HIGH PREVALENCE OF HEPATITIS-C VIRUS IN THE NORMAL LIBYAN POPULATION

The prevalence of hepatitis C virus (HCV) in Libya has been investigat ed by seeking evidence of HCV infection in 266 healthy Libyan subjects (147 females, 119 males; age range 1-78 years), 76 of whom were regis tered blood donors. None had any history of blood transfusions, surger y, homosexuality, drug misuse or other risk factor for viral hepatitis . Sera from all subjects were tested for anti-HCV antibodies by enzyme -linked immunosorbent assay against synthetic structural and non-struc tural HCV peptides from the HCV core, envelope, NS1, NS3/NS4 and NS5 r egions. Eighteen (6.8%), all of whom were seronegative for hepatitis B surface antigen (HBsAg), were found to be anti-HCV positive (includin g 5 blood donors). The patterns of reactivity against: the individual peptides varied between subjects as follows: core (14 subjects), envel ope (11), NS1 (9), NS3/NS4 (10), and NS5 (6). Fourteen of the 18 had e levated serum aminotransferase activities (AST/ALT) but so also did 9 other subjects who were seronegative for both HBsAg and anti-HCV. Twel ve of the 18 anti-HCV positive subjects, including 3 of the 5 anti-HCV positive blood donors, had circulating HCV RNA detected by the polyme rase chain reaction. HCV RNA was also detected in 3 of the 9 anti-HCV negative cases with elevated AST/ALT. The finding that 21 (7.9%) of th e 266 subjects had evidence of HCV infection indicates that there is a very high frequency of 'community-acquired' HCV in the normal Libyan population, and this has major implications for blood transfusion in t hat country.