Is the hepatitis C virus epidemic over in Egypt? Incidence and risk factors of new hepatitis C virus infections
Version of Record online: 5 FEB 2010
© 2010 John Wiley & Sons A/S
Volume 30, Issue 4, pages 560–566, April 2010
How to Cite
Mostafa, A., Taylor, S. M., El-Daly, M., El Hoseiny, M., Bakr, I., Arafa, N., Thiers, V., Rimlinger, F., Abdel-Hamid, M., Fontanet, A. and Mohamed, M. K. (2010), Is the hepatitis C virus epidemic over in Egypt? Incidence and risk factors of new hepatitis C virus infections. Liver International, 30: 560–566. doi: 10.1111/j.1478-3231.2009.02204.x
- Issue online: 22 FEB 2010
- Version of Record online: 5 FEB 2010
- Received 15 September 2009Accepted 22 December 2009
- intrafamilial transmission;
- risk factors
Objectives: To estimate hepatitis C virus (HCV) incidence rates and identify risk factors for current HCV transmission with emphasis on the role of living with infected household family members in rural Egypt.
Methods: A 4-year population-based, cohort study of seronegative villagers was conducted to identify incident HCV seroconversion cases. A risk factor questionnaire and blood samples for anti-HCV EIA-3 and HCV RNA polymerase chain reaction testing were collected at two rounds of follow-up. Incidence rates, relative risks and 95% confidence interval (CI) were calculated based on a Poisson distribution. A matched case–control analysis to explore specific behavioural predictors of infection was conducted and odds ratios were obtained by conditional logistic regression.
Results: Twenty-five participants (11 females) seroconverted in 10 578 person years of follow-up (PY), (incidence rate of 2.4/1000 PY; 95% CI: 1.6–3.5). The median age at seroconversion was 26 years [interquartile range (IQR) 19–35] among males and 20 years (IQR 13–24) among females. The only significant risk factor identified for these cases was receiving injections [adjusted odds ratio (ORadj)=3.3; 95% CI: 1.1–9.8]. Two of the 17 viraemic seroconvertors were infected with the same strain as at least one of their family members.
Conclusion: This study identified the important role of injections in spreading HCV infection in this rural community. National healthcare awareness and infection control programmes should be strengthened to prevent further transmission. Screening of families of infected HCV subjects should be an essential part of case management for early detection and management.