Incidence and risk factors for hepatitis C infection in a cohort of women in rural Egypt.
A prospective cohort study of the incidence and risk factors for hepatitis C virus (HCV) infection was performed in 2171 pregnant women in three rural Egyptian villages who were HCV antibody (anti-HCV) and RNA (HCV-RNA) negative at baseline. During an average of 2.2 years follow up, 25 incident cases were observed, giving an estimated HCV incidence of 5.2/1000 person-years (PY). The infection rate correlated with community anti-HCV prevalence in pregnant women, while the perinatal incidence rate of 11.2/1000 PY was almost five times that of the non-perinatal rate (2.3/1000 PY). The data suggested iatrogenic perinatal risk factors were associated with infection in one village, while health education reduced infections in another. Among the 25 incident cases, eight were HCV-RNA negative when they were first found to be anti-HCV positive and one-third of the 15 viraemic cases with follow-up data available cleared their HCV-RNA after an average of 1.3 years. None of the 25 incident cases were jaundiced or had symptoms of hepatitis but elevated serum alanine aminotransferase levels confirmed hepatitis in nine. Our data suggest that asymptomatic HCV infections frequently occurred during the perinatal period but often cleared and that educating medical personnel on safe practices possibly reduced HCV transmission.
Department of Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
Doa'a A
DA
Saleh
Fatma
F
Shebl
Mohamed
M
Abdel-Hamid
Shaker
S
Narooz
Nabiel
N
Mikhail
Manal
M
El-Batanony
Sherif
S
El-Kafrawy
Mai
M
El-Daly
Soraya
S
Sharaf
Mohamed
M
Hashem
Samer
S
El-Kamary
Laurence S
LS
Magder
Sonia K
SK
Stoszek
G Thomas
GT
Strickland
D000328:Adult; D004534:Egypt / Q000453:epidemiology; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data
D018937:Hepatitis C Antibodies; D012367:RNA, Viral