title: Case control study to identify risk factors for acute hepatitis C virus infection in Egypt.
abstract: BACKGROUND
  Identification of risk factors of acute hepatitis C virus (HCV) infection in Egypt is crucial to develop appropriate prevention strategies.
  
  
  METHODS
  We conducted a case-control study, June 2007-September 2008, to investigate risk factors for acute HCV infection in Egypt among 86 patients and 287 age and gender matched controls identified in two infectious disease hospitals in Cairo and Alexandria. Case-patients were defined as: any patient with symptoms of acute hepatitis; lab tested positive for HCV antibodies and negative for HBsAg, HBc IgM, HAV IgM; and 7-fold increase in the upper limit of transaminase levels. Controls were selected from patients' visitors with negative viral hepatitis markers. Subjects were interviewed about previous exposures within six months, including community-acquired and health-care associated practices.
  
  
  RESULTS
  Case-patients were more likely than controls to have received injection with a reused syringe (OR=23.1, CI 4.7-153), to have been in prison (OR=21.5, CI 2.5-479.6), to have received IV fluids in a hospital (OR=13.8, CI 5.3-37.2), to have been an IV drug user (OR=12.1, CI 4.6-33.1), to have had minimal surgical procedures (OR=9.7, CI 4.2-22.4), to have received IV fluid as an outpatient (OR=8, CI 4-16.2), or to have been admitted to hospital (OR=7.9, CI 4.2-15) within the last 6 months. Multivariate analysis indicated that unsafe health facility practices are the main risk factors associated with transmission of HCV infection in Egypt.
  
  
  CONCLUSIONS
  In Egypt, focusing acute HCV prevention measures on health-care settings would have a beneficial impact.
authors.affiliation: Global Disease Detection and Response, U.S. Naval Medical Research Unit No. 3 (NAMRU-3), Naval, PSC 452 Box 5000 FPO, AE 09835, USA.
authors.forename: Amr M
authors.initials: AM
authors.lastname: Kandeel
authors.forename: Maha
authors.initials: M
authors.lastname: Talaat
authors.forename: Salma A
authors.initials: SA
authors.lastname: Afifi
authors.forename: Nasr M
authors.initials: NM
authors.lastname: El-Sayed
authors.forename: Moustafa A
authors.initials: MA
authors.lastname: Abdel Fadeel
authors.forename: Rana A
authors.initials: RA
authors.lastname: Hajjeh
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Mahoney
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult