Risk Factors Associated with a High Seroprevalence of Hepatitis C Virus Infection in Egyptian Blood Donors

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  • Department of Microbiology, Ain Shams University Faculty of Medicine, Manchiet El Bakrey Hospital, Department of Pathology, University of Maryland School of Medicine, Epidemiology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Division of Geographic Medicine, Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Cairo, Egypt

We performed serologic tests for hepatitis C virus (HCV) infection on sera obtained from 163 volunteer blood donors seen at one Cairo hospital. We found HCV infection in 36 donors (22%) measured by a second generation enzyme immunoassay. Thirty-five of these 36 positive sera were tested with a second generation recombinant immunoblot assay (RIBA-2); 22 (63%) were reactive and another 12 (34%) showed an indeterminate reaction. Overall, 13.6% (95% confidence interval [CI] = 8.3–18.9%) of these Egyptian blood donors were serologically confirmed to be infected with HCV. Of several demographic variables and medical risk factors examined, the serologically confirmed (RIBA-2 reactive) donors were significantly older than nonreactive donors, and the age-adjusted risk of being HCV-positive was significantly greater in individuals residing outside Cairo. A knowledge of having received injections, of having a history of schistosomiasis, or of having concomitant hepatitis B surface antigen or antibody were significantly associated with an increased risk of HCV-seropositivity; however, after adjusting for confounding demographic factors, only schistosomiasis (odds ratio = 8.9, 95% CI = 2.35–33.52) was significantly associated with HCV infection. The HCV seropositive rate of 13.6% among Egyptians is 5–35-fold higher than that reported from volunteer blood donors in other countries. Screening for HCV should be instituted in Egyptian blood banks. Blood banks that do not test for HCV should include a history of schistosomiasis in their exclusion criteria used for routine screening of blood donors.