HEPATITIS-C VIRUS-INFECTION AND CHRONIC LIVER-DISEASE IN ETHIOPIA WHERE HEPATITIS-B INFECTION IS HYPERENDEMIC

To assess the prevalence and possible aetiological association of hepa titis C virus (HCV) with chronic liver disease and hepatocellular carc inoma (HCC), antibodies to HCV (anti-HCV) were determined by enzyme-li nked immunosorbent and recombinant immunoblot assays in 500 healthy vo lunteer blood donors, 14 patients with chronic hepatitis, 156 cirrhoti cs and 68 cases of hepatocellular carcinoma (HCC) in Ethiopia. The pre valences of anti-HCV were 1 . 4%, 21%, 36% and 46%, respectively. Ther e was no apparent risk factor to suggest the mode of transmission of H CV. Of the 238 patients, 65 (27%) had circulating hepatitis B surface antigen (HBsAg) (denoting current infection), 131 (55%) had antibodies to hepatitis B surface (anti-HBs) and/or core (anti-HBc) antigens (pa st infection) and 42 (18%) had no hepatitis B virus (HBV) marker. Anti -HCV antibodies were present in only one patient with HBsAg, in 54% wi th past infection and in 68% of those without HBV markers. Thus, HCV i nfection was uncommon in HBsAg-positive patients but significantly mor e common in patients with chronic liver disease and HCC who had eviden ce of past HBV infection or no marker for HBV infection. HCV infection appeared to be a more common cause of chronic liver disease and HCC t han HBV infection in this population. However, considering the high pr evalence of overall exposure to HBV infection (68% in healthy blood do nors and 82% in those with chronic Liver disease, including HCC), HBV is significant in terms of national preventive strategies.