oa Molecular Diagnosis and Vaccines - Hepatitis C virus and GBV-C co-infection in high risk Egyptian population



Blood-born viral infections are common in Egypt especially hepatitis C virus (HCV) and hepatitis B virus (HBV). Abbott investigators in 1995 discovered two new Flavi-like viruses (GBV-A and GBV-B) derived from tamarins inoculated with GB agents. A third genus was subsequently isolated and given the name GBV-C. We investigated the clinical and epidemiological factors attributed to HCV/GBV-C co-infection as well as HCV genotypes in 246 anti-HCV positive Egyptian high-risk subjects: chronic liver disease (CLD), blood donors, hemodialysis patients, and family contacts of index patients. Detection of HCV antibodies was carried out by EIA-2, HCV RNA by nested RT-PCR. HCV genotypes by RFLP, HCV viral quantitation by bDNA-2, and GBV-C RNA by LCx assay. HCV RNA was detected in 53% of the overall population, 56% of CLD, 60% of blood donors, 54% hemodialysis patients, and 0% family contacts. HCV-viremia was unrelated to all risk factors including schistosomiasis, duration of disease or pathology of schistosomiasis. HCV type-4 was found in 74.5% of patients, type-1b in 15.6%, and type-1a in 5.7%. An overall GBV-C RNA prevalence of 12.8% was found [CLD (11.2%), blood donors (6.7%), hemodialysis (11.1%), family contacts (0%)]. However, GBV-C viremia as well as HCV/GBV-C co infection was associated with a greater frequency of schistosomal infection (p=0.005, and p=0.000 respectively). In conclusion, in Egypt (i) GBV-C infection is high among Egyptian high risk patients, (ii) GBV-C infection and GBV-C/HCV co-infection are associated with schistosomiasis, (iv) HCV genotype 4 is the most common genotype, with a minority of 1a and 1b, (v) HCV but not GBV-C viremia is associated with elevated liver enzymes (vi) both HCV and GBV-C infections are not associated with any of the known parentral risk factors, raising the possibility of non-parentral or occult routs of transmission.


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