High Frequency of Active HCV Infection Among Seropositive Cases in West Africa and Evidence for Multiple Transmission Pathways

Abstract

Viremic infection was common among serologically confirmed cases. Attention to testing algorithms is needed in order to define the true HCV burden in SSA. These data also suggest that several transmission modes are likely contributing to the current HCV epidemic in Ghana and that the distribution of these practices may result in substantial regional variation in prevalence.

A re-evaluation of the origin of hepatitis C virus genotype 2 in West Africa

“…Instead, its frequency fluctuates. Among all HCV strains from West Africa, HCV2 was found in 85% of cases in Guinea, Guinea-Bissau (Markov et al , 2009) and Ghana (Layden et al , 2015), and only in 33, 25 and 15% (Forbi et al , 2012, 2014; Markov et al , 2009) of cases in Côte d’Ivoire, Cameron and Nigeria, respectively. Thus, the countries of Guinea and Ghana with the highest HCV2 frequency are separated by Côte d’Ivoire with a low HCV2 frequency, which is inconsistent with the west-to-east gradient of HCV2 frequency proposed earlier.…”

“…The HCV2 sequences from that study have the GenBank accession numbers KM213527–KM213591. Additional details can be found in Layden et al (2015).…”

The present and future disease burden of hepatitis C virus infections with today's treatment paradigm: Volume 4

“…Expert consensus estimated that <1% of the 2015 infected population was infected through this means. Meanwhile, between 2008 and 2013, 1.20% of HCV cases were assumed to have occurred as a result of contaminated blood transfusions …”

The Prevalence of Hepatitis C Virus Antibody in HIV-Negative Persons in Kenya, 2007

“…The study from Ghana used a PCR assay that was different from those used in the two studies in Malawi and Uganda. 5,6,15 This study found that the initial screening anti-HCV positivity rate, although not statistically significantly different, was disproportionately highest in the Nyanza Province at 10.6% (95% CI: 7.1-15.5%) and among persons aged 55-64 years at 8.7% (95% CI: 4.0-18.0%). The reason behind this disparity is not apparent based on the findings from this study but warrants future investigation to understand the link between local disease epidemiology and seropositivity with standard anti-HCV screening tests.…”

“…3 However, the fact that five specimens with high positive signal to cutoff ratios could not undergo HCV RNA testing because of insufficient sera volume leaves uncertainty in determining if any current HCV infection was present in the population. A recent study by Layden et al 15 found that 74-88% of HCV antibody-positive blood donors from Ghana had HCV RNA. However, in the national Kenya population and in subpopulations in Malawi, Uganda, and Kenya, there was a high HCV antibody positivity rate with low or no circulating HCV viremia among HIV-positive and HIVnegative persons.…”