Abstract
ObjectivesHepatitis C virus (HCV) prevalence is poorly mapped in the East African region; with the advent of novel HCV therapies, better epidemiological data are required to target the infection. We sought to estimate HCV prevalence in healthy Malawian mothers and assess mother-to-child transmission (MTCT); context is provided by reviewing previously published HCV prevalence data from the region.MethodsUsing ELISA screening and confirmatory blot, serological testing of 418 healthy Malawian mothers for HCV was performed. To examine MTCT, the children of any positive women were also tested for HCV; all children had malignant disease unrelated to hepatocellular carcinoma. We compared our results to published literature on HCV prevalence in Malawi and its neighbouring countries.ResultsThree of 418 women were HCV reactive by ELISA; two were confirmed positive by immunoblot (0.5%). One child of an HCV-infected mother was HCV seropositive. The literature review revealed HCV prevalence ranging from 0 to 7.2% in the region, being highest in Tanzania and specifically for cohorts of inpatients and HIV-co-infected people. The overall estimated prevalence of HCV in Malawi was 1.0% (95%CI 0.7–1.4) when all studies were included (including this one), but lower in healthy cohorts alone at 0.3% (95%CI 0.1–1.2).ConclusionsThis is the first study using confirmatory tests to examine HCV prevalence in healthy Malawian mothers; the prevalence was low. Future studies need to address the source of infection in healthy women.
Highlights
Hepatitis C virus causes hepatitis, cirrhosis and hepatocellular carcinoma [1]
We examined the prevalence of Hepatitis C virus (HCV) retrospectively as part of an ongoing study of infections and cancers among children in Malawi [12]
We report our findings in the context of previous HCV prevalence studies from Malawi and its neighbouring countries by way of a comprehensive literature review
Summary
Hepatitis C virus causes hepatitis, cirrhosis and hepatocellular carcinoma [1]. It is a bloodborne infection and prevalent among intravenous drug users (IVDU) [2] and men who have sex with men (MSM), those with HIV co-infection [3, 4] and their contacts. In Malawi, the reported prevalence of HCV in healthy blood donors ranges from 0.1% to 18% [6, 7]. Other modes of transmission, such as iatrogenic spread in medical facilities, or among intravenous drug users, are thought to be rare [9, 10]. A study from Tanzania, a neighbouring country, reports that MTCT is low [11], but this has not been assessed in Malawi
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