Intrafamilial transmission of hepatitis C in Egypt

Abstract

The incidence of hepatitis C (HCV) infection and associated risk factors were prospectively assessed in a cohort of 6,734 Egyptians from 2 rural villages who were negative for antibodies to HCV (anti‐HCV). Initial and follow‐up sera were tested for anti‐HCV by enzyme immunoassay (EIA), and possible incident cases were confirmed by using the microparticle enzyme immunoassay (MEIA) and tested for HCV RNA. All follow‐up serum samples converting from negative to positive without detectable HCV‐RNA were further tested by recombinant immunoblot assay. Over an average of 1.6 years, asymptomatic anti‐HCV seroconversion occurred in 33 people (3.1/1,000 person‐years [PY]), including 28 (6.8/1,000 PY) in the Nile Delta village (AES), where prevalence was 24% and 5 (0.8/1,000 PY) in the Upper Egypt village (baseline prevalence of 9%). The strongest predictor of incident HCV was having an anti‐HCV–positive family member. Among those that did, incidence was 5.8/1,000 PY, compared (P < .001) with 1.0/1,000 PY; 27 of 33 incident cases had an anti‐HCV–positive family member. Parenteral exposures increased the risk of HCV but were not statistically significant; 67% of seroconverters were younger than 20 years of age, and the highest incidence rate (14.1/1,000 PY) was in children younger than 10 who were living in AES households with an anti‐HCV–positive parent. In conclusion, young children would especially benefit from measures reducing exposures or preventing infection with HCV. (HEPATOLOGY 2005.)