Hepatitis C Virus Seropositivity Research Articles

Seroprevalence of hepatitis C infection in type 2 diabetes mellitus.

Introduction:Hepatitis C is an emerging disease with different studies showing varying prevalence rates across India. In several studies, prevalence of hepatitis C infection was found to be higher in diabetics than nondiabetics. However, none has been reported from India.Objectives:The aim was to determine the sero-prevalence of hepatitis C infection in type 2 diabetes mellitus (T2DM).Settings and Design:Cross-sectional study of all T2DM patients attending endocrine clinic in Regional Institute of Medical Sciences, Imphal from October 2011 to September 2013.Subjects and Methods:All T2DM patients included and exclusion criteria are patients with other forms of diabetes, liver failure, renal failure, malignancy or other chronic illness. Patient's age, sex, height, weight, body mass index, history of risk factors, etc., collected and investigated for blood glucose fasting and prandial levels, transaminases levels, hepatitis C virus (HCV) screening, etc.,Statistical Analysis:Statistical analysis was performed using Statistical Package for the Social Sciences version 20; appropriate test used where applicable.Results:Out of the 192 T2DM patients screened, prevalence rate of HCV sero-positivity is found to be 5.7% (11/192), higher in males. History of jaundice in the past was the only significant history among sero-positive patients. Transaminases levels are significantly higher in sero-postive cases. They had higher fasting and postprandial blood glucose, fasting glucose levels being significantly higher.Conclusion:Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics.

Hepatitis C virus (HCV) infection & risk factors for HCV positivity in injecting & non-injecting drug users attending a de-addiction centre in northern India.

Background & objectives:Injecting drug use is a major route of hepatitis C virus (HCV) infection in India, but there may be other risk factors also. This study was carried out to determine the seroprevalence of anti-HCV antibody in injecting drug users (IDUs) vs. non-IDUs (NIDUs), and to study the risk estimates for HCV seropositivity in the total sample of substance users with regard to various demographic, clinical, behavioural and personality factors.Methods:The IDUs (n = 201) and NIDUs (n = 219) were assessed for demographic, clinical and behavioural information, and were rated on instruments for severity of dependence, risk behaviour and personality profiles. Anti-HCV antibody was tested by ELISA and confirmed by recombinant immunoblot assay (RIBA) test.Results:Almost one-third of the IDUs (64 of 201; 31.8%) were positive for anti-HCV antibody, as opposed to only seven (3.2%) of the NIDUs. The four risk factors strongly associated with HCV positivity in multivariate analysis were sharing syringe [Exp(B) 75.04; 95%CI 18.28-307.96; P<0.001], reuse of injection accessories (16.39; 3.51-76.92; P<0.001), blood transfusion (5.88; 1.63-21.23; P=0.007) and IDU status (3.60; 1.26-10.31; P=0.017). Other variables less strongly but significantly associated with HCV positivity were multiple sex partners, opioid dependence, risk behaviour scores, impulsivity, and lower age of onset of drug use.Interpretation & conclusions:Our study showed a high seroprevalence of anti-HCV antibody in IDUs. In the substance users, HCV positivity was significantly and independently associated with several clinical, behavioural, and personality risk factors.

Transfusion History and Risk of Non-Hodgkin Lymphoma (NHL): an Interlymph Pooled Analysis

Background. A recent meta-analysis of 9 case-control and 5 cohort studies reported a positive association of transfusion history with risk of NHL (RR=1.20; 95% CI 1.07-1.35), which was only evident in cohort (RR=1.25) and not case-control (RR=1.05) studies (Castillo et al., Blood 2010;116:2897-2907). Risk was similar in men and women, and for transfusions before or after 1992. In subset analyses, elevated risk was only apparent for chronic lymphocytic leukemia (CLL) and not diffuse large B-Cell lymphoma (DLBCL) or follicular lymphoma, but power was low. To further investigate these findings, particularly from studies conducted after 1990, better assess confounding, and address heterogeneity by NHL subtypes, we conducted an individual-level, pooled analysis of 13 case-control studies in the InterLymph Consortium (including 11 studies conducted after 1990; 8 studies were not included in the published meta-analysis).Methods. There were a total of 10,805 cases and 14,026 controls with transfusion data from 13 studies conducted in Europe, North America, and Australia. Transfusion history and other risk factors were self-reported in interviewer-administered or self-administered questionnaires. All risk factor data were harmonized centrally, and cases were grouped into NHL subtypes according to the WHO classification using guidelines from the InterLymph Pathology Working Group. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression, adjusted for age, sex, and study center.Results. The median age at diagnosis was 60 years for cases (range, 18-97) and 59 years for controls (range, 16-97). The overall prevalence of a history of any transfusion in controls was 15.5%, was higher in women (18.6%) than men (13.0%), and increased with age, but was not associated with race/ethnicity (Asian, Black, Hispanic, White, other) or geographic region after adjusting for age and sex. Among whites, history of any transfusion was inversely associated with NHL risk among men (OR=0.74; 95% CI 0.65-0.83) but not women (OR=0.92; 95% CI 0.83-1.03); there were no significant results for other race/ethnicity groups, and ORs were highly variable and imprecise due to small sample sizes. Thus analyses were restricted to white men, where there was no trend with the number of transfusions, time since first transfusion, age at first transfusion, or decade of first transfusion. Further adjustment for socioeconomic status, body mass index, smoking, alcohol use or hepatitis C virus (HCV) seropositivity did not alter these results. The associations were stronger in hospital-based (OR=0.56; 95% CI 0.45-0.70) than population-based (OR=0.84; 95% CI 0.72-0.98) studies, and were stronger in studies from Southern Europe (OR=0.53; 95% CI 0.36-0.79) than northern Europe (OR=0.67; 95% CI 0.53-0.83) or North America (OR=0.82; 95% CI 0.70-0.98). For NHL subtypes, statistically significant inverse associations were observed for follicular lymphoma (OR=0.70; 95% CI 0.56-0.88), DLBCL (OR=0.72; 95% CI 0.59-0.87), and CLL/SLL (OR=0.67; 95% CI 0.52-0.87), whereas weaker and non-statistically significant associations were observed for mantle cell (OR=0.81; 95% CI 0.54-1.23), marginal zone (OR=0.78; 95% CI 0.54-1.15), lymphoplasmacytic (OR=0.82; 95% CI 0.47-1.42) and peripheral T-cell (OR=0.83; 95% CI 0.49-1.40) lymphomas.Conclusion. Contrary to earlier results, transfusion history was inversely associated with risk of NHL and the common subtypes of follicular lymphoma, DLBCL and CLL/SLL among white men, whereas associations were null among white women and other racial/ethnic groups. These results were not explained by confounding by lifestyle factors or HCV seropositivity, era of first transfusion, hospital versus population-based study design, or geographic location. Despite dramatic changes in transfusion practice over the past 40 years, results were similar for decade of first transfusion, suggesting secular trends are a less likely explanation. Our results are unexpected and bias cannot be ruled out. Further studies, particularly cohort studies, are needed to clarify the role of transfusion history in NHL risk. DisclosuresNo relevant conflicts of interest to declare.

HCV seropositivity in inmates and in the general population: an averaging approach to establish priority prevention interventions

ObjectivesDespite the fact that a considerable portion of hepatitis C virus (HCV) positive individuals are viraemic, the risk of transmitting HCV to others is context dependent. Prison is a particularly...

Outcomes and Survival in Hepatitis C Virus Seropositive Lymphoma and Myeloma Patients After Autologous Stem Cell Transplantation

Introduction: Hepatitis C virus (HCV) seropositive patients who undergo autologous hematopoietic stem cell transplantation (HSCT) are at risk of HCV acute exacerbation (AE). Furthermore impact of high dose chemotherapy in patients who have hepatitis C is unknown. We sought to determine the risk factors for AE and the impact of HCV seropositivity on survival post-autologous HSCT. Methods: We retrospectively reviewed the medical records of all 64 HCV seropositive patients who had undergone autologous HSCT at our institution. COX regression model was used to evaluate the predictive risk factors for AE. Results: Twenty (32%) of the 64 patients had AE, defined as a 3-fold or greater increase in serum alanine aminotransferase level (ALT) from the pre-transplant value. Age above 60 years was found to be a risk factor for post-transplant AE (Figure 1). The occurrence of AE (analyzed as time-dependent variable) had no impact on the overall survival of patients who had undergone autologous HSCT. The overall and progression-free survival rates for chemosensitive lymphoma patients 2 years after autologous HSCT were 64% (range 41-80) and 47% (range 27-64), respectively. Median overall and progression-free survival durations in myeloma patients were 54 and 22 months, respectively.Figure 1: Cumulative incidence of acute exacerbation (AE) for all patients in the study and for the two age groups >60 years and ≤60 years.Conclusion: Our results suggest that the survival post autologous HSCT is not impacted by either the development of AE or the pre-transplant HCV seropositivity, as the survival of HCV seropositive patients post-transplant is similar to the survival of non-HCV seropositive historical controls. Hence, our study implies that HCV seropositivity is not a contraindication for autologous transplant.

Prescription opioid injection and risk of hepatitis C in relation to traditional drugs of misuse in a prospective cohort of street youth

ObjectiveDespite dramatic increases in the misuse of prescription opioids, the extent to which their intravenous injection places drug users at risk of acquiring hepatitis C virus (HCV) remains unclear. We...

Seroprevalence of human herpesvirus 8 and hepatitis C virus among drug users in Shanghai, China.

To elucidate and compare the seroprevalence of human herpesvirus 8 (HHV8) and hepatitis C virus (HCV) among Chinese drug users, a cross-sectional study of 441 participants, was conducted in Shanghai, China, from 2012 through 2013. Seventy-seven (17.5%) participants were found to be positive for HHV8 antibodies, while 271 (61.5%) participants were positive for HCV. No significant association between HHV8 seropositivity and drug use characteristics, sexual behaviors, HCV, or syphilis was observed. In contrast, a statistically significant association between HCV seropositivity and injected drug history (OR, 2.18, 95% CI 1.41–3.37) was detected, whereas no statistically significant association between HCV seropositivity and syphilis infection (OR, 7.56, 95% CI 0.94–60.57) were observed. Pairwise comparisons showed no significant differences between latent and lytic antibodies regarding HCV and HHV8 serostatus. The study demonstrated a moderate but elevated prevalence of HHV8 infection among drug users. The discordance between HHV8 and HCV infections suggests that blood borne transmission of HHV8 might not be the predominant mode of transmission in this population, which is in contrast to HCV.

Evolution of the global burden of viral infections from unsafe medical injections, 2000-2010.

BackgroundIn 2000, the World Health Organization estimated that, in developing and transitional countries, unsafe injections accounted for respectively 5%, 32% and 40% of new infections with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). Safe injection campaigns were organized worldwide. The present study sought to measure the progress in reducing the transmission of these viruses through unsafe injections over the subsequent decade.MethodsA mass action model was updated, to recalculate the number of injection-related HIV, HCV and HBV infections acquired in 2000 and provide estimates for 2010. Data about the annual number of unsafe injections were updated. HIV prevalence in various regions in 2000 and 2010 were calculated from UNAIDS data. The ratio of HIV prevalence in healthcare settings compared to the general population was estimated from a literature review. Improved regional estimates of the prevalence of HCV seropositivity, HBsAg and HBeAg antigenemia were used for 2000 and 2010. For HIV and HCV, revised estimates of the probability of transmission per episode of unsafe injection were used, with low and high values allowing sensitivity analyses.ResultsDespite a 13% population growth, there was a reduction of respectively 87% and 83% in the absolute numbers of HIV and HCV infections transmitted through injections. For HBV, the reduction was more marked (91%) due to the additional impact of vaccination. While injections-related cases had accounted for 4.6%–9.1% of newly acquired HIV infections in 2000, this proportion decreased to 0.7%–1.3% in 2010, when unsafe injections caused between 16,939 and 33,877 HIV infections, between 157,592 and 315,120 HCV infections, and 1,679,745 HBV infections.ConclusionFrom 2000 to 2010, substantial progress was made in reducing the burden of HIV, HCV and HBV infections transmitted through injections. In some regions, their elimination might become a reasonable public health goal.

Predictors of liver-related death among people who inject drugs in Vancouver, Canada: a 15-year prospective cohort study.

IntroductionWhile HIV/AIDS remains an important cause of death among people who inject drugs (PWID), the potential mortality burden attributable to hepatitis C virus (HCV) infection among this population is of increasing concern. Therefore, we sought to identify trends in and predictors of liver-related mortality among PWID.MethodsData were derived from prospective cohorts of PWID in Vancouver, Canada, between 1996 and 2011. Cohort data were linked to the provincial vital statistics database to ascertain mortality rates and causes of death. Multivariate Cox proportional hazards regression was used to examine the relationship between HCV infection and time to liver-related death. A sub-analysis examined the effect of HIV/HCV co-infection.Results and discussionIn total, 2,279 PWID participated in this study, with 1,921 (84.3%) having seroconverted to anti-HCV prior to baseline assessments and 124 (5.4%) during follow-up. The liver-related mortality rate was 2.1 (95% confidence interval [CI]: 1.5–3.0) deaths per 1,000 person-years and was stable over time. In multivariate analyses, HCV seropositivity was not significantly associated with liver-related mortality (adjusted relative hazard [ARH]: 0.45; 95% CI: 0.15–1.37), but HIV seropositivity was (ARH: 2.67; 95% CI: 1.27–5.63). In sub-analysis, HIV/HCV co-infection had a 2.53 (95% CI: 1.18–5.46) times hazard of liver-related death compared with HCV mono-infection.ConclusionsIn this study, HCV seropositivity did not predict liver-related mortality while HIV seropositivity did. The findings highlight the critical role of HIV mono- and co-infection rather than HCV infection in contributing to liver-related mortality among PWID in this setting.

Seropositivity of hepatitis C infection among voluntary and replacement blood donors in a tertiary-care hospital in Punjab

Background: Blood transfusion is the main source for the spread of hepatitis C virus (HCV) and other related infections throughout the world. These infections are more common in replacement donors than in voluntary blood donors. Aims and Objectives: To evaluate various demographic and etiological factors for the transmission of HCV infection among voluntary and replacement blood donors. Materials and Methods: This prospective study was conducted on 5000 healthy blood donors (3261 replacement and 1739 voluntary donors) in Amritsar to know HCV seropositivity in the region, and to compare it in relation to type of donor and various demographic and etiologic factors. All blood samples were tested for anti-HCV antibody by third-generation enzyme-linked immunosorbent assay. The results of the study were analyzed statistically using X2-test. Results: HCV seropositivity among 5000 donors was found to be 0.98%, which was significantly lower in voluntary than in replacement donors (0.23 vs. 1.37%). Maximum HCV seropositivity was seen in 30- to 39-year age group in both voluntary and replacement donors. Rural blood donors had higher seropositivity than urban donors. Most prevalent risk factor was injection drug use followed by tattooing, sharing shaving kits or roadside barber visits, and multiple sex partners. Conclusion: The study concluded that voluntary blood donations are safer and free from risk of transmitting infectious agents, so an effort to increase voluntary blood donation should be made.

Safety of Blood Transfusion: An Egyptian Study

Introduction: Blood safety presents a serious challenge in Egypt, having the highest prevalence of hepatitis C virus (HCV). Objectives: To evaluate the effectiveness of blood donor recruitment strategies, the seroprevalence of positive infectious markers among volunteer donors (VD) and family replacement donors (RD) at a University Hospital Blood Bank was studied. Methodology: Donors’ records covering the period between 2006 and 2012 were reviewed. All donations had been tested using the following screening tests ; Ortho for HCV antibody (enzyme-linked immunosorbent assay test system Version 3.0, Ortho Clinical Diagnostics, Inc., Raritan, NJ) and Siemens (Siemens Enzygnost assay, Healthcare Diagnostic Products, Marburg, Germany) for HBsAg (Enzygnost HBsAg 6.0), human immune deficiency virus (HIV)-1 and HIV-2 antibodyies (Enzygnost HIV integral II), and syphilis antibodies. Reactive samples were not confirmed with additional tests. Results: Of 308,762 donors, 63.4% were VD. The overall prevalence of HCV antibodies, HBsAg, human immunodeficiency virus (HIV) and syphilis antibodies were 4.3%, 1.22%, 0.07%, and 0.13%, respectively. After stratification for age and gender, all tested markers (except HIV) were significantly higher among RD.A significant decline in HCV seropositivity was observed in RD and VD from 8.9% and 4.2% in 2007/2008 to 3.8% and 1.5% in 2011/2012, respectively. A significant decrease in HBsAg was demonstrated in VD from 1.2% in 2007/2008 to 0.53% in 2011/2012. During the period 2007- 2011, an increasing trend for HIV and syphilis was noted. Conclusion: The decreasing trend in HCV antibodies and HBsAg could be related to the strict donor selection criteria.

Treponema pallidum hemagglutination assay seroreactivity among healthy Indian donors and its association with other transfusion transmitted diseases.

Background:The aim of the present study was to determine the prevalence of syphilis infection by Treponema pallidum hemagglutination assay (TPHA) among blood donors in Delhi and to study their correlation with other markers of transfusion transmitted infections such as hepatitis C virus (HCV), human immunodeficiency virus (HIV) and hepatitis B surface antigen (HBsAg) so as to establish the utility of TPHA over and above venereal diseases research laboratory test (VDRL), not only as a marker for testing T. pallidum infection, but also as a marker of high risk behavior.Materials and Methods:This prospective study was carried out in the Regional Blood Transfusion Centre, Lady Hardinge Medical College and associated Sucheta Kriplani Hospital, New Delhi for a period of 2 years. Donated blood was screened for TPHA seroreactivity along with screening for anti HIV I and II, anti-HCV, HBsAg by third generation enzyme-linked immunosorbent assay test. A total of 8082 serum samples of blood donors were collected from healthy blood donors in our blood bank. They were classified into two groups- test group and control group based on TPHA positivity. The co-occurrence of HBsAg, HIV and HCV infection were determined in TPHA positive blood donors (test group) in comparison with TPHA negative blood donors (control group).Results:We found the TPHA seroreactivity to be 4.4% in Delhi's blood donors. Nearly 8.2% (663/8082) of the donated blood had serological evidence of infection by at least one pathogen (syphilis/HIV/hepatitis B virus/HCV) and 6.63% (44/663) donors with positive serology had multiple infections (two or more). Quadruple infection was seen in one donor, triple infection was seen in three donors and double infection was seen in 40 donors. Prevalence of HIV seroreactivity was found to be statistically significant and HCV seroreactivity statistically insignificant in TPHA positive group in comparison to TPHA negative group.Discussion:In our study, the TPHA seropositivity correlated with higher HIV and HCV seropositivity and the same correlation has been observed by several other studies also. In view of these observations, we propose that testing for syphilis by more sensitive and specific treponemal markers like TPHA rather than VDRL, rapid plasma reagin tests; as TPHA also has the added advantage of picking up all the high risk donors, whereas, VDRL picks up only currently infected donors. Moreover, TPHA should be continued as a marker of high risk behavior especially in high prevalence areas like India where we don’t have universal access to markers like nucleic acid amplification technique.

Genotype distribution of hepatitis C virus in Khorasan Razavi Province, Iran.

Several types of the hepatitis C virus (HCV), with variations in different parts of the genome, have been isolated from different regions of the world. Based on heterogenic sequences in the isolated genome, HCV is classified into different genotypes and subtypes. Data on distribution of HCV genotypes in a certain region could be important to patient management. Therefore, this study was conducted to determine the distribution of HCV in Mashhad, Northeast Iran. This cross-sectional study was conducted on 103 patients with HCV infections in Mashhad. Among the participants, at least 22 (21.4%) were intravenous drug users. HCV seropositivity was determined by an enzyme-linked immunosorbent assay and was confirmed by reverse transcriptase polymerase chain reaction. HCV-positive samples were selected for HCV genotyping using genotype specific primers. Of 103 subjects, 43 (41.7%) and 34 (33.0%) had genotypes 1a and 3a, respectively. Other genotypes including 1b, 2a, 2b, 3b, and 5a were found in 4 (3.9%), 1 (1.0%), 3 (2.9%), 4 (3.9%), and 1 (1.0%), respectively. Coinfections with 2 genotypes were also observed in 11 (10.7%) patients. Genotyping for 2 (1.9%) of 103 samples did not produce any results. Genotypes la and 3a were found to be the most prevalent HCV genotypes in Mashhad, Iran.

Age and gender differences in the relationship between hepatitis C infection and all stages of Chronic kidney disease

Chronic kidney disease (CKD) is a worldwide health issue with heavy economic burden. Chronic hepatitis C virus (HCV) infection is a common cause of CKD, which can significantly impact the progression and mortality among patients with CKD. The prevalence of both illnesses is high in Taiwan. A multicentre and population-based cross-sectional study including 24 642 subjects was conducted to explore the association of HCV infection with the prevalence and severity of CKD. The measurements of metabolic parameters, eGFR and CKD stages were compared between subjects with HCV seropositivity and seronegativity. The analyses of association between HCV infection with CKD stages and evaluation of potential risk factors of CKD were performed by gender and age (≤ and >45 years). HCV-seropositive subjects accounted for 6.9% and had a significantly older age. The prevalence of CKD increased in those with HCV seropositivity (16.5%). Significantly higher prevalence of CKD stages ≥3 in HCV-seropositive subjects was noticed (7.8%). Age (>45 year), male gender, alcohol drinking, hypertension, creatinine and HCV infection were the significant factors associated with the presence of CKD. HCV seropositivity was an independent risk factor of developing CKD and associated with an increased risk of having CKD of all stages. The higher prevalence of earlier stage of CKD warrants longitudinal studies with frequent testing on renal function and sufficient duration to determine the changes of eGFR over time. Implementation of effective treatment intervention is also required for these subjects to prevent the progression of CKD to late stages.

High rate of seronegative HCV infection in HIV-positive patients

Co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is a significant global health problem. The two viruses are transmitted with high efficacy via blood-to-blood contact, mainly intravenous drug use (IVDU), whereas HCV is less easily transmitted sexually. Antibody testing is the main screening method for HCV infection, although it may not be the optimal option for HIV infection. The aim of this study was to investigate HCV infection in HIV-positive patients, with and without a detectable anti-HCV antibody response. A total of 187 plasma samples were obtained from HIV-positive patients in Surabaya, Indonesia and examined for anti-HCV [HCV enzyme immunoassay (EIA) 3.0], HCV genotype/subtype [reverse transcription-polymerase chain reaction (RT-PCR) using primers targeting a part of NS5B/5'UTR followed by sequencing] and HCV viral load (quantitative RT-PCR). A total of 119 patients (63.6%) were found to be anti-HCV-positive and, among these, HCV RNA was detected in 73 (61.3%), with HCV-1a as the predominant subtype (31.5%). Of the 68 anti-HCV-negative samples, HCV RNA was detected in 26/68 (38.2%) mostly as the HCV-3a subtype (50%). High HCV viral loads were more common among the HCV-seropositive patients. The HCV-seropositive samples with detected HCV RNA were mostly obtained from HIV-positive patients with parenteral transmission (IVDU) (76.7%); however, the HCV-seronegative samples with detected HCV RNA were mostly from patients who had acquired HCV through heterosexual transmission (61.5%). In conclusion, HIV-positive patients were at high risk of becoming co-infected with HCV and several remained HCV-seronegative. Furthermore, there may exist differences in HCV seropositivity and subtypes between HIV-positive patients who acquired HCV sexually and those who acquired HCV parenterally.

THU0366 Does being a hepatitis B virus carrier decrease applying to hospital in patients with rheumatoid arthritis and ankylosing spondylitis?

BackgroundImmunosupressive therapy, especially tumor necrosis factor-α (TNF-α) inhibitors can induce viral reactivation and potentially fatal liver failure in patients with concurrent Hepatitis B virus (HBV) or Hepatitis C virus (HCV)...

Impact of hepatitis C virus infection on clinical outcome in recipients after allogeneic hematopoietic cell transplantation

The impact of hepatitis C virus (HCV) infection on outcomes following allogeneic hematopoietic cell transplantation (HCT) remains a matter of debate. We have retrospectively examined the significance of HCV infection among recipients who received allogeneic HCT, using a Japan transplant outcome registry database between 2006 and 2009. Among 7,831 recipients, 136 were HCV-positive. The rate of hematopoietic recovery was lower in the HCV-positive group (neutrophil recovery of 500 × 10(6) /L or higher: 79% vs. 87% at Day 30, P = 0.087; platelet recovery of 50 × 10(9) /L or higher: 57% vs. 65% at Day 60, P = 0.012). The HCV-positive group had a significantly higher incidence of nonrelapse mortality 38% vs. 25% at 2 years, P < 0.01) and inferior overall survival (41% vs. 51% at 2 years, P < 0.01). A multivariate analysis revealed that HCV seropositivity was associated with an independent risk for higher nonrelapse mortality (hazard ratio: 1.65, P < 0.01) and inferior overall survival (hazard ratio: 1.39, P < 0.01). The incidences of death due to hepatic problems (8% vs. 2%, P < 0.01), bacterial infection (10% vs. 4%, P < 0.01), or graft failure (5% vs. 2%, P = 0.084) tended to be higher in the HCV-positive group. HCV infection had an adverse impact on the clinical outcome following HCT, especially in the setting of unrelated transplantation. Careful evaluation before embarking on HCT and intensive assessment against complications are warranted in HCV-infected recipients.

Female Genital Cutting and Hepatitis C Spread in Egypt.

A recent analysis of Egypt's first nationally representative survey of hepatitis C virus (HCV) infection found female genital cutting (FGC) to be an independent risk factor for HCV infection for women in urban areas. We use the same dataset to extend this analysis. In an ecological analysis, we find a strong association between FGC and HCV prevalence (Pearson R 2—74%; P < 0.0001). HCV prevalence is significantly higher if FGC is performed by a non-Doctor (15.4%) than a Doctor (4.2%; P < 0.001), and the calculated population attributable fraction of FGC for prevalent HCV seropositivity is high in women (79.8%).

The Prevalence of Hepatitis C Virus in Mashhad, Iran: A Population-Based Study

BackgroundHepatitis C virus (HCV) infection is a significant health problem throughout the world. Chronic form of the disease is found in about 75% to 85% of the newly infected individuals. The chronic infection may lead to severe forms including chronic liver disease, cirrhosis and with a higher mortality rate, hepatocellular carcinoma. Since no vaccine has yet been developed against HCV, there is an increasing need to take measures to control the spread of the infection. Therefore, epidemiologic study of the virus is important to manage and monitor the spread of the virus in the community.ObjectivesThe aim of this study was to determine the prevalence of hepatitis C seropositivity in the general population of Mashhad, northeast of Iran.Patients and MethodsThree thousand, eight hundred and seventy (3870) individuals living in the city of Mashhad were recruited using cluster sampling method. HCV seropositivity was determined with HCV antibody detection ELISA kit and was confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) method.ResultsIn this study the overall seroprevalence of hepatitis C was founded to be 0.2% by using ELISA method. However, the overall Hepatitis C virus infection prevalence was found to be 0.13% with RT-PCR method.ConclusionsOur study suggested that the prevalence rate of Hepatitis C virus is below 1% in the general population of Mashhad.

Rate of seroconversion in repeat blood donors at the national blood centre, kuala lumpur.

The World Health Organization (WHO) recommend that all donated blood are to be screened for at least three viral infections [human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV)]. The National Blood Centre, Kuala Lumpur (NBCKL) aims to reduce transfusion transmitted infections (TTI) as it still remains as one of the major risk for blood transfusion. A cross sectional study was conducted at the National Blood Centre, Kuala Lumpur from 1st January 2009 to 31st June 2010. Data from 581,020 donors were analyzed from year 2004 to 2008. All data were retrieved from NBCKL Blood Bank Information System (BBIS). A total of 201 repeat donors were included in the study based on the inclusion criteria but only 132 repeat donors agreed to participate. Information on sociodemographic, risk factors, knowledge of donors and high risk behavior were extracted from standardize questionnaire. Data were analyzed using SPSS version 14.0. The aim of this study was to determine the predictors of the seropositive infectivity among repeat blood donors at the NBCKL. The results showed Syphilis accounts for the highest and increasing seroconversion rate among other infections from 20.83% in year 2004 to 44.6% in year in year 2008. HIV and HCV infection also showed increasing seroconversion rate in 5years' time from 6.41% in year 2004 to 17.54% in year 2008 and 4.8% in year 2004 to 5.94% in year 2008 respectively. However, HBV infection alone showed a decreasing seroconversion rate from 20.83% in year 2004 to 10.4% in year 2008. Level of donors' awareness regarding high risk factors (activities or behaviour) can lead to higher risk of TTI with significant p value in this predictors model(p<0.05). Repeat blood donors with high risk activities are more likely to have seropositive results for HBV, HIV and Syphilis. This study found that the frequency of HCV seropositivity is higher among lapsed donor. Socio demographic factors such as male and working in the private sector predominates in all TTI markers. Majority of the respondents were aware about relation of high risk activities and risk of TTI.