Epidemiology of viral hepatitis B and C in Iraq: a national survey 2005-2006

ABSTRACT

Viral Hepatitis Type Band C is serious public health challenge throughout the world. Hepatitis B and C viruses still remain to be the major causes of chronic hepatitis. It is estimated that around 350-400 million people in the world are chronic carriers of HBV, which represents approximately 7% of the total population whereas infection with HCV is found in approximately 3% of the world population, which represents 160 million people. Hepatitis B infection has a wide range of seroprevalence in the Mediterranean countries ranging from intermediate [=>2%] to high prevalence [=>7%]. World Health Organization estimated a prevalence rate for HCV infection of about 4.6% in Eastern Mediterranean in 1999. During the eightieths years of the last century, Iraq was considered to be of intermediate endemicity with hepatitis B as reflected by 3% seroprevalence of HBsAg in normal population. Hepatitis C was found to be of low endemicity among blood donors 0.5%. There were no national wide epidemiological studies regarding the prevalence of hepatitis Band C accordingly we conduct this study to determine the prevalence of both types all over the Iraq. From the 1[st] of January 2005 to 31[st] of December 2006, a community based cross-sectional study was conducted all over Iraqi governorates. A total of 9610 persons, recruited by surveying a nationally representative random sample of households were analyzed. A stratified random sample proportional to size of each of the 18 Iraqi governorates, both urban and rural areas were included. Prevalence estimates were therefore weighted and age-adjusted. Five [5ml] of blood samples were taken from the study subjects, and tested for hepatitis B surface antigen, antibody to hepatitis B core antigen antibody to hepatitis B surface antigen and hepatitis C antibodies. The national prevalence rate of HBs Ag was 1.6% and correlated positively with age. The prevalence rate of anti-HBs antibodies was 17%. The prevalence of anti-HBc was 9.7%. The prevalence of anti-HCV was low [0.4%]. The prevalence rate of anti-HBs anti-bodies in <10 years children is only 32.2%, which raise the issue of incomplete coverage of hepatitis B vaccine during the years preceding the study years. The findings revealed that Iraq is of low prevalence with HBsAg. On the other hand, hepatitis C was found to be of very low prevalence. As a marker of exposure to hepatitis B, Anti HBcIgG was found to increase with age