Hepatitis C virus infection and genotypes among human immunodeficiency virus high-risk groups in Cameroon.

Parenteral transmission of HCV is well established but other possible routes such as heterosexual transmission are still questioned. The Central African region is characterised by a high HCV endemicity without any evidence on the route of transmission. The information on HCV genotypes that circulate in this area is also limited and controversial. HIV infection is very frequent in this region and mostly acquired via the heterosexual route. The aim of this work was to investigate the trend of HCV infection and genotypes among HIV high-risk groups from Cameroon. Four hundred eighty-two patients including 229 tuberculosis clinic attendants, 184 sexually transmitted disease clinic attendants, and 69 HIV clinical suspects from another clinic were enrolled. All plasma samples were screened for antibodies to HCV and HCV RNA. Genotypes were assigned by sequencing a 5'UTR amplified fragment. The overall prevalence of HCV markers was 11.6% and a significant increasing trend with respect to age was observed. A proportion of 64.1% (34/53) of HCV antibody positive samples was viraemic. HCV RNA was found in 3 samples that were indeterminate in RIBA 3.0. One was negative in the antibody screening test and the two others were weakly positive. The data on HCV genotypes revealed that genotype 1 was involved in 57% of viraemias, genotype 2 in 24%, while genotypes 4 and 5a accounted for 16 and 3%, respectively. In contrary to the predominance of genotype 4 reported in some African countries and even the neighbouring countries, these data demonstrate clearly that HCV infection in Cameroon is dominated by genotypes 1 and 2. No association was found between the HCV markers and the presence of HIV infection. It is concluded, therefore, that the heterosexual route plays a minor role in HCV transmission in this country.     

High rate of hepatitis C virus infection and predominance of genotype 4 among elderly inhabitants of a remote village of the rain forest of South Cameroon

To determine the prevalence of hepatitis C virus (HCV) infection and genotype distribution in a rural isolated area of Central Africa, plasma of 409 Bantous (mean age, 32 years; range, 2-78 years) living in a remote village of the rain forest of Southern Cameroon was screened for anti-HCV antibodies. HCV seropositive samples were also subjected to qualitative detection of viral RNA. HCV antibodies were detected in 70 (17.1%) individuals, 48 (68.8%) of whom had detectable viremia. The seroprevalence did not differ by gender (P = 0.37), but increased significantly with age (P < 0.05), with a strong increase in the oldest age groups. Indeed, nearly one-half (48%) of the adults >50 years old were HCV seropositive. The characterization of the viral genotypes indicated that most of the HCV strains were of genotype 4 (76%), while genotype 2 (16%), and 1 (8%) were marginally represented. The results suggest a cohort effect with an old, possibly iatrogenic, group exposure rather than a continuous exposure. A more in-depth population-based epidemiological study is needed to address this issue further.     

Hepatitis C virus infection in cameroon: A cohort-effect

A hepatitis C virus (HCV) serological study conducted in 2003 on 1,434 individuals in Yaounde and other HCV seroepidemiological studies on 2,066 sera sampled between 1993 and 1997 in four geographically distinct rural areas (Ntem, Mekas, Yokadouma, and Nditam) in Cameroon, are described. Two patterns of HCV seroprevalence were observed. The first pattern, represented by Nditam and Yokadouma populations, showed low HCV seroprevalence rates (2.9% and 3.3%, respectively) increasing moderately with age (9.0% and 16.7% after age 50). The second pattern showed high seroprevalence rates (6.9% for Yaounde, 14.4% and 16.7% for Ntem and Mekas, respectively). These rates increased dramatically with age (32.8%-49.5% after age 50). The age-specific anti-HCV prevalence curve of the 1993 Mekas survey paralleled those of the 1997 Ntem and 2003 Yaounde surveys. Using the year of birth as the x-axis, the three curves closely matched each other. This clearly indicates a cohort effect for which the seroprevalence trends are clearly related with the year of birth, rather than the age. The highest prevalence was observed among people born around 1940.     

Hepatitis C virus infection and genotypes in Southern Israel and the Gaza strip

The Gaza Strip borders the southern part of Israel and Egypt. There is a remarkable difference in the prevalence of antibodies to hepatitis C virus (HCV) between Israel (0.5%) and Egypt (10%). A few thousand inhabitants cross the borders daily from the Gaza Strip to both countries. The objectives of this study were to investigate the prevalence of HCV infection in the Gaza Strip, an area that was not studied before, and to study HCV transmission in the Gaza Strip by characterizing the genotypes of HCV in Southern Israel and the Gaza Strip and comparing them with those found in Egypt. HCV prevalence in the Gaza Strip was found to be 2.2%, relatively higher than in Israel but lower than in Egypt. The most common genotypes found were type 1b in Southern Israel and type 4 in the Gaza Strip, corresponding to the most prevalent genotype in Egypt. Similarity between type 4 isolates from the Gaza Strip and Egypt was illustrated further by sequence analysis of the HCV 5′ noncoding region (NCR). J. Med. Virol. 56:230–233, 1998. © 1998 Wiley-Liss, Inc.     

Rapid screening for co-infection of HIV and HCV in pregnant women in Benin City,Edo State,Nigeria

Background

Human Immunodeficiency virus (HIV) and Hepatitis C virus (HCV) are both major global health concerns as they cause high mortality and morbidity in the developing countries. However, while data exists for the co-infection in other countries, little or no information can be found with regard to the sero-prevalence of HIV and HCV co-infection in Nigeria, albeit in pregnant women attending antenatal care clinics in Benin City, Nigeria.

Objective

The objective of the study was to determine the sero-prevalence of HIV and HCV among pregnant women seeking antenatal care in Benin City.

Methods

In determining the sero-prevalence in a cross-sectional study, 200 pregnant women, aged between 15 and 49 years were screened for HIV and HCV using rapid screening test kits. Using closed ended structured questionnaires; the respondents volunteered socio-demographic information associated with risk factors of HIV and HCV acquisition.

Results

Results indicated sero-prevalence of HIV and HCV in the sampled population was 3% and 5% respectively. Thirty three percent of the pregnant women that were HCV positive were co-infected with HIV-1 infection. HIV sero-prevalence was highest in the age group, 25–29 representing 5.1%, while HCV sero-prevalence was noted highest among the women in the age group 30–34 years, representing 7.9%. Two percent of the pregnant women had equivocal (ambivalent) HIV-1 results.

Conclusion

The study has shown a prevalence of HIV-HCV co-infection among the tested pregnant women in Benin City and more epidemiological surveys are needed in larger scale to decipher the prevalence in other states of Nigeria.     

Worldwide prevalence of human papillomavirus among pregnant women: A systematic review and meta-analysis

Human papillomavirus (HPV) is the causative agent of cervical cancer and a suspected agent for ovarian and endometrial cancers in women. It is associated with adverse outcomes during pregnancy. To date, there is no estimate of the prevalence of HPV infection in pregnant women at the regional and global levels. This study evaluated the global prevalence of HPV infection based on all observational studies that had reported the prevalence of HPV among pregnant women between January 1980 and December 2021 in PubMed/MEDLINE, Scopus, Web of Science, Embase, and SciELO databases. We utilised a random-effect model to determine the global prevalence and related risk factors of HPV infection. Between-studies heterogeneity was assessed using I² statistic. Moreover, subgroup and meta-regression analyses were employed to assess the source of heterogeneity and the relationship between HPV prevalence and socio-demographic factors, respectively. Among 144 eligible studies comprising 189 datasets, the overall prevalence rates of HPV at the 95% confidence interval (CI) were estimated as 30.38% (26.88%–33.99%), 17.81% (9.81%–27.46%), 32.1% (25.09%–39.67%), 2.26% (0.1%–8.08%) and 25.5% (23.3%–27.8%) in cervico-vaginal, placenta, serum, amniotic fluid and urine samples, respectively. The highest prevalence rates were estimated for countries in the African region, while countries in the European and Eastern Mediterranean regions showed the lowest prevalence rates. HPV-16 and -18 were the most prevalent isolated strains. The pregnant women living with HIV and those with pregnancy disorders had significantly higher prevalence rates than general pregnant women (p < 0.05). The younger ages for first intercourse and pregnancy, multiple lifetime sexual partners, and lower education levels were primary risk factors for HPV infection. In conclusion, although the overall HPV prevalence varied markedly based on sampling sites and geographical locations, the highest prevalence rates were observed in less-developed countries. Our findings imply that implementing behavioural and therapeutic interventions as well as vaccination programs are crucial to prevent and reduce the current burden of HPV infection among pregnant women.     

Low prevalence of hepatitis E infection among pregnant women in Madrid,Spain

Hepatitis E virus, a cause of sporadic hepatitis in developed countries is present in Spain. The aims of this study were to determine whether the prevalence of IgG anti‐hepatitis E virus antibodies has increased in recent years in Spain and the prevalence in a study population at risk of developing the disease following the infection. Serum samples from 1,040 women in the first trimester of pregnancy were studied. The prevalence rate of 3.6% has not increased significantly since 1999 in spite of the large number of immigrants from endemic regions. IgM anti‐HEV antibodies were detected in 0.67% of the patients suggesting that although subclinical infection exists the prevalence is very low. The reasons for the differences in the morbidity of HEV in pregnant women in different geographical areas remain unclear. Good hygienic measures and public health conditions are important factors for ensuring low prevalence of hepatitis E in Spain. J. Med. Virol. 82:1666–1668, 2010. 2010 Wiley‐Liss, Inc.     

Hepatitis C virus genotypes in different regions of the former Soviet Union (Russia,Belarus, Moldova,and Uzbekistan)

The prevalence of HCV genotypes in four republics of the former Soviet Union (Russia, Belarus, Moldova, and Uzbekistan) was investigated. Overall, 197 HCV isolates from 66 blood donors and 131 patients with chronic hepatitis were typed. Viral sequences from sera of infected subjects were amplified by nested RT-PCR using primers from the core region and typed by one or two techniques: (1) DNA enzyme immunoassay (DEIA) and (2) PCR with a set of type-specific primers. Only three major HCV genotypes were identified in this study population. HCV 1b was found to be the predominant virus type both among blood donors and chronic hepatitis patients, followed by 3a, 2a, and 1a (chronic hepatitis patients: 1b-82%; 3a-10%; 2a-4%, 1a-5% and 2c-1%; blood donors: 1b-77%; 3a-17%; and 2a-6%). No significant difference in genotype distribution was observed between different countries or between blood donors and chronic hepatitis patients within the same country. Results of the genotyping procedures were confirmed by direct sequencing of 216 nt PCR fragments corresponding to part of HCV core gene. Phylogenetic analysis of HCV 1b sequences from this study and from the Genbank demonstrated that the sequences from the former Soviet Union do not form evolutionary lineage(s) different from those of strains of the same subtype circulating in other geographical regions. J. Med. Virol. 53:36–40, 1997. © 1997 Wiley-Liss, Inc.     

Hepatitis C virus genotypes in 1,504 patients in Slovenia, 1993–2007

In order to identify the main routes of hepatitis C (HCV) transmission and to determine the HCV genotype distribution and its dynamics during a 15‐year period in Slovenia, HCV genotypes were detected using the INNO‐LiPA HCV II (Innogenetics) test for serum samples obtained from 1,504 patients representing 72.6% of all patients with chronic hepatitis C diagnosed from 1993 to 2007. HCV genotype 1 was predominant (56%), followed by genotypes 3, 2, and 4, with a prevalence of 37.8%, 5%, and 1.2%, respectively. HCV genotypes 5 and 6 were not detected in any patient. Patients infected with HCV genotype 3 were significantly younger (mean age 28.9 ± 8.5 years) than those infected with genotype 1 (mean age 38.9 ± 14.8 years; P < 0.0001) and those infected with HCV genotype 2 (mean age 50.3 ± 18.2 years; P < 0.0001). Intravenous drug use was identified as the most frequent possible HCV transmission route (34.3%), followed by medical‐related transmission such as transfusion of HCV‐contaminated blood or blood products, and hemodialysis (12.5%). Being an intravenous drug user was found to be strongly associated with HCV genotype 3 (OR, 3.71 [95% CI, 2.97–4.65]; P < 0.0001) and reporting infection by transfusion of blood or blood products was found to be strongly associated with HCV genotype 1 (OR, 3.28 [95% CI, 2.18–4.95]; P < 0.0001). During the 15‐year period, the proportion of genotype 3 increased substantially, reflecting the fact that the HCV epidemic in Slovenia is driven mostly by intravenous drug use. J. Med. Virol. 81:634–639, 2009 © 2009 Wiley‐Liss, Inc.     

Hepatitis C virus recombinants are rare even among intravenous drug users

Systematic studies of the circulation of hepatitis C virus (HCV) recombinants in different parts of the world have been initiated only recently, and no detailed information on this subject is available. The aim of the current investigation was to determine the frequency of HCV recombinants in intravenous drug users (IVDU) from two European countries. HCV RNA from serum samples was tested by RT‐PCR with primers derived from the core and NS5B regions with subsequent sequencing and genotype assignment. The 118 samples from Germany (100%) and 45 out of 47 (96%) sera from Russia demonstrated concordant genotyping results. In the two genotype discrepant sera from Russia 2k/1b recombinants were identified. In order to test the hypothesis that the individuals from the IVDU group might be multiply exposed to various genotypes, 145 out of 165 genotyped serum samples, which were found to be positive for anti‐NS4 antibodies, were serotyped with the Murex HCV serotyping kit that is based on detection of antibodies to type‐specific peptides derived from the NS4 proteins of different HCV genotypes. Discrepancy in genotype and serotype attributions was observed in 11% cases. Retesting of 99 type 1a or 3a samples with a set of type‐ and subtype‐specific primers revealed the presence of a mixed infection only in one case (1a/3a). Thus, the cases of the mixed infection with different HCV genotypes as well as the recombinant forms of HCV are very rare even in such a highly exposed group as IVDU. J. Med. Virol. 82:232–238, 2010. © 2009 Wiley‐Liss, Inc.     

Hepatitis C virus infection among drug addicts in Italy

There is a lack of updated nationwide records regarding hepatitis C virus (HCV) infection among drug addicts in Italy. The prevalence and characteristics of HCV infection in a national sample of drug addicts in Italy were determined. Five hundred forty‐three drug addicts (mean age 35.3 years, 85.1% males), selected from 25 Italian Centers for Substance Dependence were enrolled to be evaluated for anti‐HCV, HCV‐RNA, HCV genotype, HBV markers, anti‐HDV, and anti‐HIV during the period of April–November 2009. Anti‐HCV prevalence was 63.9%. HCV‐RNA was detected in 68.3% of patients positive for anti‐HCV. Genotypes 1 and 3 prevailed (49.3% and 39.7%, respectively). However, 9.3% of the subjects had genotype 4, a rate over threefold higher than the one observed in 1996 among drug addicts in central Italy. Needle sharing was the strongest independent predictor of the likelihood to contract an HCV infection (OR 8.9; 95% CI: 5.0–16.0). Only 19.3% of subjects received antiviral treatment for HCV. The prevalence of HBsAg and HIV positivity was 2.8% and 3.1%, respectively. The pattern of HBV markers showed that nearly one‐third of subjects had been vaccinated, while 42.3% were negative for any marker of HCV. The prevalence of HCV infection is high among drug addicts in Italy. The incidence of Genotype 4 is increasing and this may lead to the spreading of the disease to the general population in the near future. Efforts should be made to improve the rate of antiviral treatment for drug addicts with HCV infection and vaccination against hepatitis B. J. Med. Virol. 84:1608–1612, 2012. © 2012 Wiley Periodicals, Inc.     

Hepatitis B virus infection among pregnant women in Haiti: A cross-sectional serosurvey

BackgroundHepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule.ObjectivesDetermine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT.Study designWe selected 1364 residual serum specimens collected during a 2012 human immunodeficiency virus (HIV) sentinel serosurvey among pregnant women attending antenatal care clinics. Haiti was stratified into two regions: West, which includes metropolitan Port-au-Prince, and non-West, which includes all other departments. We evaluated the association between demographic and socioeconomic characteristics and HIV infection with HBV infection.ResultsOf 1364 selected specimens, 1307 (96%) were available for testing. A total of 422 specimens (32.7%) tested positive for total anti-HBc (38.2% in West vs. 27% in non-West, p < 0.001), and 33 specimens (2.5%) were HBsAg positive (2.1% in West vs. 3% in non-West, p = 0.4). Of HBsAg positive specimens, 79% had detectable HBV DNA. Women aged 30 and older had more than double the odds of positive total anti-HBc than women aged 15–19 years (p < 0.001). Women with secondary (adjusted odds ratio (aOR) = 0.54; 95% CI: 0.36–0.81) and post-secondary education (aOR = 0.40, 95% CI: 0.19–0.79) had lower odds of total anti-HBc positivity compared with women with no education. HIV-status was not associated with HBV infection.ConclusionsHaiti has an intermediate endemicity of chronic HBV infection with high prevalence of positive HBV DNA among chronically infected women. Introduction of a universal birth dose of hepatitis B vaccine might help prevent perinatal HBV transmission.     

Prevalence and correlates of GB virus C infection in HIV-infected and HIV-uninfected pregnant women in Bangkok, Thailand

GB virus C (GBV-C) is an apathogenic virus that has been shown to inhibit HIV replication. This study examined the prevalence and correlates of GBV-C infection and clearance in three cohorts of pregnant women in Thailand. The study population consisted of 1,719 (1,387 HIV-infected and 332 HIV-uninfected) women from three Bangkok perinatal HIV transmission studies. Stored blood was tested for GBV-C RNA, GBV-C antibody, and if RNA-positive, genotype. Risk factors associated with the prevalence of GBV-C infection (defined as presence of GBV-C RNA and/or antibody) and viral clearance (defined as presence of GBV-C antibody in the absence of RNA) among women with GBV-C infection were examined using multiple logistic regression. The prevalence of GBV-C infection was 33% among HIV-infected women and 15% among HIV-uninfected women. GBV-C infection was independently associated (AOR, 95% CI) with an increasing number of lifetime sexual partners (referent-1 partner, 2 partners [1.60, 1.22-2.08], 3-10 partners [1.92, 1.39-2.67], >10 partners [2.19, 1.33-3.62]); injection drug use (5.50, 2.12-14.2); and HIV infection (3.79, 2.58-5.59). Clearance of GBV-C RNA among women with evidence of GBV-C infection was independently associated with increasing age in years (referent <20, 20-29 [2.01, 1.06-3.79] and ≥30 [3.18, 1.53-6.60]), more than 10 lifetime sexual partners (3.05, 1.38-6.75), and HIV infection (0.29, 0.14-0.59). This study found that GBV-C infection is a common infection among Thai women and is associated with HIV infection and both sexual and parenteral risk behaviors.     

Toxoplasma gondii, HCV, and HBV seroprevalence and co-infection among HIV-positive and -negative pregnant women in Burkina Faso

Toxoplasma gondii (T. gondii) infections can cause serious complications in HIV-infected pregnant women, leading to miscarriage, stillbirth, birth defects (e.g., mental retardation, blindness, epilepsy etc.) and could favor or enhance the mother-to-child transmission of HCV, HBV, and HIV vertical transmission. From May 20, 2004 to August 3, 2005, 336 18-45 years aged pregnant women, were enrolled for an investigation of the prevalence of serum antibodies against T. gondii, HCV, HBV, and HIV using ELISA. The prevalence of T. gondii, HCV, and HBV in pregnant women was 25.3%, 5.4%, and 9.8%, respectively and the HIV serostatus (61.6%) seems to be associated with greater prevalence rates of both T. gondii (28.5% vs. 20.2%) and HBV (11.6% vs. 7.0%). Without taking into account HIV, only 65.5% (220 of 336) of the women were not infected with these agents. The co-infection rate between HIV-infected and -negative women was different statistically: T. gondii/HBV 0.048 versus 0.015, T. gondii/HCV 0.014 versus 0.008, and HCV/HBV 0.005 versus 0.008, respectively. The elevated co-infection rate in HIV-positive women demonstrated that they are exposed to T. gondii, HCV, and HBV infections prevalently by sexual contact.     

Group B streptococcus prevalence in pregnant women from North-Eastern Italy: advantages of a screening strategy based on direct plating plus broth enrichment

AIMS: To assess the sensitivity of a combined selective broth enrichment technique plus selective plating for the detection of group B streptococcus (GBS) colonisation in a large cohort of pregnant women from North-Eastern Italy. METHODS: During 2002-2005, 5020 pregnant women were screened between the 35th and the 37th week of gestation. A lower vaginal sample and a rectal sample were collected and inoculated onto LIM broth and a selective colistin aztreonam blood agar plate (CAP). Direct agar plates were examined after 18-24 hours and, if negative, after 48 hours. LIM broth was subcultured after 18-24 hours onto a Columbia blood agar plate. All colonies suggestive for GBS were submitted to phenotypic identification. RESULTS: 901 Women (17.9%) were positive for GBS. On 728 positive samples, corresponding to patients enrolled between 2003 and 2005, the results of selective direct plating and selective broth enrichment were compared. A total of 561 (77.1% of positive samples, corresponding to 13.9% of patients) were positive on direct selective agar; an additional 167 isolates (22.9% of samples, 4.1% of patients) were recovered from the LIM broth subculture. CONCLUSIONS: The prevalence of GBS carriage in this population-based study is a reliable estimate considering the sensitivity of the microbiological methods used, the rate of attendance of pregnant women to clinical and laboratory settings and the compliance to the protocol. Results confirm that the combination of selective enrichment broth and selective direct plating is a time-saving and sensitive method.