Percent and risk factors of HCV infection in Egyptians attending Alexandria University Hospital

ABSTRACT

In Egypt HCV infection is a serious problem. The prevalence in 1999 was 18% according to MOHP survey. This study tried to get a clear idea about the percent of HCV in a random sample of students and employees in Alexandria University as compared to the percent of HCV infection in blood donors and to shed light on most of the risk factors. As well as to clarify the relation between DM and HCV infection. Random samples of 428 students, 479 employees and 24,064 blood bank donors were involved in this study. A standard questionnaire was issued to the students and the employees to collect data concerning age, sex, history of previous hepatitis history of blood transfusion, IV schistosomal treatment, intravenous injection [IV], intramuscular injection [IM], subcutaneous injection [SC], tattoo, circumcision, Hogamma [suction cupping], diabetes mellitus [DM] and marital state. Blood samples from the same patients were collected for HCV antibodies, alanine transferase [ALT] and fasting blood sugar levels. Cases with the risk factors were compared with those lacking them using logistic regression, odd ratios and confidence intervals. The prevalence of HCV in the whole group of students and employees was 11.6%. It was 17.2 in the age group above 30 years, and 7.6 in those below 30 years, odd ratio between the two age groups [OR= 2.5, 95% CI 1.6-3.8, p 0.001]. Percent of HCV in males was 13.5 while in females 7%, [OR= 2.06, 95% CI 1.2-3.5, p<0.01]. HCV infection in apparently healthy blood bank donors was 3.9% which as expected was lower significantly than the normal population even after it was adjusted for the age variable [p<0.01 vs normal population]. The adjusted OR of the studied risk factors which were statistically significant was as follows IV schistosomal treatment [tarter emetic] [OR=53, 95% CI 32-199, p <0.001], blood transfusion before 1994 [OR= 2.5, 95%vacuum cupping] [OR=2.4, 95% CI 1.1-5.7, P<0.05], IV injection [OR=1.8, 95% CI 1.04-3.2, p<0.01], circumcision in females [OR= 1.7, 95% CI 1.05-6.6, p<0.05], tattoo [OR- 1.6. 95% CI 1.02-2.4, p<0.05]. Other risk factors which were not statistically significant including IM injections [OR= 1.1, 95% CI0.7-2.5, p <0.1], circumscion in males by non professionals [OR=1.3, 95%CI0.8-2.6, p<0.1], blood transfusion after 1994 [OR=1.2.95%-CI0.4-4.8, p injection [OR= 1.002,95% CI0.5-1.7, p<1]. DM was a risk for developing HCV infection in the age group above 30 regardless the level of ALT. [OR= 1.9, 95% CI 1.01-3.8, p<0.05]. Marital state does not affect HCV infection transmission between the married couples. We concluded that HCV infection is more common in males and in patients above thirty. We also concluded that there is some risk for HCV infection via most invasive skin procedures. The percent of HCV in Egypt is declining because the two major causes the IV tarter emetic and the unscreened blood transfusion are now strictly prohibited. However our percent of HCV infection is still higher than many countries and the infected population serve as a reservoir for transmission of HCV infection. Strict sterilization for any invasive procedure is mandatory and publicity to make people understand the dangers of this technique. A relationship between DM and HCV infection is existing and cases with HCV positive who are above 30 years must be screened for DM because they are prone to develop DM type 2. There was no clear cut association between HCV transmissions in married couples