Changing pattern of hepatitis C virus spread in rural areas of Egypt.
OBJECTIVE
To identify patterns of HCV spread in the Nile Delta of Egypt.


METHODS
Residents in a Nile Delta village were invited to participate in a cohort study of HCV infection. Risk factors for past or current infection were identified at cohort intake using generalized estimated equations models. Attributable fractions were calculated for all independent risk factors.


RESULTS
The prevalence of HCV antibodies increased from 2.7% in those <20 years of age to more than 40% in males aged 40-54 years. The peak in HCV prevalence in the 40-54 year age group corresponds to the aging of the cohort of children infected through schistosomiasis intravenous treatments in the 1960s-70s (accounting for 12.4% of all HCV infections observed today among adults). Following this initial founding event, the HCV epidemic has spread in the community through iatrogenic factors, and particularly injections (37.9% of the overall attributable fraction in adults). In children, however, no iatrogenic factors were associated with increased risk of infection, suggesting a change in the pattern of HCV spread.


CONCLUSIONS
While HCV infections in adults could be attributed to iatrogenic factors, and particularly injections, infections in children could not be explained by similar routes of transmission.
Arafa
Naglaa
N
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
El Hoseiny
Mostafa
M
Rekacewicz
Claire
C
Bakr
Iman
I
El-Kafrawy
Sherif
S
El Daly
Mai
M
Aoun
Saeed
S
Marzouk
Diaa
D
Mohamed
Mostafa K
MK
Fontanet
Arnaud
A
D000293:Adolescent; D000328:Adult; D002648:Child; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors