title: A comprehensive hepatitis C virus risk factors meta-analysis (1989-2013): do they differ in Egypt?
abstract: OBJECTIVE
  The prevention and control of HCV infection is complex and challenging in terms of describing risk factors and modes of transmission. This meta-analysis was conducted to summarize the best available data on HCV risk factors worldwide and in Egypt.
  
  
  METHODS
  Through exhaustive literature searches (1989-2013) of HCV risk factors, 357 original eligible articles were included in this study.
  
  
  RESULTS
  The highest detected risk was intravenous drug users (IDUs) (OR = 9.6) followed by HIV infection (OR = 4.9), having an IDU partner (OR = 4.1), HBV infection (OR = 3.5), Caesarean section (CS) (OR = 3.35), blood transfusion (OR = 3.2) and having an HCV+ partner (OR = 3). Organ transplantation, hospital admission, haemodialysis and having a sexually transmitted infection carry 2.96, 2.4, 2.18 and 2 risks of having HCV respectively. Other significant risk factors included poor education, older age, sharing sharp or blunt objects, MSM, tattooing, hijama, body piercing, minor operations and medical procedures. Some risks showed a decrease over the previous decade, including blood transfusion, organ transplantation, IDUs, IDU partner and CS. Others showed rising risks, including having an HCV+ partner, MSM and suffering from STI. In Egypt, male gender, rural residence, acupuncture and receiving parenteral antischistosomal treatment were significant risks, while neither HIV nor HBV were found to carry a risk of HCV infection.
  
  
  CONCLUSIONS
  Blood transfusion, organ transplantation, CS, IDUs, haemodialysis, minor operations and medical procedures are established risk factors. Attention and urgent intervention should be given to the sexual route of transmission, as well as that through minor operations and medical procedures.
authors.affiliation: Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
authors.forename: Engy Mohamed
authors.initials: EM
authors.lastname: El-Ghitany
authors.forename: Moataza M
authors.initials: MM
authors.lastname: Abdel Wahab
authors.forename: Ekram W
authors.initials: EW
authors.lastname: Abd El-Wahab
authors.forename: Safaa
authors.initials: S
authors.lastname: Hassouna
authors.forename: Azza G
authors.initials: AG
authors.lastname: Farghaly
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects*; D004534:Egypt / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000821:virology*; D065227:Transfusion Reaction
keywords: Egypt and meta-analysis; HCV; risk factors