Injection drug use is a risk factor for HCV infection in urban Egypt.
OBJECTIVE
To identify current risk factors for hepatitis C virus (HCV) transmission in Greater Cairo.


METHODS
A 1:1 matched case-control study was conducted comparing incident acute symptomatic hepatitis C patients in two "fever" hospitals of Greater Cairo with two control groups: household members of the cases and acute hepatitis A patients diagnosed at the same hospitals. Controls were matched on the same age and sex to cases and were all anti-HCV antibody negative. Iatrogenic, community and household exposures to HCV in the one to six months before symptoms onset for cases, and date of interview for controls, were exhaustively assessed.


RESULTS
From 2002 to 2007, 94 definite acute symptomatic HCV cases and 188 controls were enrolled in the study. In multivariate analysis, intravenous injections (OR = 5.0; 95% CI = 1.2-20.2), medical stitches (OR = 4.2; 95% CI = 1.6-11.3), injection drug use (IDU) (OR = 7.9; 95% CI = 1.4-43.5), recent marriage (OR = 3.3; 95% CI = 1.1-9.9) and illiteracy (OR = 3.9; 95% CI = 1.8-8.5) were independently associated with an increased HCV risk.


CONCLUSIONS
In urban Cairo, invasive health care procedures remain a source of HCV transmission and IDU is an emerging risk factor. Strict application of standard precautions during health care is a priority. Implementation of comprehensive infection prevention programs for IDU should be considered.
Emerging Disease Epidemiology Unit, Institut Pasteur, Paris, France. adelapaez@yahoo.com
Adela
A
Paez Jimenez
Mostafa K
MK
Mohamed
Noha Sharaf
NS
Eldin
Hasnaa Abou
HA
Seif
Said
S
El Aidi
Yehia
Y
Sultan
Nasr
N
Elsaid
Claire
C
Rekacewicz
Mostafa
M
El-Hoseiny
May
M
El-Daly
Mohamed
M
Abdel-Hamid
Arnaud
A
Fontanet
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004534:Egypt; D005260:Female; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications* / Q000635:transmission* / Q000821:virology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014505:Urban Population