RESUMO
Both hepatitis C virus [HCV] and schistosomiasis are highly endemic in Egypt and coinfection is frequently encountered. Such coinfection is responsible for leading to a more severe liver disease. Hence, the aim of the study was to assess the fibroscan in chronic HCV patients coinfected with Schistosoma. This study included 231 chronic HCV patients. Routine pre-treatment work-up was done including anti-schistosomal antibodies. Liver stiffness measurements using fibroscan and reference needle-liver biopsy were done. Patients were categorised into two groups: HCV patients with positive schistosomal serology and HCV patients with negative schistosomal serology. Anti-schistosomal antibody was positive in 29% of the studied population. Positive schistosomal serology status was significantly associated with the disagreement between the results of liver biopsy [Metavir] and the fibroscan results [p value = 0.02], which was more obvious in F2 and F3 fibrosis stages. The sensitivity of fibroscan for the detection of the F2 stage decreased from 64% among negative schistosomal serology patients to 30.8% among positive schistosomal serology patients, and for the F3 stage it decreased from 43.8% to 21.4%, respectively. Multivariate logistic regression showed that fibrosis stages [FO-F1 and F4] were the most independent factors that were associated with the agreement between fibroscan and liver biopsy [odds ratio [OR] 3.4, 7.12 and p value <0.001, <0.001, respectively]. Although the sensitivity of fibroscan for the detection of fibrosis stages [F2 and F3] was impaired in patients with positive schistosomal serology, fibrosis stages [FO-F1 and F4] were the most independent factors associated with the agreement between fibroscan and liver biopsy
RESUMO
Developing a National surveillance system for hepatitis C virus infection could provide a reasonable tool for reflecting changes in the trend of the disease in the Egyptian community. The aim of the study is to develop a national sentinel surveillance system, based on blood banks, by measuring the prevalence of hepatitis C virus antibody in the sera of blood donors. The results were compared with that of the National community-based survey [NS] of the year 1997 from the areas surrounding the blood banks by age-standardized methods. Data were collected retrospectively from 3 blood banks in Cairo. The study population included 2845 consecutive blood donors from the years 1999 and 2000: 1265 [998 males and 267 females] from Mansheyat Elbakry blood bank, 986[840 males and 146 females] from El Galaa blood bank, and 594 [531 males and 63 females] from Ahmed Maher blood bank. Data collected from sheet includes personal data, blood banks serology results of HCV through testing with third generation ELISA. The over all prevalence of HCV among blood donors aged from 18-59 years was 7.6% [males 7.8%, females 6.9%] [NS=15.2%, males 15.5%, females 15.0% for the same age group]. Among different age groups the total prevalence of HCV was; 4.2% in the 18-29 years age group [NS=5.3%], 9.1% in the 30-39 age group [NS=17.9%], 19.0% in the 40-49 age group [NS=19.0%] and 20% in the 50-59 age group [NS=23%]. The prevalence of HCV is higher among replacement blood donors than those in campaign blood donors [8.9%, 3.9% respectively, OR=2.9]. It is also higher among blood donors living in rural areas than those living in urban areas [14.1%, 6.8% respectively, OR=2.3]. Age adjusted rates of HCV among the blood donors were; totally 10.6% [NS=14.7%], males 12.5% [NS=15.1%], females 8.5% [NS=14.5%]. Age and gender standardized HCV prevalence ratio [blood donors/NS] was; total ratio=0.7. Among the different age groups the ratio was; 18-29 years=0.8, 30-39 years=0.5, 40-49 years=0.9, and the 50-59 years age group=0.8. In conclusion, as a sentinel group, the total - as well as the female- population of blood donors have a lower prevalence of HCV with comparison to the National survey. However, with regards to the male population in the 18-29 years age group of blood donors, after age standardization, the rate of HCV among them is equal to that of the National survey, suggesting that male blood donors aged 18-29 years may provide an appropriate group for monitoring HCV prevalence in males of same age group in the general population