Hepatitis C Virus Genotype 4 in Ugandan Children and Their Mothers

Abstract

In Kampala, Uganda, in 2001, hepatitis C virus antibodies were found in 27 (4%) of 603 children and in 62 (12%) of 525 of their mothers. However, only ≈10% of positive results were confirmed by reverse transcription-PCR, which suggests frequent false-positive results or viral clearance. All sequenced types were genotype 4.T he prevalence of hepatitis C virus (HCV) infection in sub-Saharan African populations is an estimated 3%, with modest regional variation (1). The true prevalence may be lower because some positive HCV ELISA results may be due to cross-reactivity, and the reliability of recombinant immunoblot assay (RIBA) as a confirmatory assay is unclear (2,3). Few studies have confirmed antibody-positive results by molecular methods, and data on HCV genotypes in Africans are limited.In Uganda, 2 studies showed a low HCV seroprevalence (2,4), but neither examined samples for viral RNA. In 2001, we conducted a survey of Ugandan children with sickle cell disease and their mothers and found that human herpesvirus 8 infection was associated with transfusion in these children (5). Children with sickle cell anemia receive frequent injections during their care, and transfusions are frequently required for anemia. We therefore assumed that our population would be at increased risk for HCV infection. We tested for HCV antibodies and, on antibody-positive samples, sought HCV RNA to confirm antibody reactivity. For RNA-positive samples, we identified genotypes by sequencing and phylogenetic analysis. The StudyIn 2001, we enrolled 603 children (1-16 years of age) attending the Sickle Cell Clinic at Mulago Hospital, Kampala, in our study. By design, approximately half of the children had a history of blood transfusion. When available, the mothers of these children were also enrolled. Participants provided standardized information and blood samples. Plasma and buffy coats were immediately prepared and frozen at −80°C until testing.Plasma specimens were tested by using an ELISA for HCV antibodies to recombinant antigens c22, c200, and NS5B (ELISA-3.0, Ortho-Clinical Diagnostics, Raritan, NJ, USA) according to the manufacturer's instructions. To conserve samples we did not confirm positive results by RIBA but instead tested for virus in plasma by using a realtime reverse transcription (RT)-PCR assay for HCV RNA developed in our laboratory. This quantitative assay amplified a conserved 155-nucleotide target sequence within the HCV 5′ untranslated region and had an absolute sensitivity of 9 IU/mL of viral load (43 copies/mL). Total RNA was extracted from 140 µL plasma by using the Qiagen Viral RNA Mini kit (Qiagen, Valencia, CA, USA). RT-PCR was performed in a Thermo Hybaid MBS 0.2S (Fisher Scientific International, Hampton, NH, USA) in triplicate reactions that used 10 µL RNA per reaction. After cDNA synthesis, quantitative PCR was performed by using an ABI Prism 7700 or 7900 Sequence Detection System (Applied BioSystems, Foster City, CA, USA). HCV RNA-positive specimens were further characterized by sequencing parts of the ...

Seroprevalence of HBV and HIV Co-infection in Children in Nnewi, South-East, Nigeria

“…This is consistent with those of Bukbuk et al [21] and Zhou et al [37]. On the contrary, Narcissi et al and Teletela et al [38] documented no association between age and HBV/HIV co-infection.…”

“…This assertion is supported by a study in China [37]. However; the smaller sample size of subjects within the age group might also have influenced this finding.…”

“…The lower prevalence in this study could be attributed to increasing availability of HBV vaccine which is now included in the National Programme on Immunization in Nigeria. Hepatitis B virus vaccine has been proven to reduce the prevalence of HBV even among HIV positive population [37]. The low prevalence of HBV in this study could also be due to the current increased awareness of HIV and health education concerning preventive methods particularly the observation of universal precaution.…”

Trends in the incidence of primary liver cancer in Central Uganda, 1960–1980 and 1991–2005

“…Although increasing HCC rates in Europe and North America are largely attributed to HCV, chronic HCV infection is very uncommon in Uganda (Hladik et al, 2006). Chronic HCV infection with viremia is rare even in high-risk persons (Jackson et al, 1991;Biggar et al, 2006). Although it is unlikely that HCV would fully explain the increasing HCC rates, further evaluation is warranted, particularly because PLC increases among older Ugandans are consistent with an HCV cohort effect reported from other subSaharan African populations (Kirk et al, 2006).…”

Hepatitis C and blood transfusion among children attending the Sickle Cell Clinic at Mulago Hospital, Uganda

“…The prevalence of HCV in the general population and among SS patients in Uganda is not known. Secondary analysis on blood among SS patients at Mulago Hospital found a prevalence of 4% using antibody test 4 . among blood donors5 the prevalence is 0.5%.…”