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Open Access Research article

Case control study to identify risk factors for acute hepatitis C virus infection in Egypt

Amr M Kandeel1, Maha Talaat2, Salma A Afifi2*, Nasr M El-Sayed1, Moustafa A Abdel Fadeel2, Rana A Hajjeh3 and Frank J Mahoney4

Author Affiliations

1 Preventive and Endemic Disease Sector, Ministry of Health and Population, Cairo, Egypt

2 Global Disease Detection and Response, U.S. Naval Medical Research Unit No. 3 (NAMRU-3), Naval, PSC 452 Box 5000 FPO, AE, 09835, USA

3 Division of bacterial diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

4 Centers for Disease Control and Prevention, Jakarta, Indonesia

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BMC Infectious Diseases 2012, 12:294  doi:10.1186/1471-2334-12-294

Published: 12 November 2012

Abstract

Background

Identification of risk factors of acute hepatitis C virus (HCV) infection in Egypt is crucial to develop appropriate prevention strategies.

Methods

We conducted a case–control study, June 2007-September 2008, to investigate risk factors for acute HCV infection in Egypt among 86 patients and 287 age and gender matched controls identified in two infectious disease hospitals in Cairo and Alexandria. Case-patients were defined as: any patient with symptoms of acute hepatitis; lab tested positive for HCV antibodies and negative for HBsAg, HBc IgM, HAV IgM; and 7-fold increase in the upper limit of transaminase levels. Controls were selected from patients’ visitors with negative viral hepatitis markers. Subjects were interviewed about previous exposures within six months, including community-acquired and health-care associated practices.

Results

Case-patients were more likely than controls to have received injection with a reused syringe (OR=23.1, CI 4.7-153), to have been in prison (OR=21.5, CI 2.5-479.6), to have received IV fluids in a hospital (OR=13.8, CI 5.3-37.2), to have been an IV drug user (OR=12.1, CI 4.6-33.1), to have had minimal surgical procedures (OR=9.7, CI 4.2-22.4), to have received IV fluid as an outpatient (OR=8, CI 4–16.2), or to have been admitted to hospital (OR=7.9, CI 4.2-15) within the last 6 months. Multivariate analysis indicated that unsafe health facility practices are the main risk factors associated with transmission of HCV infection in Egypt.

Conclusion

In Egypt, focusing acute HCV prevention measures on health-care settings would have a beneficial impact.

Keywords:
Acute Hepatitis C; Risk factor; Egypt