High rate of hepatitis C virus infection in an isolated community: Persistent hyperendemicity or period-related phenomena?

Abstract

We investigated underlying risks for hyperendemic hepatitis C virus (HCV) infection among the 1853 inhabitants of a mountainous village in Eastern Taiwan with high prevalence of HCV and hepatitis B virus (HBV). Among the 80 selected adults, we found that having resided away from the village before 1985 was protective against HCV infection, while residing in the village after 1985 posed little risk for HCV infection to children and young adults < 30 years of age. Among the 559 school children 7 through 14 years of age, anti-HCV prevalence was 1.9%, and the HBV carrier rate was 29%. Following up 270 children 1 year later, we found that new HCV infection occurred in 0.74% and new or repeated HBV infection occurred in 6.5% of the children, indicating distinct transmission patterns between HBV and HCV. Children of anti-HCV-positive mothers were either anti-HCV-negative or were infected by distinct genotypes of HCV from those infecting their mothers; most married couples in whom both were infected, were infected by HCV of discordant genotypes, indicating negligible importance of sexual or vertical HCV transmission. A case-control study comparing 13 anti-HCV-positive and 53 anti-HCV-negative children showed that having received parenteral medication in local clinics was a significant risk for HCV infection. Our data indicate that, unlike the case of HBV, HCV transmission by vertical or sexual route, or through casual contact are extremely inefficient, and our data further suggest that HCV hyperendemicity is unlikely to persist as a result of the more stringent practice of parenteral precautions in nearly all aspects of daily life.

Chronic hepatitis C increased the mortality rates of patients with hepatocellular carcinoma and diabetes mellitus in a triple hepatitis virus endemic community

“…Our study subjects were also older than those in previous studies [4,19,20]. Chronic HBV infection is spread by peri-natal or early infection, while chronic HCV infection is acquired in adulthood [33][34][35][36][37][38][39][40][41][42][43]. Previous studies have noted that the study area used in our investigation has been an HCV endemic area since 1994 [12,29].…”

Hepatitis C virus infection in a community in the Nile Delta: Risk factors for seropositivity

“…Similar to the role of shared use of syringes for administration of illicit drugs in Western countries, 15,24 the reuse of syringes for therapeutic reasons was shown to be responsible for high HCV prevalence in many different parts of the world. 21,[25][26][27] Two common potential HCV exposures for males are shaving by a community barber and smoking tobacco with a water pipe. Men are often shaved in groups, usually using the same razor blade, which is mechanically cleaned between customers.…”

Genetic Epidemiology of Hepatitis C Virus throughout Egypt

“…The presence of novel subtypes in Egypt has been suggested [34], but small PCR amplicon size (152 nucleotides [nt] from NS5B) prevented reliable resolution of subtypes [35], and current recommendations for subtype assignment require data from more than 1 genomic region [36]. HCV transmission between individuals has been assessed by comparison of viral sequences [37][38][39][40]. Likewise, the hypothesis that HCV was extensively transmitted in Egypt during a 1970s countrywide campaign to treat schistosomiasis would be supported by a higher-than-expected degree of viral homology throughout the country.…”