Risk Factors For Hepatitis C Virus Infection Research Articles

Risk Factors of Hepatitis C Virus Infection in Drug Users From Eleven Methadone Maintenance Treatment Clinics in Xi'an, China.

Background:Hepatitis C virus (HCV) infection rates in drug users vary among different regions of China. Drug users who are unaware of their HCV serostatus tend to engage in more risky behaviors.Objectives:This prospective study aimed to assess risk factors of HCV infection in drug users among 11 methadone maintenance treatment (MMT) clinics in Xi’an, China.Patients and Methods:Baseline characteristics and drug use information of patients were collected upon enrollment in the study and anti-HCV tests were performed within one month after the enrollment. Data on daily medication, monthly random urine morphine test results, illicit drug use and MMT retention time were recorded during a 5-year follow-up.Results:Of 10243 patients, 58.0% had positive results for anti-HCV. Injection drug use, longer duration of drug abuse, older age, female gender, unmarried status and unemployment were independent risk factors of HCV infection. Urine test positivity rate was lower (14.8% vs. 16.7%, χ2 = 100.235, P < 0.05), but MMT retention rate was higher (log-rank χ2 = 4.397, P < 0.05) in the anti-HCV positive group than anti-HCV negative one. However, multivariate regression revealed no significant association between anti-HCV serostatus and either MMT retention time or illicit drug use.Conclusions:The major risk factor of HCV infection was injection drug use. The patient’s awareness of his or her HCV status had a minor effect in reduction of illicit drug use and improvement in MMT retention. Therefore, adequate counseling is necessary for drug users in MMT clinics in Xi’an.

Rate of infection and related risk factors on hepatitis C virus in three counties of Jiangsu province

To investigate the hepatitis C virus (HCV) infection rate among general population in Jiangsu province and to analyze the main risk factors for HCV infection. Subjects in 3 counties were surveyed by stratified cluster random sampling in the National Major Science and Technology Projects demonstration area in Jiangsu province. Interview was carried out with uniformly- designed questionnaires. Blood samples were collected and anti-HCV tested. Data were analysed under SPSS 13.0. Case-control study was conducted on two groups with subjects under 1:4 matching by sex, age, village of residence and status of HCV infection. Cox's proportional hazards regression analysis was then performed to analyze the risk factors for HCV infection. The positive rate of anti-HCV was higher in females (0.965%, 95%CI:0.899%-1.035%) than in males (0.572%, 95%CI:0.517%-0.632%). Significant differences were noticed among the positive rates of anti-HCV in the three counties (0.131%, 95%CI:0.103%-0.164%;0.316%, 95%CI: 0.268%-0.370%; 2.173% , 95% CI:2.039%-2.315% , respectively). Peak prevalence of anti-HCV (1.577%, 95%CI:1.425%-1.740%) was observed among persons at 50-59 years of age. Bottom rate (0.161%, 95%CI:0.125%-0.204%) was observed below 30 years of age. High anti-HCV positive rate was detected in people with lower education background or belonged to 'floating population'. Factors as having histories of hospitalization (OR = 3.049, 95% CI:1.322-7.036), blood transfusion (OR = 14.319, 95%CI:2.318-88.459) or sharing razor (OR = 3.604, 95%CI:1.096-11.851) were risk factors of HCV infection in the area with the lowest anti-HCV positive rate. In another county, factor as having histories of 'blood products transfusion' (OR = 7.202, 95% CI:1.170-44.310) appeared important while in the third county, having history of 'blood donation' (OR = 7.496, 95%CI:6.121- 9.180); 'blood transfusion' (OR = 2.305, 95%CI:1.578-3.369) and 'invasive physical examination' (OR = 1.258, 95% CI:1.021-1.549) appeared to be important. Age seemed a risk factor for HCV infection. "Sharing razor" was a specifically important risk factor among the 30- year-olds. "Having received acupuncture" was noticed a risk factor only among people at 50-59 years of age while "Having received invasive physical examination" was important in the 50-59 and 60-69 year-olds. High anti-HCV positive rate was observed in people at middle of aged population, as well as in those with poor education or under 'floating'. Unsafe blood donation or having received blood-product transfusion might be the risk factors in the last decades. Factors as sharing razor, having received acupuncture or invasive examination might be specifically risky in different populations.

Low Prevalence of Hepatitis C Virus Infection Among HIV-Positive Patients: Data From a Large-Scale Cohort Study in Istanbul, Turkey.

Background:Rate of coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) varies in different countries. This may be attributable to common transmission routes as well as social, economic, and cultural factors.Objectives:The purpose of this study was to investigate the prevalence and risk factors of HCV infection among HIV-positive patients in Istanbul, Turkey.Patients and Methods:Since January 2006 to November 2013, 949 HIV-positive patients that were enrolled in this study by ACTHIV-IST (Action Against HIV in Istanbul) Study Group, which consists of five centers to follow up HIV-positive patients in Istanbul. Epidemiologic and clinical data were collected retrospectively from medical records and were transferred to an HIV database system.Results:Among 949 patients, 84% were men and the mean age was 37.92 ± 11.54 years (range, 17-79). The most frequent route of transmission was heterosexual intercourse (48.8%), followed by men having sex with men (30.5%). Only nine patients (0.9%) had history of injection drug use (IDU). The prevalence of HIV/HCV coinfection was 0.9% (9:949). The IDU rate was 44.4% (4:9) in patients with HIV/HCV coinfection (three of them were not Turkish citizens), whereas this rate was only 0.6% (5:881) in patients with only HIV infection (P < 0.01). Genotypes 1b, 2a/2c, and 3 were determined in five, one, and two patients, respectively. Genotype could not be determined in one patient. History of residence in a foreign country (P < 0.01) and imprisonment (P < 0.01) were also considered as risk factors in terms of HIV/HCV coinfection.Conclusions:Prevalence of HIV/HCV coinfection is considerably low in Turkey. The extremely rare prevalence of IDU might have a role in this low prevalence.

Prevalence and Molecular Determination of Hepatitis C Infection in Khyber Pakhtunkhwa, Pakistan

Background: Hepatitis C virus (HCV) infection is the most significant source of chronic liver diseases in the globe. About 170 million individuals are infected by HCV worldwide. The reported prevalence of HCV in different areas of Khyber Pakhtunkhwa (KP) ranges from 4.1 to 36%. Objectives: The current study aimed to analyze the true prevalence of HCV infection in Khyber Pakhtunkhwa, Pakistan. Materials and Methods: Three hundred and ninety HCV enzyme-linked immunosorbent assay (ELISA) positive samples that belonged to the different regions of Khyber Pakhtunkhwa were sent to the Genome Centre for Molecular Based Diagnostics & Research (GCMBDR), Lahore, from January 2011 to March 2011, and were selected for the current study. Serological and biochemical data of these samples were provided by clinicians. Out of 390 samples, 40 were provided from Mardan, 65 from Dir (Lower), 185 from Swat and 100 from Malakand districts of Pakistan. Results: Out of 390 patients, 140 were found HCV RNA positive (by Polymerase Chain Reaction method) and 250 subjects were excluded from further analysis. Out of PCR positive subjects, 81 were male and 59 were female. All individuals were categorized in four age groups that is, 0 to 20, 21 to 40, 41 to 60 and above 60 years. HCV RNA was found in 16.67%, 37.5%, 35.51% and 36% of these groups, respectively. District wise HCV positivity rates were 36.2 % in Swat, 38.4% in Dir (L), 36% in Malakand and 30% in Mardan, respectively. Conclusions: It was found that among the studied areas, Dir district had the highest prevalence of HCV, the majorly of affected patients were among the age group of 21 to 40 , male patients were found more susceptible to this infection (P = 0.0103 < 0.05), and the possible reason can be the high exposure of males to the HCV infection risk factors. Furthermore the current study was unable to find the important risk factors responsible for the frequent prevalence of HCV infection in Khyber Pakhtunkhwa

Risk Factors of HCV Seroconversion in Hemodialysis Patients in Tabriz, Iran

Background:Hepatitis C virus (HCV) infection is a significant health concern in patients with end-stage renal disease under dialysis. Epidemiological studies have reported a prevalence rate of 5.5-55.9% for this condition in Iran.Objectives:We evaluated the risk factors for HCV infection and seroconversion in hemodialysis patients.Patients and Methods:A retrospective analysis was performed on 455 hemodialysis patients from each of the five dialysis units in Tabriz, northwest Iran. Possible risk factors for HCV infection and seroconversion were evaluated.Results:A total of 37 patients were HCV positive (8.1% of the study population) and seroconversion occurred in 18 of them during the dialysis treatment (3.95% of the study population). History of renal transplantation (44.4%, P < 0.0001), surgical intervention (except for renal transplantation and AV fistula placement) (94.4%, P = 0.03), and mean duration of dialysis (106.06 ± 55.519, P < 0.0001) had strong statistically significant associations with the seroconversion.Conclusions:The current study indicates increased risk for HCV infection in patients under dialysis and its relation with the mean duration of hemodialysis, history of renal transplantation and surgical intervention. Considering the immune deficiency in these patients, intense education to both patients and medical staff will be beneficial.

An Unbelievable Fact on “Dialysis Centers Without Hepatitis C Infection”

Hepatitis C virus (HCV) infection is the second viral cause for chronic liver disease (CLD) in the world and nearly 170 million people are infected worldwide (1, 2). The history of transfusion before 1992 (time of blood and blood products screening), illegal drug using, exposures among health care workers, unprotected multi-partner sexual contact, and chronic hemodialysis are known risk factors for HCV infection (3-5). HCV infection is a common infection in hemodialysis (HD) patients as well as dialysis centers (6). It is currently the major cause of CLD and mortality after kidney transplantation (7). Distribution of HCV infection among HD patients is not globally homogenous. We performed a multicenter study in Tehran in 2002 and the prevalence of HCV infection among HD patients was around 13% (8). We systematically reviewed all published and unpublished documents related to HCV infection prevalence in Iranian HD patients from April 2001 to March 2008 (9). Eighteen studies from 12 provinces (consisting of 49.02% of the total Iranian population) reported prevalence of HCV infection in Iranian HD patients. HCV infection prevalence in Iranian HD patients was 7.61% and showing that the burden has changed during the recent years (9). In 2006, we started a project for control of hepatitis C infection in dialysis patients (10). Iran Hepatitis Network (IHN), Ministry of Health and Medical Education (MOHME), many experts in hemodialysis and gastroenterology and infectious departments in many universities were involved in it in Iran. We presented main strategies for control of HCV infection in dialysis centers that consisted of: periodic screening of HCV in dialysis centers and reporting to MOHME for evaluation, distributing information to both patients and health staffs, training courses and congresses in various cities with more focus on the cities with higher HCV infection prevalence, treatment of HCV-positive patients with approved protocols, treatment according to a widely approved protocol, and putting HCV-positive HD patients in the top of waiting list for kidney transplantation (10). Changes in the epidemiology of HCV infection and decrease in the burden of liver diseases in HD patients has been reported according to the report of MOHME in Iran (11). The prevalence of HCV has decreased from 14.4% in 1999 to 4.5% in 2006 (11). Recently published articles of different centers from various parts of Iran showed the continuation of this burden decrease. Samimi-Rad et al. reported the prevalence of HCV antibody among HD patients around 5.0% in Yazd province and 5.4% in Markazi province (12, 13). Fortunately, the authors performed the molecular tests for all anti-HCV antibody-positive cases in their study. Zahedi et al. reported the prevalence of HCV antibody among HD patients around 7% in Kerman province (14) and Assarehzadegan et al. reported it 7.9% in Khuzestan province (15). In Zahedi et al. study, less than 50% of positive cases were HCV RNA-positive, meaning that less than 3.5% of their samples were HCV infected. I would like to mention that we should evaluate the epidemiology of HCV infection in addition to serological tests, using molecular tests such as RT-PCR, and ask the history of antiviral therapy in hemodialysis patients with anti-HCV Ab-positive results and consider the RT-PCR negative results as cured cases, not positive ones. This mistake might result in over-estimation of the prevalence of HCV infection in this high group. antiviral therapy; introduction of erythropoietin which has resulted in the decrease of transfusion needs; early transplantation; treatment of positive cases; training health staffs; and higher mortality of HD patient with HCV infection on hemodialysis. Finally, I would like to emphasize that we can imagine the “dialysis center without HCV” if we follow the standard infection precautions for control of HCV infection.

Alcohol misuse and illicit drug use are associated with HCV/HIV co-infection

We studied hepatitis C virus (HCV) prevalence and risk factors for HCV infection in a sample of Brazilian HIV-positive patients. A cross-sectional study was conducted with 580 HIV-positive patients from a specialized HIV/AIDS diagnosis and treatment centre in southern Brazil. All patients were interviewed for socio-demographic and risk factors and tested for HCV antibodies and HCV-RNA detection. A multivariate analysis was performed to identify risk factors for HCV infection. A total of 138 (24%) patients had past or chronic hepatitis C. The following risk factors were associated with HCV infection for each gender: alcohol misuse and injecting drug use in women (P < 0·001) and low educational level, smoking drug use, and injecting drug use in men (P < 0·01). These results suggest that alcohol misuse, low educational level, smoking drug use, and injecting drug use are probable risk factors for HCV infection in HIV-positive patients. This information contributes to an understanding of the epidemiology of HIV/HCV co-infection in Brazil.

Geographic differences in the epidemiological features of HCV infection in Korea.

Background/AimsThe prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla.MethodsIn total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed.ResultsThe analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures.ConclusionsThere was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection.

Trends in hepatitis C infection among hemodialysis patients in Senegal: results of a decade of prevention.

Chronic kidney disease is an emerging public health issue in Africa. At end-stage renal disease (ESRD), patients need hemodialysis (HD), which may expose them to blood transmitted infections, such as the hepatitis C virus (HCV). Sub-Saharan Africa has the highest HCV prevalence in the world, but data on HD patients is scarce and shows an exceptionally high rate in Senegal. To assess the efficacy of preventive measures in reducing HCV infection among dialysis patients, we retrospectively conducted a cross-sectional study in three Senegalese HD centers, including all HD patients who performed HCV serology between 1 st and 31 st August 2011. The demographical, clinical, and biological data were collected for each patient. We included 106 patients with a mean age of 43.4±15.8 years (range from 18 to 80 years), with 52.8% males. HD vintage was 60.5±15 months (range from six to 206 months). The main causes of kidney disease included nephrosclerosis (36%) and diabetes (24%). The prevalence of HCV was 5.6%, with one patient co-infected with the hepatitis B virus. After adjusting for age and sex, HD vintage was the only risk factor for HCV infection, while nutritional status and the number of blood transfusions did not significantly correlate with HCV infection. We conclude that during the past decade, the prevalence of HCV infection in HD patients living in Senegal has declined considerably, mainly because of improved transfusion measures and better clinical practice in the HD centers. Such efforts should be maintained and reinforced to reduce the seroprevalence of HCV infection.

Clinical Evaluation of Chronic Hepatitis C and Indications for HCV Treatment

Hepatitis C virus (HCV) is the most common cause of liver cirrhosis in the United States. If untreated, HCV can lead to death from complications of liver failure or hepatocellular carcinoma, making screening imperative in high-risk patients. Established risk factors for HCV infection include injection drug use, receipt of blood transfusion or organ transplantation prior to 1992, and hemodialysis. Recent evidence has demonstrated that those born between 1945-1965 are additionally at high risk for HCV acquisition and should undergo one time screening. Once diagnosed, consideration for treatment should be based on patient motivation, concurrent medical co-morbidities, degree of liver injury, and risk of progression to cirrhosis. Therapy may also be indicated in patients with extra-hepatic manifestations of HCV.

Pathology Features and Molecular Genetic Mechanisms of Hepatocellular Carcinoma Development in Patients with Hepatitis C Associated Liver Cirrhosis

Hepatitis C virus (HCV) is a single stranded RNA virus belonging to the family of Flaviviridae. The hepatitis C virus has unique ability to cause persistent infection in susceptible host. The chronicity rate is 75-85% after acute infection and 20-30% of HCV infected patients will develop cirrhosis, end-stage liver disease or hepatocellular carcinoma (HCC). Post transfusion HCV has been virtually eliminated by screening of donor blood after 1992 and injection drug use now appears to be the most common remaining risk factor for HCV infection. Chronic infection of HCV is a major risk of hepatocellular carcinoma and the pathogenesis of HCC in chronic HCV infection is due to chronic inflammation for long period of time which leads to fibrosis, cirrhosis and carcinoma formation. Pathology features of chronic hepatitis C, cirrhosis and hepatocellular carcinoma were described. Molecular genetic mechanisms involved in the development of hepatitis C associated cirrhosis and hepatocellular carcinoma were reviewed. Understanding the mechanisms of initiation and progression of HCC will provide principles for early diagnosis, treatment, and prevention.

Prevalence and Risk Factors of Hepatitis C Virus Infection in Amol City, North of Iran: A Population-Based Study (2008-2011)

BackgroundHepatitis C Virus (HCV) infection is one of the most important causes of chronic liver disease and related problems in the world .There are few population-based studies on the prevalence and risk factors of hepatitis C infection in Iran, which could not provide enough information. Moreover, the prevalence and risk factors of hepatitis C infection are not similar in all parts of Iran.ObjectivesThe aim of this survey was to determine the prevalence and risk factors of HCV infection in the general population of the city of Amol, north of Iran.Patients and MethodsThis was a population-based study. Using a cluster sampling approach, 6145 individuals of both genders and different ages were involved from general population of urban and rural areas of Amol, The inclusion criteria were Iranian nationality, willing to participate in the study, and lifelong residence in Amol city and surrounding areas. Anti-hepatitis C antibody was measured by a third generation of ELISA. The positive results were confirmed by Recombinant Immuno Blot Assay (RIBA) and quantitative HCV-RNA polymerase chain reaction (PCR) tests. Potential risk factors of HCV transmission were recorded.ResultsThe mean age of participants was 42.70 ± 17.10 years. Of these participants, 57.2% (n = 3483) were male. Anti-HCV antibody was positive in 12 individuals from which five were RIBA positive. Three of these subjects were PCR positive. The prevalence of HCV was more predominant among males than females. The common risk factors among the study subjects included history of minor or major surgery (34.7%), unsterile punctures (21.2%), history of traditional phlebotomy (5.8%), and history of hepatitis among close relatives (5.7%). In univariate regression analysis, unsterile punctures and history of infection in family members were associated with HCV infection.ConclusionsWe confirm that in Amol city and surrounding areas, the prevalence of true HCV infection is 0.05%, which is lower than that previously reported from Iran.

Less-Established Risk Factors Are Common in Asian Americans with Hepatitis C Virus: A Case–Controlled Study

The Centers for Disease Control and Prevention recommend screening for hepatitis C virus (HCV) in patients with injection drug use, blood transfusion before 1992, stigmata of liver disease, or born between 1945 and 1965. The purpose of this study was to examine risk factors for HCV acquisition in Asian Americans. This was a case-controlled study, with 471 consecutive patients testing positive for anti-HCV between January 2001 and December 2008. Controls included 471 patients with negative HCV matched at a one-to-one ratio for sex, age (±5 years), and ethnicity. For Asian patients, the most common risk factors were blood transfusion and acupuncture or exposure to dirty needles (27 and 20 %, respectively). On multiple logistic regression, potential predictors for a positive anti-HCV test in Asians were acupuncture or exposure to dirty needles (OR = 12.9, P < 0.0001), body tattoo (OR = 12.0, P = 0.001), and history of blood transfusion (OR = 5.7, P < 0.0001). Acupuncture and exposure to dirty needles are independent risk factors of HCV infection. Asians coming from endemic areas should be screened for HCV even when commonly-known risk factors for Western patients are not present.

Epidemiology of Hepatitis C Virus Infection and Risk Factor Analysis in the Hebei Province, China

BackgroundIn 1985, a hepatitis C virus (HCV) outbreak caused by plasmapheresis donation was reported in the Hebei Province, China. However, studies assessing the epidemic features and risk factors of HCV in the general population of Hebei have been limited until now.MethodsThe multicenter cluster sampling method was used to collect samples. The participants were interviewed. Relevant information was obtained from the general population using a standardized questionnaire, and association and logistic regression analyses were conducted. Serum samples were taken to test anti-HCV by enzyme immunoassays.ResultsA total of 4562 participants from 11 cities of the Hebei Province were enrolled. The average anti-HCV positive rate was 0.62% (29/4562), which was 1.07% in the rural population, compared with 0.22% in the urban population. The anti-HCV positive rate in the 40–59-year age group was higher than in those aged <40 years. History of blood transfusion and transmission in families were the main risk factors for HCV infection in this area.ConclusionThe anti-HCV positive rate in Hebei has decreased significantly from that two decades ago. Safety of blood products and health education about HCV still need to be improved.

Mannose-binding lectin exon 1 polymorphisms in Egyptian patients with chronic hepatitis C virus infection

Persistent infection with hepatitis C virus (HCV) is a major cause of liver cirrhosis and subsequently liver cancer. Mannose-binding lectin 2 (MBL2) plays an important role in innate immunity, and its genetic polymorphisms are associated with deficient serum level of MBL2 and with frequent and prolonged infections. This study was undertaken to investigate the association between polymorphisms of MBL2 gene and hepatitis C virus infection and its association with response to treatment. We determined MBL2 gene polymorphism within exon 1 in 51 Egyptian patients with chronic hepatitis C virus infection and 49 healthy blood donors. MBL2 gene mutations were determined by means of polymerase chain reaction and restriction fragment length polymorphism analysis. Codons 52 and 54 mutant genotypes were significantly lower in HCV cases: odds ratio (OR) 0.28, 95 % confidence interval (CI) 0.10 to 0.76, p = 0.012; and OR 0.15, 95 % CI 0.04 to 0.55, p = 0.004, respectively. While codon 57 mutant genotypes were significantly higher in HCV cases: OR 4.54, 95 % CI 1.56 to 13.23, and p = 0.006. MBL2 mutant genotypes at codons 52 and 54 are a protective factor for HCV infection, while MBL2 mutant genotypes at codon 57 are a risk factor for HCV infection. MBL2 D allele at codon 52 and B allele at codon 54 are a protective factor for HCV infection, while C allele at codon 57 is a risk factor for HCV infection.

P3.096 HIV and HCV Prevalence and Risky Behaviors Among Needle Exchange Program Users in Albania

BackgroundHIV and Hepatitis C virus (HCV) infection is one of the most frequent chronic blood-borne infections among injecting drug users (IDU) causing significant morbidity and mortality among them and their...

Clinical and epidemiological features of hepatitis C virus infection in South Korea: A prospective, multicenter cohort study

The epidemiological and clinical features of hepatitis C virus (HCV) infection in South Korea were examined in a prospective, multicenter cohort study that included 1,173 adult patients with positive results for anti-HCV antibody who completed a questionnaire survey on the risk factors for HCV infection from January 2007 to December 2011 at five university hospitals. The HCV cohort had a mean age of 55.4 years with 48.3% men, and diagnostic categories of acute hepatitis (n = 63, 5.3%), past infection (n = 37, 3.2%), chronic hepatitis (n = 777, 66.2%), cirrhosis of the liver (n = 179, 15.3%), and hepatocellular carcinoma (n = 117, 10.0%). The major HCV genotypes were genotype 1 (52.7%) and genotype 2 (45.3%). Liver biopsy was performed in 301 patients (25.7%), and 42.8% of the subjects received antiviral therapy against HCV. The behavioral risk factors possibly related to HCV infection were intravenous drug use (5%), needle stick injury (7%), blood transfusion before 1995 (19%), sexual relationship with more than three partners (28%), piercings (35%), tattoos (36%), surgery (43%), acupuncture (83%), diagnostic endoscopy (85%), and dental procedures (93%). Age, intravenous drug use, needle stick injury, transfusion before 1995, and tattoos were the independent risk factors of HCV infection.

Association of tattooing and hepatitis C virus infection: A multicenter case-control study

Although injection drug use (IDU) and blood transfusions prior to 1992 are well-accepted risk factors for hepatitis C virus (HCV) infection, many studies that evaluated tattooing as a risk factor for HCV infection did not control for a history of IDU or transfusion prior to 1992. In this large, multicenter, case-control study, we analyzed demographic and HCV risk factor exposure history data from 3,871 patients, including 1,930 with chronic HCV infection (HCV RNA-positive) and 1,941 HCV-negative (HCV antibody-negative) controls. Crude and fully adjusted odds ratios (ORs) of tattoo exposure by multivariate logistic regression in HCV-infected versus controls were determined. As expected, IDU (65.9% versus 17.8%; P < 0.001), blood transfusion prior to 1992 (22.3% versus 11.1%; P < 0.001), and history of having one or more tattoos (OR, 3.81; 95% CI, 3.23-4.49; P < 0.001) were more common in HCV-infected patients than in control subjects. After excluding all patients with a history of ever injecting drugs and those who had a blood transfusion prior to 1992, a total of 1,886 subjects remained for analysis (465 HCV-positive patients and 1,421 controls). Among these individuals without traditional risk factors, HCV-positive patients remained significantly more likely to have a history of one or more tattoos after adjustment for age, sex, and race/ethnicity (OR, 5.17; 95% CI, 3.75-7.11; P < 0.001). Tattooing is associated with HCV infection, even among those without traditional HCV risk factors such as IDU and blood transfusion prior to 1992.

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%).

Seroprevalence and risk factors for hepatitis C virus (HCV) infection in pregnant women attending public sector tertiary care hospital in Hyderabad Sindh

Pakistan is among the countries having high prevalence of HCV infection in the population but there is dearth of proper epidemiological data regarding acquisition of HCV infection in the pregnant population. Our objective was to determine the seroprevalence of HCV antibodies in healthy pregnant women and to assess the potential risk factors for HCV infection in HCV positive subjects and in the control group. This cross sectional and comparative study was conducted from 1(st) January to 31(st) December 2010 in the Department of Obstetrics/Gynaecology Unit-I, Liaquat University Hospital Hyderabad. Sera were collected from all admitted pregnant women and tested for HCV anti bodies using Elisa kits (Abbott, USA). Data were analyzed using SPSS version 16.0 statistical package. The seroprevalence of HCV among pregnant population was found to be 4.7%. HCV positive women were more likely to have a history of blood transfusion (OR 1.99, 95% CI 1.26- 3.12), History of therapeutic injection use (OR 2.46, 95% CI 1.43-4.26), history of surgery (OR 1.72, 95% CI 1.12-2.66) and history of sharing household products (OR 1.81, 95% CI 1.14-2.87). HCV seropositive pregnant women were more likely to have a history of blood transfusion, therapeutic injection use, surgery and sharing household items.