Study of the high prevalence of HCV in Egypt

The correlation of schistosomiasis and other variables as a risk factor behind the remarkable high rates of HCV seropositivity in Egypt was studied by examining the sera of 188 subjects (94 apparently healthy villagers and 94 non professional blood donors) for schistosoma antibodies by Falcon assay screening test enzyme linked immunosorbent assay (FAST-ELISA) and for HCV antibodies by the application of screening (ELISA) and confirmatory (RIBA) techniques. The results showed that the overall prevalence of HCV antibodies was 29.8% by ELISA reduced to 21.8% i.e. 73.2% confirmation by RIBA test. HCV-RNA (HCV viraemia) was detected in 76% of 25 ELISA anti-HCV positive sera by P.C.R. technique. After adjustment for age, there was no statistical significant correlation between the remarkable high rates of HCV seropositivity in Egypt and risk factors studied other than blood transfusion, and schistosomiasis.     

Antibodies to hepatitis C virus in blood donors

Recently a recombinant polypeptide of hepatitis C virus (HCV) has been developed by the Chiron Corporation in California. This antigen has been used to develop an ELISA test (Ortho Diagnostic Systems) for serum anti-HCV antibodies. Preliminary data have shown that this virus is the major cause of NANB hepatitis in the world. We examined differences in anti-HCV prevalence among subgroups of blood donors (total sera examined 639) classified for past or present exposure to HBV or not, and for ALT levels. The anti-HCV prevalence found in regular blood donors with normal ALT levels and no antibody to HBcAg was 1.2%. No significant difference in the anti-HCV prevalence was found among other subgroups of blood donors except that a higher prevalence (10%) was found in a group with both elevated ALT and HBV markers.These preliminary findings suggest that the policy of blood supply should take into account the advent of HCV antibody test.     

Prevalence of and risk factors for hepatitis C in rural pregnant Egyptian women

Prevalence and risk factors for hepatitis C virus (HCV) infection were studied in 2,587 pregnant women from three rural Egyptian villages in the Nile Delta being admitted to a prospective cohort study of maternal-infant transmission; 408 (15.8%) had antibodies to HCV (anti-HCV) and 279 (10.8%) also had HCV-RNA. Fewer than 1% gave a history of jaundice or liver disease. Risk factors for anti-HCV included increasing age, low socioeconomic status and a history of blood transfusion or injection therapy for schistosomiasis. Sub-analyses after stratification of subjects by village revealed risks associated with specific venues for medical care, having a previous delivery attended by a traditional birth assistant (TBA), receiving medical care in a temporary clinic located in a mosque, overnight admission to a private doctor's clinic, and circumcision by a TBA or a 'health barber'. Our results suggest HCV causes very little detected illness in young adult Egyptian women and some sources of HCV transmission in rural Egypt in the past were associated with the provision of medical care and varied by location. Prevention should be focused on providing appropriate resources and health education should be given to formal and informal health care providers and should be sufficiently broad to adjust for local variations in exposures.     

Incidence of hepatitis C virus antibodies in blood donors, high risk patient groups, liver diseases and health professionals. Multicenter study of the ABBOT ELISA method, comparison with the ORTHO test

Serum samples from 1185 individuals (blood donors, health care workers, patients on haemodialysis or from other high risk groups or with non-A, non-B [NANB] hepatitis and other liver diseases) were examined for antibody to a recombinant antigen of hepatitis c virus (anti-HCV). A new ABBOTT HCV EIA system was used and a parallel study with ORTHO HCV ELISA was also done for 380 samples to compare the two anti-HCV tests. A confirmatory neutralizing ABBOTT ELISA probe was also performed in 45 cases. Anti-HCV seropositivity was found in 1.60% of accepted healthy blood donors, while among subjects excluded from donation for elevated aminotransferase the rate was 8.95%. In patients on haemodialysis 47.15% anti-HCV prevalence was found, in other high risk group subjects 32.5%. Patients with acute post-transfusion (PT) NANB hepatitis showed 40% prevalence, this rate in chronic PT-NANB was 77.8%. The two ELISA tests revealed 95% agreement in the parallel determinations. Serial dilution studies of anti-HCV positive sera showed that ABBOTT test was of superior sensitivity. The results of the confirmatory test suggest that reactive (positive) samples of low optical density near to the cut-off value require a confirmation with the neutralization test. In conclusion HCV infection in Hungary seems to be a common aetiologic factor in PT-NANB hepatitis and the screening of blood donors for anti-HCV may be useful. However, because of financial difficulties, cost/benefit calculations are recommended before the introduction of this preventive measure.     

近期ALT升高史单采浆供者乙型肝炎和丙型肝炎病毒感染现状的调查

对一组一年内一次以上ALT升高史的单采浆供者血清中多项乙肝与丙肝病毒感染标志进行了检查,并与本地区无ALT升高史供浆者进行比较。两组检测结果分别为抗HCV:14.03%和6.45%;抗HCV-IgM:3/8和2/13;HBsAg:2.82%和0.46%;抗HBs:32.39%和25.35%;抗HBc:45.07%和33.18%;其检出率前者均高于或显著高于后者,并与ALT升高次数有显著的伴随关系。     

TT virus among blood donors in Alexandria

TTV is a non enveloped, single-stranded, circular- DNA virus that has been assigned to the Family Circiniviridae. The primary mode of TTV transmission was proposed to be transfusion (and hence its name). Little is known about the clinical significance and the natural history of TTV infection. Hence, responsibility of the virus for specific liver disease is still debated. In our study, we tested ninety five blood donors attending Kom EL-Decka regional blood bank in Alexandria for the presence of TTV DNA in their sera by PCR technique. The same samples were tested for ALT and AST levels by colorimetric technique and for HBsAg and anti-HCV by the ELISA technique. Out of the 95 blood donors, 46 (48.4%) had TTV DNA in their sera. None of the 95 blood donors included in this study was positive for HBsAg, while 22 (23.2%) were anti-HCV positive. Out of the 22 anti-HCV positive blood donors, 13 (59.1%) were TTV DNA positive, while out of the 73 anti-HCV negative blood donors, 33 (45.2%) had TTV DNA in their sera. There was no statistically significant difference between the prevalence of TTV DNA and anti-HCV in blood donors. No biochemical evidence of liver disease potentially linked to the TTV infection was observed in our blood donors who were TTV DNA positive. Furthermore, the occurrence of elevated serum AST and ALT was most often linked to HCV rather than TTV.     

降低输血后HCV感染的临床研究

目的：探讨输血后ＨＣＶ感染高发的原因并提出降低发生率的可行措施。方法：对１３８例定期筛检供血及６８例献血前筛检供血的受血者进行了前瞻性调查。用定量ＰＣＲ试剂盒,通过荧光检测仪对１０份供血进行ＨＣＶ ＲＮＡ定量分析;对４１例血清进行ＨＣＶ ＲＮＡ定量、ＡＬＴ用抗－ＨＣＶ检测;用ＲＴ－ＰＣＲ法对３４份抗－ＨＣＶ（－）供血作ＨＣＶ ＲＮＡ定性分析。结果：两种方法筛检供血所致的输血后ＨＣＶ感染率分别为３４     

献血员人群HCV感染状况及其输血传播的调查

采用ELISA对1572份献血员血清进行抗HCV检测,阳性率为12.15％。其中女性献血员抗HCV阳性率较男性为高、单采浆献血员者较单纯献血全血者为高,抗HCV检测阳性率随献血员年龄增长而增高。近期ALT升高的单采浆献血者血清抗HCV阳性者显著地高于无近期ALT升高史的同类单采浆献血员。结果证实严格开展献血员HCV感染者筛选将有助于输血相关性的丙肝的预防。     

山西有偿献血地区某村HBV、HCV、HIV感染现状分析

目的了解山西省农村有偿献血地区HBV、HCV、HIV感染状况及有偿献血对其分布的影响.方法对某村的946名20～65岁居民进行调查,采用ELISA法分别检测血清中HBsAg、HBsAb、HBeAg、HBeAb、anti-HCV和HIV抗体.结果HIV抗体全为阴性,HBsAg、HBsAb、HBeAg、HBeAb、anti-HCV的阳性率分别为5.3%、54.5%、2.5%、22.5%、1.7%;其中有偿献血人员108名,相应的阳性率分别为0.9%、63.9%、0.9%、18.5%、4.6%,从未有偿献血人员838名,相应的阳性率分别为5.8%、53.3%、2.7%、23.0%、1.3%.与未有偿献血的研究对象相比,曾经有偿献血的研究对象HBsAg、HBsAb和anti-HCV的阳性率差异有显著性.结论该村未发现HIV感染者,HBV、HCV感染与其他地区无明显不同,有偿献血人员HCV感染率较高.     

人类免疫缺陷病毒血源传播问题的探讨

目的　探讨人类免疫缺陷病毒 (HIV)血源传播来源问题。方法　收集全国各地HIV阳性血清 6 2份 ,其中献血员血清 2 7份 ,静脉吸毒者血清 35份 ,用EIA法进行HBV、HCV血清学检测。结果　HIV感染者HBV总感染率为 5 3.2 % (33/ 6 2 ) ;抗 -HCV阳性率为 95 .2 % (5 9/ 6 2 )。HIV、HBV、HCV三重感染率为 5 1.6 % (32 / 6 2 ) ,HIV、HCV和HIV、HBV二重感染率分别为 2 7.4% (17/6 2 )和 1.6 % (1/ 6 2 )。献血员中HBV总感染率 44 .4% (12 / 2 7) ,抗 -HCV阳性率 10 0 % (2 7/ 2 7) ;静脉吸毒者中HBV总感染率 6 0 .0 % (2 1/ 35 ) ,抗 -HCV阳性率 91.4% (32 / 35 )。经统计学处理 ,两人群HBV感染率与抗 -HCV阳性率差异无显著性 (P >0 .0 5 )。对两人群中HIV、HBV、HCV三重、双重、单一感染率分析发现 ,两人群间差异也无显著性 (P >0 .0 5 )。结论　结果提示 ,HIV感染献血员和HIV感染静脉吸毒者HCV感染率很高 ;两人群在感染HIV、HBV、HCV高危因素上存在着一定的内在联系 ,静脉吸毒可能是引起我国HIV血源传播的主要根源     

我国部分地区献血员HCV感染的血清流行病学研究

对甸部分地区献血２２７３人ＨＣＶ感染的血清流行病学进行了研究。义务献血员抗－ＨＣＶ检出率为０－１．１０％，辽宁和安微职业献血员抗－ＨＣＶ检分别为１．４９％和３．１４％，但河北和内蒙职业献血－ＨＣＶ检出率高达３０．１３％和３１．８６％。既往有肝炎病史、ＡＬＴ异常史以及ＡＬＴ异常者抗－ＨＣＶ检明显高于无肝炎病史和ＡＬＴ异常者抗－ＨＣＶ检出率明显高于无肝炎病史和ＡＬＴ正常者；献血浆是感染ＨＣＶ的主要原因     

Risk factors for hepatitis C virus infection among blood donors in an HIV-epidemic area in Thailand.

OBJECTIVE: The role of sexual transmission in hepatitis C virus (HCV) infection has not yet been completely elucidated. This study aimed to compare the risk factors for HCV and human immunodeficiency virus (HIV) infection in an HIV epidemic area of Thailand where HIV is mainly transmitted heterosexually. DESIGN AND SUBJECTS: Sera from 3053 blood donors were collected and tested for HCV and HIV between January and March 1994. Altogether 1756 (57.5%) of the donors were interviewed about demographics and several risk factors. RESULTS: The prevalence rates of HIV and HCV infections determined by antibody assays were 2.3% and 2.2%, respectively. Sexual risk factors were clearly shown among anti-HIV positive donors. These clear associations were not found, however, among anti-HCV positive donors. In contrast, previous histories of injecting drug use and being tattooed were found in some anti-HCV positive donors but less frequently in anti-HIV positive donors. CONCLUSIONS: Sexual transmission may play a relatively minor role in HCV transmission compared with HIV, in this area.     

The prevalence of hepatitis C virus antibodies among the voluntary blood donors of New Delhi,India

Infection with hepatitis C virus (HCV) is a major cause of transfusion-associated hepatitis, cirrhosis and hepatocellular carcinoma. The present study was conducted with an objective to evaluate the prevalence of anti-HCV antibody in New Delhi, India using a large number of healthy voluntary blood donors. A total of 15,898 healthy voluntary blood donors were subjected to anti-HCV testing (using a commercially available third generation anti-HCV ELISA kit) and 249 were found to be reactive for anti-HCV antibody, yielding an overall prevalence of 1.57%. No significant difference was found between the HCV positivity rate of male (1.57%; 238/15,152) vs. female (1.47%; 11/746) donors, family (1.58%; 213/13,521) vs. altruistic (1.51%; 36/2377) donors and first-time (1.55%; 180/11,605) vs. repeat (1.61%; 69/4293) donors. The age distribution of anti-HCV reactivity showed a maximum prevalence rate of 1.8% in the age group of 20–29 years. In addition, there was a clear trend of decreasing positivity for anti-HCV with increasing age and this trend was statistically significant. The results of the present study show that the prevalence of anti-HCV antibodies in the healthy voluntary blood donors of New Delhi, India is considerably higher than the reported seroprevalence of HCV in majority of the industrialized nations and this represents a large reservoir of infection capable of inflicting significant disease burden on the society. In addition, donors of New Delhi, India showed a trend of decreasing seroprevalence with increasing age, possibly implying a higher exposure rate to HCV in younger subjects.     

Surveillance system for HCV infection: testing a model based on blood banks

Developing a National surveillance system for hepatitis C virus infection could provide a reasonable tool for reflecting changes in the trend of the disease in the Egyptian community. The aim of the study is to develop a national sentinel surveillance system, based on blood banks, by measuring the prevalence of hepatitis C virus antibody in the sera of blood donors. The results were compared with that of the National community-based survey (NS) of the year 1997 from the areas surrounding the blood banks by age-standardized methods. Data were collected retrospectively from 3 blood banks in Cairo. The study population included 2845 consecutive blood donors from the years 1999 and 2000: 1265 (998 males and 267 females) from Mansheyat Elbakry blood bank, 986(840 males and 146 females) from El Galaa blood bank, and 594 (531 males and 63 females) from Ahmed Maher blood bank. Data collected from sheet includes personal data, blood banks serology results of HCV through testing with third generation ELISA. The over all prevalence of HCV among blood donors aged from 18-59 years was 7.6% (males 7.8%, females 6.9%) (NS=15.2%, males 15.5%, females 15.0% for the same age group). Among different age groups the total prevalence of HCV was; 4.2% in the 18-29 years age group (NS=5.3%), 9.1% in the 30-39 age group (NS=17.9%), 19.0% in the 40-49 age group (NS=19.0%) and 20% in the 50-59 age group (NS=23%). The prevalence of HCV is higher among replacement blood donors than those in campaign blood donors (8.9%, 3.9% respectively, OR=2.9). It is also higher among blood donors living in rural areas than those living in urban areas (14.1%, 6.8% respectively, OR=2.3). Age adjusted rates of HCV among the blood donors were; totally 10.6% (NS=14.7%), males 12.5% (NS=15.1%), females 8.5% (NS=14.5%). Age and gender standardized HCV prevalence ratio (blood donors/NS) was; total ratio=0.7. Among the different age groups the ratio was; 18-29 years=0.8, 30-39 years=0.5, 40-49 years=0.9, and the 50-59 years age group=0.8. In conclusion, as a sentinel group, the total - as well as the female- population of blood donors have a lower prevalence of HCV with comparison to the National survey. However, with regards to the male population in the 18-29 years age group of blood donors, after age standardization, the rate of HCV among them is equal to that of the National survey, suggesting that male blood donors aged 18-29 years may provide an appropriate group for monitoring HCV prevalence in males of same age group in the general population.     

177例毒瘾者丙型肝炎病毒感染的流行病学调查

采取ELISA法对167例静脉内毒瘾者、10例口吸毒瘾者、49例非肝病病人及58例供血员作了抗-HCV检测。结果发现,抗-HCV阳性率分别为92.2%、10%、2.0%和1.7%,静脉内毒瘾者的HCV感染率非常显著高于其他各组(P<0.001),后3组之间差异无显著意义(P>0.05)。表明静脉内毒瘾者是HCV感染的高危人群,造成该人群HCV感染的流行可能与HCV感染者合用注射器静注毒品、注射器和毒品溶剂不消毒等因素有关,与用毒时间无显著相关。HCV感染在不同特征的静脉内毒瘾者的分布是一致的。     

输血后肝炎流行现状及预防措施评价

采用队列研究方法，对202例受血者和65例手术未受血者PTH流行现状及献血员HBsAg和抗-HCV筛检的效果进行了研究。结果表明，71例输入未经抗-HCV筛检血液者丙肝罹患率为16．9％，131例输入经筛检血液者为1．5％，前者抗-HCV阳转率为33．8％，后者为9．1％，65例未受血手术者抗一HCV阳转率为1．5％，未发现显性感染者。202例输入经HBsAg筛检血液者HBV感染标志阳转率为25．2％，65例未经受血手术者为4．6％。结果提示，献血员HBsAg和抗-HCV筛检能有效降低输血后乙、丙型肝炎罹患率和病毒感染率。但对病毒含量低的供血者仍不能检出。     

献血感染丙型肝炎人群转归分析

目的研究献血感染丙型肝炎病毒（HCV）人群16年后的转归。方法对该人群问卷收集一般情况,肝脏B超检查;采集5ml静脉血,进行丙型肝炎病毒抗体、RNA、谷丙转氨酶（ALT）和血清生化指标（透明质酸、Ⅲ型前胶原肽、Ⅳ型胶原）检测。结果162名研究对象尚未出现晚期肝病患者。抗-HCV阳性率95.68%,RNA阳性率77.78%,ALT异常率20.37%。不同急性期症状感染者,16年后抗-HCV阳性率、ALT异常率和RNA阳性率差异无统计学意义。经性别分层分析,女性感染年龄〉40岁抗体较易阴转（χMH^2=8.26,P=0.04）。结论HCV感染16年后,不同急性期症状感染者转归无差异,病毒清除与性别和初始感染年龄有关。     

某农村人群甲、乙、丙、戊和庚型肝炎病毒感染的现况研究

目的　了解某农村人群甲、乙、丙、戊和庚型肝炎病毒的感染状况及其流行特点。方法　应用酶联免疫试验 (EIA)检测血清抗 -HAV、HBsAg、抗 -HBs、抗 -HBc、抗 -HCV、抗 -HEV和抗 -HGV ,并对抗 -HGV阳性者应用套式逆转录聚合酶链反应法 (RT -nPCR)检测HGVRNA。结果　该人群抗 -HAV、抗 -HCV、抗 -HEV和抗 -HGV流行率分别为 86.9%、11.5 %、2 .9%和 1.8% ,HBsAg阳性率为8.0 % ,HBV总感染率为 5 4.8%。HAV以 5岁以下儿童感染率最低 ( 35 .0 % ) ,到 10岁时 85 .0 %的儿童已感染HAV。HBsAg阳性率呈现两个高峰 ,分别在 5～ 9岁和 40～ 49岁年龄组 ;HBV总感染率到 10岁时为 5 5 .0 % ,然后随年龄增长而上升。HCV感染主要集中在 2 0～ 49岁年龄组 (占 77.8% )。各型肝炎病毒男女感染率无明显差异。献浆次数、年限与HCV、HEV、HGV感染呈正相关。HBsAg、抗 -HBc、抗 -HCV呈现家庭聚集性 ,但仅HBsAg呈现母亲与子女相关。抗 -HCV阳性者中ALT异常率 ( 15 .9% )显著高于抗 -HCV阴性者 ( 1.2 % ,P <0 .0 1)。结论　该人群甲、乙、丙、戊和庚型肝炎病毒感染具有不同的流行病学特点 ;献血浆是该人群HCV、HEV和HGV感染的主要危险因素 ;抗 -HCV阳性者多伴有肝损害     

Factors influencing Hepatitis C virus sero-prevalence among blood donors in north west Pakistan

Hepatitis C virus infection is a major health problem worldwide. The current study estimated seroprevalence of Hepatitis C virus (HCV) and evaluated associated factors among volunteer blood donors of the Northwest Frontier Province (NWFP), Pakistan. Of 1,131 volunteer blood donors enrolled, 46 (4.1%) were positive for anti-HCV antibodies. Multivariate logistic regression analysis revealed that positive donors were more likely to be 27-32 years old or >32 years old, have had 1-2 injections or >2 injections in the past year, or 1-5 intravenous (IV) drips or >5 I/V drips in the past 5 years. Positive donors had a family history of jaundice and were more likely to have been shaved (facial and armpit) by barbers. There was high prevalence of anti-HCV antibodies among blood donors of the NWFP. Public awareness programs should target the identified risk factors to prevent HCV transmission. We highlight the weakness of the health care system for blood donation, as it does not offer any record management for donors.     

Hepatitis B and C infection: Is it a problem in Polish healthcare workers?

Objectives

Hepatitis B (HBV) and C viruses (HCV) are among the most frequent blood borne pathogens. According to WHO, 5% of healthcare workers (in central Europe), are exposed to at least one sharps injury contaminated with HBV per year, 1,7% — contaminated with HCV.

Aims

The aims of the study were to determine prevalence of HCV and HBV infections, vaccination efficacy against hepatitis B and usefulness of alanine aminotransferase (ALT) testing in prophylactic examinations in healthcare workers (HCWs).

Material and Methods

In a group of 520 healthcare workers, a survey, laboratory and serologic tests such as ALT, HBsAg, anti-HBs, anti-HBcT and anti-HCV were carried out.

Results

The study revealed a low rate of workers with presence of HBsAg and anti-HCV (1,2% and 0,8% respectively). Anti-HBcT was found in 99 subjects (19%) without a significant association with experiencing an occupational percutaneous injury. Being vaccinated against HBV was declared by 90% of the subjects. There was no relationship between ALT level rise and positive HBsAg, anti-HCV and anti-HBcT tests.

Conclusion

A seroprevalence of HBV and HCV markers in HCWs found in the study is low and similar to the one found in general population. Current or past hepatitis B infections were independent of needle stick injuries. Vaccination against HBV coverage, although found to be high, should improve to 100%. Occupational prophylactic medical examinations found performing ALT test (obligatory in Poland for HCWs) not helpful. It seems that determination of anti-HBcT and anti-HCV status would be essential in pre-employment medical examinations.