Hepatitis C virus antibodies among risk groups in a South African area endemic for hepatitis B virus

Abstract

The prevalence of anti-HCV was studied in a South African area endemic for hepatitis B virus. A total of 35,685 volunteer blood donors (22,034 whites, 9,218 Asians, 3,077 Africans, 1,356 coloureds), 71 haemophiliacs, 84 chronic dialysis patients, 100 antenatal attenders, 212 nurses, and 20 HIV-positive male homosexuals were tested for anti-HCV. Repeat positive second generation Ortho HCV EIA was used to determine HCV status for the blood donors; Abbott-II HCV EIA combined with a neutralisation test was used for the other risk groups. Antibody to hepatitis B core antigen (anti-HBc) was also tested in the haemophiliacs, nurses, and chronic dialysis patients. Seroprevalence for the blood donor population was 0.16, 0.34, 0.75, and 0.22% for whites, Asians, Africans, and coloureds, respectively. Of the risk groups tested, 39.4% of haemophiliacs and 4.8% of chronic dialysis patients were positive; of the remainder tested none was positive. Fifty percent of nurses, 47.9% of haemophiliacs, and 22.6% of dialysis patients had serological evidence of past exposure to hepatitis B virus (anti-HBc positive). These findings indicate a low prevalence of anti-HCV in the blood donor population, thus probably resulting in a low prevalence in groups exposed to blood and blood derivatives. The overall difference in prevalence between the race groups was significant (P < 0.0001). The high prevalence of hepatitis B virus compared to the low prevalence of HCV suggests that the main modes of transmission of the two viruses are probably different.

High rate of hepatitis C virus infection in an isolated community: Persistent hyperendemicity or period-related phenomena?

“…In comparison, HCV infection among blood donors or the general population is mostly low (1-2%) even in areas where HBV infection is endemic [Degos 1994;Bhandari and Wright, 1995;McCarthy et al, 1994;Ochi et al, 1991;Soni et al, 1993;Biltz et al, 1994]. This discrepancy between the high HBV and low HCV infection rates has been mainly attributed to a lack of introduction of HCV to the community.…”

Nurses at risk for occupationally acquired blood-borne virus infection at a South African academic hospital

“…4 In the Caucasian and Asian populations carrier rates are low, being 0.23% and 0.18% in Caucasian South African men and women, respectively. 5 In contrast, the seroprevalence of HCV infection is low in all South African populations, 4,6 the anti-HCV prevalence being 1.2%, 0.8%, and 0.6% in blacks, Asians, and Caucasians, respectively. 3 It has been estimated that an HCW's overall risk of contracting hepatitis is four times greater than that of the general adult population.…”

“…Because HBV vaccine has been included in the Expanded Programme on Immunization (EPI) in South Africa only since 1995, these individuals would not have been immunised at birth and would therefore have been susceptible to HBV infection. 6 The prevalence of HIV/HBV co-infection in the South African population ranges between 6% and 17%. 11,12 In the USA between 50% and 90% of HIV-infected people have serological markers of past HBV infection and 5-10% are chronic carriers of the virus.…”

Should routine serological screening for HCV be mandatory in HIV/AIDS patients enrolling for HAART in South Africa?

“…1 In Africa, HCV prevalence ranges from <3% in South Africa to >20% in Egypt. In South Africa, there is a low prevalence from 0.16% to 1.8%, [2][3][4][5] but this is higher in high-risk individuals, e.g. 39.4% in haemophiliacs and 4.8% in chronic dialysis patients.…”

“…39.4% in haemophiliacs and 4.8% in chronic dialysis patients. 2 Some 4 -5 million people globally are co-infected with HCV and human immunodeficiency virus (HIV). 6 Co-infection with HCV and HIV is common owing to shared routes of transmission -via blood and blood products and sharing of needles for injecting drugs.…”