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Derbala M, Chandra P, Amer A, John A, Sharma M, Amin A, Thandassery RB, Faris A. Reexamination of the relationship between the prevalence of hepatitis C virus and parenteral antischistosomal therapy among Egyptians resident in Qatar. Clin Exp Gastroenterol 2014; 7:427-433. [PMID: 25395869 PMCID: PMC4224023 DOI: 10.2147/ceg.s65369] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Egypt has the highest prevalence of recorded hepatitis C virus (HCV) worldwide, estimated nationally at 14.7%, which is attributed to extensive iatrogenic transmission during the era of parenteral antischistosomal therapy (PAT) mass-treatment campaigns. The objective of our study was to attempt to highlight to what extent HCV transmission is ongoing and discuss the possible risk factors. We studied the prevalence of HCV among 7.8% of Egyptians resident in Qatar in relation to age, socioeconomic status, and PAT and discuss the possible risk factors. HCV testing was conducted in 2,335 participants, and results were positive for 13.5%, and 8.5% for those aged below 35 years. The prevalence of HCV in the PAT-positive population was 23.7% (123 of 518, 95% confidence interval [CI] 20.2%-27.6%) compared with 11.2% in the PAT-negative group. Significantly higher HCV prevalence occurred in participants who were older than 50 years (23%, 95% CI 19.3%-27.1%) compared to those aged 45-50 years (19.3%, 95% CI 15.2%-23.8%), 35-45 years (11.1%, 95% CI 8.9%-13.7%), and less than 35 years (8.5%, 95% CI 6.8%-10.4%) (P<0.0001). Insignificant higher prevalence occurred in the low socioeconomic group (14.2%, 95% CI 11.3%-17.4%). Logistic regression analysis revealed that increasing age, history of PAT, bilharziasis, and praziquantel were common risk factors, but there was no relation with dental care. Host genetic predisposition seems to be a plausible underlying factor for susceptibility among Egyptians and intense ongoing infection.
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Affiliation(s)
- Moutaz Derbala
- Gastroenterology and Hepatology Department, Hamad Hospital, Doha, Qatar
- Medical Department, Weill Cornell Medical College, Qatar Branch, Doha, Qatar
| | - Prem Chandra
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Aliaa Amer
- Laboratory Medicine and Pathology Department, Hamad Hospital, Doha, Qatar
| | - Anil John
- Gastroenterology and Hepatology Department, Hamad Hospital, Doha, Qatar
| | - Manik Sharma
- Gastroenterology and Hepatology Department, Hamad Hospital, Doha, Qatar
| | - Ashraf Amin
- Gastroenterology and Hepatology Department, Hamad Hospital, Doha, Qatar
| | | | - Amr Faris
- Cardiovascular Surgery Department, Hamad Hospital, Doha, Qatar
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Féray C, Bouscaillou J, Falissard B, Mohamed MK, Arafa N, Bakr I, El-Hoseiny M, Daly ME, El-Kafrawy S, Plancoulaine S, Abdel-Hamid M, Thiers V, Fontanet A. A novel method to identify routes of hepatitis C virus transmission. PLoS One 2014; 9:e86098. [PMID: 24465895 PMCID: PMC3900465 DOI: 10.1371/journal.pone.0086098] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 12/04/2013] [Indexed: 01/18/2023] Open
Abstract
Background We propose a new approach based on genetic distances among viral strains to infer about risk exposures and location of transmission at population level. Methods We re-analysed 133 viral sequences obtained during a cross-sectional survey of 4020 subjects living in a hepatitis C virus (HCV) endemic area in 2002. A permutation test was used to analyze the correlation between matrices of genetic distances in the NS5b region of all pairwise combinations of the 133 viral strains and exposure status (jointly exposed or not) to several potential HCV risk factors. Results Compared to subjects who did not share the same characteristics or iatrogenic exposures, the median Kimura genetic distances of viral strains were significantly smaller between brothers and sisters (0.031 versus 0.102, P<0.001), mother and child (0.044 versus 0.102, P<0.001), father and child (0.045 versus 0.102, P<0.001), or subjects exposed to periodontal treatment (0.084 versus 0.102, P = 0.02). Conversely, viral strains were more divergent between subjects exposed to blood transfusions (0.216 versus 0.102, P = 0.04) or tooth filling or extraction (0.108, versus 0.097, P = 0.05), suggesting acquisition of the virus outside of the village. Conclusion This method provided insights on where infection took place (household, village) for several socio-demographic characteristics or iatrogenic procedures, information of great relevance for targeting prevention interventions. This method may have interesting applications for virologists and epidemiologists studying transmission networks in health-care facilities or among intravenous drug users.
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Affiliation(s)
- Cyrille Féray
- Inserm 955, Hopital Henri Mondor, Créteil, France
- * E-mail:
| | - Julie Bouscaillou
- Institut Pasteur, Unité d’Epidémiologie des Maladies Emergentes, Paris, France
| | | | - Mostafa K. Mohamed
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Naglaa Arafa
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Iman Bakr
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mostafa El-Hoseiny
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mai El Daly
- National Liver Institute, Menoufia University, Shebeen El-Kom, Menufia, Egypt
- Viral Hepatitis Research Laboratory, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Sherif El-Kafrawy
- National Liver Institute, Menoufia University, Shebeen El-Kom, Menufia, Egypt
- Viral Hepatitis Research Laboratory, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | | | - Mohamed Abdel-Hamid
- Viral Hepatitis Research Laboratory, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
- Department of Microbiology, Faculty of Medicine, Minia University, Minya, Egypt
| | - Valérie Thiers
- Unité INSERM 785, Centre Hépato-Biliaire, Villejuif, France
| | - Arnaud Fontanet
- Institut Pasteur, Unité d’Epidémiologie des Maladies Emergentes, Paris, France
- Conservatoire National des Arts et Métiers, Chaire Santé et Développement, Paris, France
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Sanghvi MM, Hotez PJ, Fenwick A. Neglected tropical diseases as a cause of chronic liver disease: the case of Schistosomiasis and Hepatitis C Co-infections in Egypt. Liver Int 2013; 33:165-8. [PMID: 23295048 DOI: 10.1111/liv.12052] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 11/09/2012] [Indexed: 12/24/2022]
Affiliation(s)
- Menka M. Sanghvi
- George Washington University School of Medicine and Health Sciences; Washington District of Columbia USA
| | - Peter J. Hotez
- Department of Pediatrics and Molecular Virology & Microbiology and National School of Tropical Medicine; Baylor College of Medicine; Houston Texas USA
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development; Houston Texas USA
| | - Alan Fenwick
- Schistosomiasis Control Initiative and Department of Infectious Disease Epidemiology; Imperial College; St. Mary's Campus London UK
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Mostafa A, Taylor SM, el-Daly M, el-Hoseiny M, Bakr I, Arafa N, Thiers V, Rimlinger F, Abdel-Hamid M, Fontanet A, Mohamed MK. Is the hepatitis C virus epidemic over in Egypt? Incidence and risk factors of new hepatitis C virus infections. Liver Int 2010; 30:560-6. [PMID: 20141592 DOI: 10.1111/j.1478-3231.2009.02204.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
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 (OR(adj))=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.
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Affiliation(s)
- Aya Mostafa
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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