Hepatitis C risk factors in Iranian volunteer blood donors: A case–control study
Seyed Moayed Alavian, Bardia Gholami, Sadegh Masarrat,
Sadegh Masarrat
Department of Gastroenterology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this authorSeyed Moayed Alavian, Bardia Gholami, Sadegh Masarrat,
Sadegh Masarrat
Department of Gastroenterology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Search for more papers by this author Seyed Moayed Alavian, 92–2nd floor, Opposite Iranian Blood Transfusion Organization, Vesal Shirazi Ave, Tehran, Iran. Email: [email protected]; [email protected]
Abstract
Background: In order to evaluate some possible risk factors for the spread of hepatitis C infection a case–control study was undertaken.
Methods: The study population consisted of first time blood donors referred to the Iranian Blood Transfusion Organization. Enzyme-linked immunosorbent assay and recombinant immunoblot assay anti-hepatitis C virus (HCV) tests were performed for all samples. Risk factors were evaluated using a questionnaire. A stepwise forward logistic regression analysis was used.
Results: The case group consisted of 193 HCV-positive donors, and 196 HCV-negative donors comprised the control group. Transfusion, undergoing endoscopy, extramarital sexual activities, non-intravenous (i.v.) drug abuse, i.v. drug abuse, and receiving wounds at war were found to be independent risk factors of being HCV-positive (Odds ratio: 17, 4, 42.2, 34.4, 52.8 and 5.2, respectively). No apparent risk factors could be demonstrated in 24.5% of the positive cases.
Conclusion: This study could be of particular interest because of the low seroprevalence of hepatitis C and the religious culture of the study population. There are certain medical procedures, lifestyle patterns, and customs and cultural matters in Iran that predispose people to a number of HCV risk factors.
References
- 1 Choo QL, Kuo G, Weiner AJ et al. Isolation of cDNA clone derived from a blood-borne non A, non B viral hepatitis genome. Science 1989; 244: 359–62.
- 2 Kuo G, Choo QL, Alter HJ et al. An assay for circulating antibodies to a major etiologic virus of human non A, non B viral hepatitis genome. Science 1989; 244: 362–4.
- 3 Simonetti RG, Camma C, Fiorello F et al. Hepatitis C virus infection as a risk factor for hepatocellular carcinoma in patients with cirrhosis. A case-control study. Ann. Intern. Med. 1992; 116: 97–102.
- 4
Tagger A,
Donato F,
Ribero ML et al.
Case-control study on hepatitis C virus (HCV) as a risk factor for hepatocellular carcinoma: the role of HCV genotypes and the synergism with hepatitis B virus and alcohol. Brescia HCC Study.
Int. J. Cancer
1999; 81: 695–9.
10.1002/(SICI)1097-0215(19990531)81:5<695::AID-IJC4>3.0.CO;2-W CAS PubMed Web of Science® Google Scholar
- 5 Alonso C, Pedroso ML, De Sanjose S et al. Hepatitis C virus among blood donors: follow-up study. Transfusion 1994; 34: 527–30.
- 6 Gaeta GB, Stroffolini T, Taliani G, Ippolito FM, Giusti G, De Bac C. Surgical procedures as a major risk factor for chronic hepatitis C virus infection in Italy: evidence from a case-control study. Int. J. Infect. Dis. 1999; 3: 207–10.
- 7 Straton E, Sweet L, Latorraca-Walsh A, Gully PR. Hepatitis C in Prince Edward island: a descriptive review of reported cases, 1990–95. Can. J. Public Health 1997; 88: 91–4.
- 8 Conry-Cantilena C, VanRaden M, Gibble J et al. Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. N. Engl. J. Med. 1996; 334: 1691–6.
- 9 Guerrero-Romero JF, Castaneda A, Rodriguez-Moran M. Prevalence of risk factors associated with hepatitis C in blood donors in the municipality of Durango, Mexico. Salud Publica Mex. 1996; 38: 94–100 (In Spanish with English abstract).
- 10 Watson JP, Brind AM, Chapman CE et al. Hepatitis C virus: Epidemiology and genotypes in north east of England. Gut 1996; 38: 269–76.
- 11 Jullien AM. Transfusion and hepatitis C. Pathol. Biol. (Paris) 1995; 43: 725–34.
- 12 Shev S, Widell A, Foberg U et al. HCV genotypes in Swedish blood donors as correlated to epidemiology, liver disease and hepatitis C virus antibody profile. Infection 1995; 23: 213–24.
- 13 Bassily S, Hyams KC, Fouad RA, Samaan MD, Hibbs RG. A high risk of hepatitis C infection among Egyptian blood donors: The role of parenteral drug abuse. Am. J. Trop. Med. Hyg. 1995; 52: 503–5.
- 14 Garcia-Bengoechea M, Emparanza JI, Sarriugarte A et al. Antibodies to hepatitis C virus: A cross sectional study in patients attending a trauma unit or admitted to hospital for elective surgery. Eur J. Gastroenterol. Hepatol. 1995; 7: 237–41.
- 15 Shev S, Hermodsson S, Lindholm A, Malm E, Widell A, Norkans G. Risk factor exposure among hepatitis C virus RNA positive Swedish blood donors—The role of parenteral and sexual transmission. Scand. J. Infect. Dis. 1995; 27: 99–104.
- 16 Crawford RJ, Gillon J, Yap PL et al. Prevalence and epidemiological characterisitics of hepatitis C in Scottish blood donors. Transfus. Med. 1994; 4: 121–4.
- 17 Goodrick MJ, Gray SF, Rouse AM, Waters AJ, Anderson NA. Hepatitis C (HCV)-positive blood donors in south west England: a case control study. Transfus. Med. 1994; 4: 113–19.
- 18 Morris JA Jr, Wilcox TR, Reed GW et al. Safety of blood supply. Surrogate testing and transmission of hepatitis C in patients after massive transmission. Ann. Surg. 1994; 219: 517–25.
- 19 Serfaty L, Giral P, Elghouzi MH, Jullien AM, Poupon R. Risk factors for hepatitis C virus infection in hepatitis C virus antibody ELISA-positive blood donors according to RIBA-2 status: a case-control survey. Hepatology 1993; 17: 183–7.
- 20 Chiaramonte M, Stroffolini T, Caporaso N et al. Hepatitis C virus infection in Italy: a multicentric seroepidemiological study (a report from the HCV Study Group of Italian Association for the Study of the Liver). Ital. J. Gastroenterol. 1991; 23: 555–9.
- 21 Iter HJ, Conry-Cantilena C, Melpolder J et al. Hepatitis C in asymptomatic blood donors. Hepatology 1997; 26: 29S–33S.
- 22 Prati D, Capeli C, Silvani C et al. The incidence and risk factors of community-acquired hepatitis C in a cohort of Italian blood donors. Hepatology 1997; 25: 702–4.
- 23 Utsumi T, Hashimoto E, Okumura Y et al. Heterosexual activity as a risk factor for the transmission of hepatitis C virus. J. Med. Virol. 1995; 46: 122–5.
- 24 Lissen E, Alter HJ, Abad MA et al. Hepatitis C virus infection among sexually promiscuous groups and the heterosexual partners of hepatitis C virus infected index cases. Eur. J. Clin. Microbiol. Infect. Dis. 1993; 12: 827–31.
- 25 Wu JC, Lin HC, Jeng FS, Ma GY, Lee SD, Sheng WY. Prevalence, infectivity, and risk factor analysis of hepatitis C virus infection in prostitutes. J. Med. Virol. 1993; 39: 312–17.
- 26 McHutchison JG, Leal RJ, Govindarajan S, Redeker AG. Hepatitis C antibodies in patients with alcoholic liver disease commonly have an identifiable risk factor. J. Clin. Gastroenterol. 1992; 15: 233–5.
- 27 Magriples U, Bernstein P, Snyder E, Copel JA. Can risk factor screening predict hepatitis C antibody reactivity? Am. J. Perinatol. 1998; 15: 395–8.
- 28 Chetwynd J, Brunton C, Blank M, Plumridge E, Baldwin D. Hepatitis C seroprevalence among injecting drug users attending a methadone programme. NZMed. J. 1995; 8: 364–6.
- 29 McLindon JP, Paver WK, Babbs C et al. Hepatitis C-related chronic liver disease among asymptomatic blood donors in the north west of England. J. Infect. 1995; 30: 253–9.
- 30 Neal KR, Jones DA, Killey D, James V. Risk factors for hepatitis C virus infection. A case-control study of blood donors in the Trent region (UK). Epidemiol. Infect. 1994; 112: 595–601.
- 31 Hardiman RP, Shaw DR, La Brooy JT et al. Chronic liver disease in asymptomatic hepatitis C antibody positive blood donors. Aust. NZ J. Med. 1993; 23: 176–80.
- 32 Kaldor JM, Archer GT, Buring ML et al. Risk factors for hepatitis C virus infection in blood donors; a case-control study. Med. J. Aust. 1992; 17: 227–30.
- 33 Win N, Frame D, Watkins R, Mitchell R. The low risk of hepatitis C virus transmission among sexual partners of confirmed HCV-positive blood donors. Transfus. Med. 1994; 4: 243–4.
- 34 Kolho EK, Krusias T. Risk factors for hepatitis C virus antibody positivity in blood donors in a low-risk country. Vox Sang. 1992; 63: 192–7.
- 35 Murphy EL, Bryzman S, Williams AE et al. Demographic determinants of hepatitis C virus seroprevalence among blood donors. JAMA 1996; 3: 995–1000.
- 36 Riestra Menendez S, Rodriguez Garcia M, Sanchez San Roman F et al. Intrafamilial spread of hepatitis C virus. Infection 1991; 19: 431–3.
- 37 Ndimbie OK, Kingsley LA, Nedjar S, Rinaldo CR. Hepatitis C virus infection in a male homosexual cohort: risk factor analysis. Genitourin. Med. 1996; 72: 213–16.
- 38 Tsega E, Nordenfelt E, Hannson BG. Hepatitis C virus infection and chronic liver disease in Ethiopia where hepatitis B infection is hyperendemic. Trans. R. Soc. Trop. Med. Hyg. 1995; 89: 171–4.
- 39 Merino-Conde E, Orozco JA, Rojo-Medina J, Tovar A. Prevalence of hepatitis C virus among candidates for blood donation at the Hospital General de Mexico. In Vivo 1994; 8: 621–3.
- 40 Ito S, Yao DF, Nii C et al. Epidemiological characteristics of the incidence of hepatitis C virus (C100–3) antibodies in patients with liver diseases in the inshore area of Yangtze River. J. Gastroenterol. Hepatol. 1993; 8: 232–7.
- 41 Soni PN, Tait DR, Kenoyer DG et al. Hepatitis C virus antibodies among risk groups in South African area endemic for hepatitis B virus. J. Med. Virol. 1993; 40: 65–8.
- 42 Iranian Blood Transfusion Organization. Internal Bulletin. Tehran: Iranian Blood Transfusion Organization, 1995 (In Parsi).
- 43 De Seta F, Riccoli M, De Santo D et al. Sexual behavior and adolescence. Minerva Ginecol. 2000; 52: 339–44 (In Italian with English abstract).
Citing Literature
