Geographic integration of hepatitis C virus: A global threat.

AIM: To assess hepatitis C virus (HCV) geographic integration, evaluate the spatial and temporal evolution of HCV worldwide and propose how to diminish its burden. METHODS: A literature search of published articles was performed using PubMed, MEDLINE and other related databases up to December 2015. A critical data assessment and analysis regarding the epidemiological integration of HCV was carried out using the meta-analysis method. RESULTS: The data indicated that HCV has been integrated immensely over time and through various geographical regions worldwide. The history of HCV goes back to 1535 but between 1935 and 1965 it exhibited a rapid, exponential spread. This integration is clearly seen in the geo-epidemiology and phylogeography of HCV. HCV integration can be mirrored either as intra-continental or trans-continental. Migration, drug trafficking and HCV co-infection, together with other potential risk factors, have acted as a vehicle for this integration. Evidence shows that the geographic integration of HCV has been important in the global and regional distribution of HCV. CONCLUSION: HCV geographic integration is clearly evident and this should be reflected in the prevention and treatment of this ongoing pandemic.

Prevalence of hepatitis C virus antibodies among different populations of relative and attributable risk.

OBJECTIVES: To determine the prevalence of hepatitis C virus (HCV) antibodies among 5 different population groups including; healthy individuals, blood donors, hospital health care workers, renal dialysis patients and multiple blood transfusion group. To compare the ratios, relative and attributable risk among these groups. To outline a specific policy to reduce the potential risk of HCV among the different groups studied. METHODS: A prospective study was carried out in the Department of Microbiology, Faculty of Medicine, Tripoli, Libya, over a 2 year period for 1999 to 2001, to determine the prevalence of HCV-antibodies in sera collected from 5 distinct groups using enzyme-linked immunosorbent assay test. The groups included 800 healthy adults, 1200 individuals of blood donors, 459 hospital health care workers, 200 patients on renal dialysis and multiple blood transfusion group which included 250 patients. The prevalence of HCV was correlated with relative and attributable risk that contributed to the infectivity of HCV. RESULTS: A total of 2909 individuals participated in this study with 1.6:1 male to female ratio. The prevalence of HCV varied from one group to another. It was found to be 1.6% among the general population, 1.2% among blood donors, 2% among hospital health care workers, 20.5% among renal dialysis patients and 10.8% in the multiple blood transfusion group. The relative risk and attributable risk among these groups varies from 1.25 to 12.8 and from 0.4-18.9. CONCLUSIONS: This study underlines the prevalence of HCV among different groups. The prevalence varies from one group to another, being the lowest among the blood donors and general population and the highest among the higher risk group in particular the renal dialysis patients. Specific measures should be implemented to reduce such risks. These may include specific programs for medical education, a meticulous infection control system in the hospitals, a registry program and clinical follow-up for patients positive for HCV.