Hepatitis C virus infection in Guinea-Bissau: a sexually transmitted genotype 2 with parenteral amplification?
BACKGROUND
Sub-Saharan Africa is the continent with the highest prevalence of Hepatitis C virus (HCV) infection. Genotype 2 HCV is thought to have originated from West Africa several hundred years ago. Mechanisms of transmission remain poorly understood.


RESULTS
To delineate mechanisms for HCV transmission in West Africa, we conducted a cross-sectional survey of individuals aged >or=50 years in Bissau, Guinea-Bissau. Dried blood spots were obtained for HCV serology and PCR amplification. Prevalence of HCV was 4.4% (47/1066) among women and 5.0% (27/544) among men. In multivariate analysis, the independent risk factors for HCV infection were age (baseline: 50-59 y; 60-69 y, adjusted odds ratio [AOR]: 1.67, 95% CI: 0.91-3.06; >or=70 y, AOR: 3.47, 95% CI: 1.89-6.39), belonging to the Papel, Mancanha, Balanta or Mandjako ethnic groups (AOR: 2.45, 95% CI:1.32-4.53), originating from the Biombo, Cacheu or Oio regions north of Bissau (AOR: 4.16, 95% CI: 1.18-14.73) and having bought or sold sexual services (AOR: 3.60, 95% CI: 1.88-6.89). Of 57 isolates that could be genotyped, 56 were genotype 2.


CONCLUSIONS
Our results suggest that transmission of HCV genotype 2 in West Africa occurs through sexual intercourse. In specific locations and subpopulations, medical interventions may have amplified transmission parenterally.
Plamondon
Mireille
M
Department of Microbiology and Infectious Diseases and Centre for International Health, University of Sherbrooke, Sherbrooke, Québec, Canada.
Labbé
Annie-Claude
AC
Frost
Eric
E
Deslandes
Sylvie
S
Alves
Alfredo Claudino
AC
Bastien
Nathalie
N
Pepin
Jacques
J
D000368:Aged; D001483:Base Sequence; D017931:DNA Primers; D005260:Female; D005838:Genotype; D006169:Guinea-Bissau / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology*
D017931:DNA Primers