Prevalence of hepatitis C virus genotypes and subtypes in Lebanese population and major high risk groups

Background and study aims: The prevalence of hepatitis C in Lebanon is low. It is estimated at 0.2% of the total population. The aim of our study is to evaluate the exact prevalence of each genotype on a large scale population and in each potential source of infection

Patients and methods: We reviewed all the data in the Ministry of Public Health related to patients who have submitted their file for treatment during a period of 9 years ranging from January 2005 till December 2013

Results: The genotype distribution in 1031 Lebanese patients was as following: Genotype 1 was the most predominant representing 47% followed by genotype 4 representing 34% then genotype 3 representing14%. Concerning sex distribution and routes of infection, there was a male predominance in intravenous drug users [IVDU], whereas approximately equal distribution was noted in haemodialysis and transfusion groups. A female predominance was noted in the "unknown" mode of infection. Concerning age distribution and routes of infection, a mean age of 27 was noted in the IVDU group, whereas mean age of 60 in the transfusion group and 50 in the haemodialysis group. In patients who acquired the infection post transfusion or during haemodialysis, genotype 1 was the most predominant, whereas in IVDU, genotype 3 was the most predominant. Concerning sub-genotyping: subtype 1b was the most predominant [84%] in genotype 1. in genotype 2 subtype b with 75%, all genotype 3 were subtype a, in genotype 4 subtype a represents 50% of genotype followed by subtype e in 30%

Conclusion: Our data concerning Lebanese population demonstrate that genotype 1 is the most prevalent genotype followed by genotype 4. In IVU, we noted genotype-3 and -1 being the most prevalent in relation to clustering in this high risk group. This distribution differs from most surrounding countries and all other Arab countries

Epidemiology of hepatitis B and hepatitis C in Lebanon

Background and study aims: Hepatitis B and C are two potentially life threatening liver infections. Lebanon is ranked as a zone of moderate endemicity. This study aimed to determine the prevalence of hepatitis B and C in Lebanon and their distribution according to age, region and sex

Patients and methods: This national prospective cross-sectional study was conducted from January 2011 till December 2012 in the six Lebanese Governorates in collaboration with municipalities, the Ministry of Public Health, Health Centres and dispensaries. An upcoming screening for hepatitis B and C was announced? in different districts of each Governorate. All individuals presenting to local laboratory, not known to have chronic hepatitis, were asked for a blood sample and answered a questionnaire addressing sex, age, place of birth and residence. Screening tests were [Abbots] for hepatitis B and [Human Hexagon] for hepatitis C. PCR testing was used to confirm the positivity of the previous tests

Results: Of 31147 individuals screened, 542 had a rapid test positive for HBV [prevalence 1.74%, 95% CI 1.6-1.89] with a male to female ratio of 1.08. This prevalence was higher in the South and Nabatieh [1.9%] compared to Beirut [0.73%]. Of 31,147 individuals screened, 64 had a rapid test positive for HCV [prevalence 0.21%, 95% CI 0.16-0.27] with a male to female ratio of 0.85. This prevalence was higher in Nabatieh [0.61%] compared to Mount Lebanon [0.08%]

Conclusions: The prevalence of HBV and HCV in Lebanon is 1.74% and 0.21%, respectively with a higher prevalence in South and Nabatieh districts. These data rank Lebanon amongst countries with low endemicity for both viruses. Decrease in the prevalence of HBV is due to awareness campaign as well as success of the MOPH National Hepatitis Program in vaccinating all new born since 1998 and in screening and vaccinating high risk groups