Intrafamilial transmission of hepatitis C virus (HCV): a major mode of spread in the Saudi Arabia population

Abstract

Age-specific prevalence of antibody to hepatitis C virus (anti-HCV) was studied in 831 Saudis (441 males, 390 females; 1-53 years old) from Al Baha region, south-west Saudi Arabia. There was a gradual exposure to HCV early in life with a gradual increase with age, reaching a peak of 5.3% in the 30-40 years age group. The overall prevalence was 3.6% and 3.1% in males and females, respectively, with no statistical difference. Comparison of positivity in family members of seven anti-HCV-positive index cases (15/44) with those of five anti-HCV-negative index cases (2/44) showed a statistically significant association (chi 2 10.5 with Yates' correction). This points to intrafamilial transmission of HCV as a route of spread among the Saudi population.

PIP: Over 90% of transfusion-related hepatitis is caused by non-A, non-B (NANB) hepatitis which has been diagnosed serologically by means of the recently cloned NANB agent designated hepatitis C virus (HCV) using a recombinant based assay. The age-specific prevalence of anti-HCV was studied in healthy Saudis, since silent carriers of NANB hepatitis occur among healthy blood donors as evidenced by a 10% rate of post transfusion hepatitis. In a prospective hospital-based study 381 children aged 1-14 treated for other ailments, 253 blood donors aged 15-53, and 192 pregnant women aged 15-38 were included who had no percutaneous exposure to blood. Also, 44 household members of 7 persons found anti-HCV positive were compared with 44 enzyme-linked immunosorbent assay (ELISA). Age-specific exposure to HCV peaked at 5.3% in the 20-40 age group after early childhood exposure. The prevalence of anti-HCV was 3.6% in males and 3/1% in females. A father and mother were found anti-HCV positive among household members of 7 anti-HCV positive cases. A 4-year old boy and a 7-year old boy in 2 families were found anti-HCV positive among household members of 5 anti-HCV-negative persons. Anti-HCV positivity in family members of HCV+index cases (15/44) was statistically significant compared with HCV index cases (2/44). Routine screening of donated blood is urged because of the high endemicity of HCV in Saudis, and the modes of transmission of HCV also requires further research.