCV was an independent risk factor for HCV infection with odds ratios of 2.1 (95% CI, 1.6–2.9) and 2.2 (95% CI, 1.6–3.1) for women and men, respectively. Husbands whose wives had experienced female genital cutting (FGC) had a higher prevalence of HCV and this relationship was driven by a strong association in urban areas. Amongst the women there was no association between FGC and HCV overall but in urban areas only women who had experienced FGC were HCV infected. Conclusions. This study provides additional evidence of the importance of intrafamilial transmission of HCV in Egypt.
    Full-text · Article · Mar 2014
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