Prevalence of hepatitis C virus infection among human immunodeficiency virus-1-infected pregnant women in Malawi: The BAN study

Abstract

Background In Sub-Saharan Africa, prevalence estimates of hepatitis C virus (HCV) vary widely. Objectives To assess the prevalence of HCV infection among HIV-infected, pregnant women screened for a large clinical trial in Lilongwe, Malawi. Study design Plasma from 2041 HIV-infected, pregnant women was screened for anti-HCV IgG using a chemiluminiscent immunometric assay (CIA). Specimens with a signal-cut-off ratio ≥ 1.00 were considered reactive and those with S/Co ratio < 1.00 non-reactive. All CIA-reactive specimens were tested by a recombinant immunoblot assay (RIBA) for anti-HCV and by PCR for HCV RNA. Results Of 2041 specimens, 110 (5.3%, 95% CI: 4.5–6.5%) were CIA reactive. Of the 109 CIA reactive specimens available for RIBA testing, 2 (1.8%) were positive, 28 (25.7%) were indeterminate, and 79 (72.5%) were negative. All CIA-reactive specimens were HCV RNA negative (n = 110). The estimated HCV prevalence based on the screening assay alone was 5.3%; based on supplemental RIBA testing, the status of HCV infection remained indeterminate in 1.4% (28/2040, 95% CI: 0.1–2.0) and the prevalence of confirmed HCV infections was 0.1% (2/2040, 95% CI: 0–0.4%). Conclusions HCV seroprevalence among HIV-infected, pregnant women in Malawi confirmed by supplemental RIBA HCV 3.0 is low (0.1%); CIA showed a high false-reactivity rate in this population.

Low prevalence of hepatitis C virus RNA in blood donors with anti‐hepatitis C virus reactivity in Rwanda

“…Only 14 of 25 blood donors with confirmed anti‐HCV reactivity (56%) were viremic, and this rate decreased to 35% when those with indeterminate reactivity were included. Such low rate has also been shown from blood donors in Kenya and HIV‐infected pregnant women in Malawi, where only 10% of the anti‐HCV–positive donors and none of the females were viremic . This may indicate that there is a relatively high rate of spontaneous clearance of HCV among the blood donors in Rwanda, since they are relatively young, and infection in younger age has been shown favorable for clearance of acute HCV infections, or that some donors may be viremic with HCV RNA concentrations below the detection limit of the assay used.…”

Three‐year cancer incidence in Blantyre, Malawi (2008–2010)

“…17,18 It is likely that this is due to underreporting. However, similar relatively low rates have been reported in data from registries across the region.…”

Hepatitis B and C virus infections among pregnant women in Arab and African countries

“…Another important feature of this part of Africa is the high prevalence of HIV infection, especially among pregnant women, with prevalence rates approaching 28% [84,85]. Nevertheless, the prevalence of coinfection was low (0.001%-0.1%) [86,87]. The scarcity of published data makes clear the need for more studies in this region.…”