Abstract
Improved awareness of the hepatitis C virus (HCV) transmission has contributed to the overall decline in the HCV infection rate in some developing countries including Thailand. Chronic HCV infection in some rural Thai communities, however, presents a challenge in the efforts to treat and manage HCV-related diseases. Published and unpublished studies have suggested an unusually high incidence of HCV infection in a Thai province of Phetchabun compared to elsewhere in Thailand. To determine the magnitude of HCV infection and identify potential factors contributing to the higher rate of HCV infection in this province, we performed a population-based study in Phetchabun (n = 1667) and the neighboring Khon Kaen province (n = 1410) where HCV prevalence is much lower. Individuals between 30 and 64 years old completed detailed questionnaires designed to identify HCV risk factors and provided blood samples for anti-HCV antibody screening. The anti-HCV seropositive rates were 15.5% (259/1667) in Phetchabun and 3.6% (51/1410) in Khon Kaen. Positive samples were subsequently genotyped for HCV core gene sequence and assessed for the hepatitis B virus surface antigen (HBsAg) and human immunodeficiency virus antigen/antibody (HIV Ag/Ab). More individuals in Phetchabun possessed the combined presence of HBsAg (5.0%) and HIV Ag/Ab (0.4%) than those in Khon Kaen (3.9% HBsAg and 0.0% HIV Ag/Ab). While male gender, intravenous drug use (IVDU) and tattoos were significant HCV risk factors in both provinces (p <0.05), education less than high school and agriculture-related occupation were additionally associated with HCV in Phetchabun. HCV genotypes 6, 3, and 1 were identified in similar frequency in both provinces. We estimated that prevalence of HCV seropositivity and viremic carriers were higher in Phetchabun (143 and 111 per 1000) than in Khon Kaen (34 and 22 per 1000). Finally, we derived a simple risk factor-based scoring system as a useful preclinical tool to screen individuals at risk of chronic HCV infection prior to intervention. Knowledge gained from this study will assist in HCV screening and promote access to anti-viral treatment in high-risk groups.
Highlights
Hepatitis C virus (HCV) is a major cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC) [1,2] and affects approximately 185 million people worldwide [3]
We proposed the use of a simple scoring system defined by several associated risk factors, which can be used to estimate crude HCV infection rate for a given community
Socio-demographic data and exposure to potential risk factors associated with HCV infection were obtained from completed questionnaires (S1 and S2 Files)
Summary
Hepatitis C virus (HCV) is a major cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC) [1,2] and affects approximately 185 million people worldwide [3]. The presence of anti-HCV antibodies can indicate current or past HCV infection, and when left untreated, chronic infection can be as high as 75% to 85% [4,7]. The prevalence rates of HCV in developing countries are generally higher than in industrialized nations, but improving socio-economic status and education in developing nations have contributed in the decline in new HCV infection. The overall HCV seroprevalence in Thailand has decreased from 2.2% to 0.9% within the past 10 years [8,9] and will likely be 0.2% over the 20 years [10]. Despite the declining trend in the general population, HCV infection rate continues to increase among individuals >30 years with the highest prevalence among individuals 41–50 years [9]. Regional pockets of relatively high HCV endemicity remained in northern and northeastern Thailand [9,11,12,13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
