Hepatitis C virus prevalence and serotypes associated with HIV in The Gambia.

Hepatitis C virus (HCV) serotypes are important in the epidemiology and pathogenesis of HCV-related disease, but little is known of this connection in West Africa. Coinfection with human immunodeficiency virus (HIV) is associated with significant morbidity and mortality. This study aims to determine the prevalence of HCV and its serotypes associated with HIV in The Gambia. A total of 1500 individuals referred to the Royal Victoria Teaching Hospital for HIV serology between July and December, 2002 were screened for antibodies to HIV and subsequently for HCV, and seropositive samples were typed. This study shows HIV and HCV prevalence of 6.7% and 1.6%, respectively, with a co-infection rate of 0.6%. Serotype 2 showed the highest prevalence (58.1%), followed by serotype 1 (19.4%). Prevalence of HCV serotype 3 was 6.5% and five samples were untypeable. Co-infection of HIV-1 with HCV serotype 1 showed a prevalence of 44.4%, and with HCV serotype 2 of 33.3%. The findings support the evidence to suggest the West African subregion as the origin of HCV serotype 2. It also demonstrates the need for routine HCV screening of HIV-infected persons and blood donations, and calls for further studies to elucidate the sources of the HCV virus.

Prevalence of HIV-1, HIV-2, hepatitis C and co-infection in The Gambia.

BACKGROUND: In most West African countries, the distribution and risk factors for co-infection with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) is unknown despite the current HIV epidemic and evidence of increasing prevalence of HCV in the region. OBJECTIVE: This study aimed to evaluate the distribution and the risk factors for the transmission of co-infection between HIV and HCV in The Gambia. METHODS: A total of 1500 persons referred for HIV serology at the Royal Victoria teaching Hospital were interviewed following informed consent to obtain information on their demographic variables, knowledge of sexually transmitted diseases and their prevention, and patterns of risk behavior. Blood was collected and tested for anti-HIV and anti-HCV antibodies by Enzyme Linked Immunosorbent Assay (ELISA). RESULTS: In the general population, the prevalence of HIV was 6.7%, while that of HCV was 2.1%. Both infections occurred more frequently in males than in females. HIV and HCV coinfection rate was 0.6%. Co-infection was significantly more common in males than females. All types of infection--HIV, HCV and HIV/HCV co-infections occurred much more in polygamous settings than in monogamy. CONCLUSION: This study has demonstrated the extent of coinfection with HIV and HCV in The Gambia. The prevalence of female circumcision may be a contributory occurrence factor in the transmission of HIV but not in that of HCV.

CD4+ lymphocyte values and trends in individuals infected with human immunodeficiency virus and/or co-infected with hepatitis C virus in the Gambia.

OBJECTIVES: This study was undertaken to monitor the CD4+ lymphocyte count in individuals infected with Human Immunodeficiency Virus (HIV) and/or co-infected with Hepatitis C Virus (HCV) and to compare this with the counts in normal individuals in The Gambia. METHODS: Blood samples were taken from 1500 individuals referred for HIV serology at the Royal Victoria Teaching Hospital (RVTH) following informed consent. Samples were tested for antibodies to HIV by the Murex ELISA, antibodies to HCV by the Ortho ELISA, and CD4 counts determined by the Dynalimmunomagnetic cell isolation method RESULTS: Of the 1500 patients screened for HIV and HCV antibodies, 6.7% (101/1500) were infected with HIV, 0.6 % (9/1500) were co-infected with HCV and 1.5 % (22/1500) were infected with HCV alone. Almost half (44.6%; 25/56) of HIV-1 infected patients had a CD4+ lymphocyte count at diagnosis of 200 cells/microl or less as compared to 41.7 % (10/24) of HIV-2 and 75% (6/8) of HIV-D infected patients. The rate of CD4 decline was higher among HIV/HCV co-infected persons than individuals infected with HIV or HCV. The rate of decline was higher among men than women. These differences did not reach statistical significance due in large part to the small number of participants who completed the programme. The CD4+ lymphocyte count of apparently healthy Gambian male and females was 489 cells/microl and 496 cells/microl respectively. This rate is lower than that reported for Caucasians, but in agreement with the global range. CONCLUSION: A significant progressive decline in CD4+ lymphocyte count was observed among the female control group who were negative for HIV and HCV. This finding is unclear and calls for a longitudinal study involving a cohort of women in this region.

Hepatitis C antibodies in asymptomatic first-time blood donors in The Gambia: prevalence and risk factors.

This study evaluates the seroprevalence and risk factors for hepatitis C (HCV) antibodies in asymptomatic first-time blood donors in The Gambia. The study population includes 460 blood donors (age range: 18-40 years [mean: 27.5]) who attended the Royal Victoria Teaching Hospital from July to December 2002. Antibodies to hepatitis C are determined using and enzyme-linked immunosorbent assay (ELISA) test system. The prevalence of hepatitis C found in this study was 1.1% (95% CI, 0.16-1.12). Previous history of sexually transmitted disease, married men in polygamous relationships, and hospital or clinic-based workers were determined to be at risk of acquiring hepatitis C. The study shows that seroprevalence of hepatitis C in The Gambia is low compared to other countries in the region.