Hepatitis c virus (HCV) infection in a community in the Nile Delta: Population description and HCV prevalence

This report describes a cross-sectional survey of the prevalence of antibod ies to hepatitis C virus (anti-HCV) in a rural Egyptian community in the Ni le Delta. One half of the village households were systematically selected a nd examined by questionnaire and testing sera for anti-HCV and HCV RNA. Blo od samples were obtained from 3,888 (75.4%) of 5,156 residents greater than or equal to 5 years of age; an additional 111 samples were obtained from c hildren younger than 5 years. Overall, 973 (24.3%) of 3,999 residents were anti-HCV-positive, and the age- and gender-adjusted seroprevalence was 23.7 %. Anti-HCV prevalence increased sharply with age! from 9.3% in those 20 ye ars of age and younger to >50% in those older than 35 years. Currently or p reviously married individuals were more likely to be seropositive than thos e never married, controlling for age (Mantel-Haenszel risk ratio = 1.8; 95% CI: 1.3, 2.6). Of the 905 anti-HCV-positive samples tested, 65% were also positive for HCV RNA. Active schistosomal infection was not associated with anti-HCV status; however, history of antischistosomal injection therapy (r eported by 19% of anti-HCV positives) was a risk for anti-HCV (age-adjusted risk ratio = 1.3; 95% CI: 1.2, 1.5). This study, the largest community-bas ed survey to date, supports earlier reports of high levels of anti-HCV amon g adults in rural areas of Egypt, although many of those who are seropositi ve will not have active liver disease. The large reservoir of HCV infection in the community provides an opportunity to investigate risk factors for t ransmission, the natural history of infection and effectiveness of preventi ve methodologies, and raises concern about the prospect of an increasing in cidence of chronic Liver disease in the coming decades.