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Researchers discover HCV prevalent in sub-Saharan Africa

Hepatitis C virus infection was seroprevalent in various populations across sub-Saharan Africa, especially among adults with HIV, according to newly published data in The Lancet Infectious Diseases.

“Viral hepatitis is a huge problem in Africa, but currently there's no fund to provide what could be curative treatment,” Graham S. Cooke, PhD, of the department of medicine at Imperial College London, said in a press release. “The global scale-up of HIV treatments has left a legacy of systems for both funding and delivering HIV treatment that could be used to tackle viral hepatitis.”

Graham S. Cooke

Cooke and colleagues analyzed data from Medline and Embase databases between January 2002 and December 2014 of 213 studies from 33 countries that contained evidence of HCV prevalence in various population groups in regions of sub-Saharan Africa. The researchers used a DerSimoniam-Laird random effects model to estimate pooled regional prevalence of HCV, according to the research.  

From the 213 studies, researchers looked at 287 cohorts with 1,198,167 people. Overall, the HCV pooled prevalence among the cohorts was 2.98% (95% CI, 2.86-3.1), with the high-risk cohorts having an HCV prevalence of 11.87% (95% CI, 7.05-16.7) and the low-risk cohorts having a lower pooled HCV prevalence of 2.65% (95% CI, 2.53-2.78).

There were 101 cohorts that included HIV-positive individuals and 42,648 were positive for HCV. Therefore, the pooled HCV prevalence in HIV-positive individuals was 5.73%.

In the antenatal clinic groups, HCV prevalence was 3.04% (95% CI, 4.9-6.56), blood donors had a 1.99% prevalence and other general population cohorts had the highest prevalence of 6.9%.

Patients with liver disease had a 9.95% HCV prevalence rate.     

“Our study also shows that the challenge spreads far beyond HIV co-infected groups into the general population,” Cooke said. “The prevalence of hepatitis C in pregnant women was similar to that in the general population, suggesting that HCV testing could “piggyback” antenatal services to improve monitoring and prioritize groups for treatment.”

Cooke further stated: “If we're serious about tackling hepatitis, we need better data on who is affected. It's challenging to test everyone so we need ways to do surveillance simply. One possibility is to test pregnant mothers as a proxy for the adult population, and these results suggest that could be a useful strategy.” – by Melinda Stevens

Disclosure: Cooke reports being an investigator on trials of HCV treatment sponsored by Boehringer-Ingelheim, Gilead Sciences, Merck and Bristol-Myers Squibb. He also reports advising for Merck, Boehringer-Ingelheim, Gilead, Janssen and the WHO.