Contrasting patterns of hepatitis C virus infection in two regions from Tunisia

Abstract

This report is a population-based study describing the pattern of hepatitis C virus (HCV) infection in two distinct regions in Tunisia. The study included a total of 11,507 individuals sampled in 1996 from both genders, all age groups, urban and rural settings belonging to 2,973 families. HCV infection was assessed by commercial enzyme immunoassay (EIA) and immunoblot assays and detection of HCV RNA by PCR. HCV genotypes and subtypes were determined by sequencing in the 5'-untranslated region (UTR) viral genomic region and the INNO-LiPA HCVII genotyping kit. Genetic relatedness between HCV strains was assessed by sequencing of a portion of the NS5B region. HCV prevalence was significantly higher in the North-Western region than in the Southern one: 1.7% versus 0.2% (P < 10(-3), chi(2) = 8,506). There was no difference in positivity according to gender or living in rural or urban settings; the only significant risk factor was advanced age. HCV prevalence among household contacts of HCV positives was not significantly higher than the prevalence in the whole study population. These results indicate a heterogeneity in the geographical distribution of HCV in Tunisia. An increased HCV transmission occurs in the North-Western region with large predominance of genotype 1b (88%) and low contribution of intrafamilial transmission.

Evaluation of a total core antigen assay for the diagnosis of hepatitis C virus infection in hemodialysis patients

“…In the present study, 90.4% of the anti-HCV positive patients were viremic and this figure was higher than estimated for the general European and Tunisian HCV population, where 80% is suggested [Hinrichsen et al, 2002;Mejri et al, 2005]; it was even higher than in Tunisian dialysis patients in whom viremia was found in 78.9% [Ben Othman et al, 2004]. Nevertheless, a Spanish study reported that 3 years after acute hepatitis C infection, 87.5% of hemodialysis patients remained HCV-RNA positive [Espinosa et al, 2002].…”

Seroprevalency of Transfusion Transmitted Infections in First-Time Volunteer and Replacement Donors in Tunisia

“…Age was found out to increase the risk of carrying anti-HCV in the general population of Tunisia [9]. Male sex was not a risk factor and this is consistent with the results of a study [31] that found no difference in the prevalence of HCV in the general population according to sex.…”

“…The same study [31] found no significant difference between the prevalency of HCV patients in family contact with the virus seropositive members, and that in the entire study population.…”

“…In multivariate analysis, only age was an independent risk factor. Tunisia has a low endemicity for HCV [31,32]. Age was found out to increase the risk of carrying anti-HCV in the general population of Tunisia [9].…”

Phylogenetic Analysis of Isolated HCV Strains from Tunisian Hemodialysis Patients

“…This variation is due to several factors such as blood transfusion, intravenous drug users (IVDU), and lapses of universal precautionary measures. In Tunisia, epidemiological and previous phylogenetic studies conducted on both healthy and HCV infected subjects, reported a large predominance of genotype 1b (4,10,12,26). Few epidemiological studies have focused on HCV-4 infection in Tunisia.…”