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Low prevalence of hepatitis C virus infection in Lusaka, Zambia
380
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE (1995) 89, 380
[Report1 Low prevalence of hepatitis infection in Lusaka, Zambia
C virus
H. Oshitanil, F. Kasolol, N. P. Luol, M. Mpabalwanil, K. Mizutal, N. Numata2, H. Suzuki3 and Y. Numazamkis and 1Virology Laboratory, University Teaching Hospital, Lusaka, Zambia; IDepartment of Microbiology, Sendai Municipal Institute of Public Health, Sendai, Japan; 3Virus Research Centre, Sendai National Hospital, Sendai, Japan Keywords:
hepatitisC, prevalence,Zambia
Although the prevalence of hepatitis B virus infection has been reported to be generally high in sub-Saharan Africa, that of hepatitis C virus (HCV) infection in this region shows wide variation: 0.5% in Niger (DEVELOUX et al., 1992), 1.2% among Black blood donors in South Africa (ELLIS et al., 1990), 6.5% in Gabon (DELAPORTE et al., 1993), and 12.5% in Cameroun (LOUIS et al., 1994). The present study was carried out at the University Teaching Hospital (UTH) in Lusaka to investigate the prevalence of HCV infection in Zambia. We tested serum samples from 3 adult groups: group (i), blood donors; group (ii), hospital patients with jaundice; and group (iii), hospital patients without jaundice. Samples were tested for hepatitis C antibody using the passive haemagglutination test (Abbott PHA HCV@ Second Generation, Dainabot, Tokyo, Japan). Reactive samples were tested for virus ribonucleic acid by the polymerase chain reaction (PCR) as described by NUMATA et al. (1993). Human immunodeficiency virus (HIV) antibody tests were also carried out on someof the hospital patients without jaundice, using an enzymelinked immunosorbent assay (Wellcozyme@ Recombinant HIV 1, VK56/57, Wellcome Diagnostics). A total of 735 samples was tested for HCV antibody: 240 in group (i), 152 in group (ii) and 343 in group (iii).
Of these, only 3 samples (0.41%) were positive for HCV antibody: 01240in group (i), 21152(1.3%) in group (ii) and 11343(0.3%) in group (iii). The 2 positive patients in group (ii) were clinically diagnosed as having liver carcinoma and chronic hepatitis respectively; clinical details for the other positive patient, in group (iii), were not available. HCV infections were confirmed by PCR in all
Address for correspondence: H. Oshitani, Ml?, Virus Research Centre, Sendai National Hospital, 2-8-8 Miyagmo Miyagmo-ku, Sendal, 983, Japan.
3 positive samples. HIV antibody tests were done on 301 samnles in groun (iii). and 182 were nositive (60.5%). The-one H& p&iv; sample in group (iii) was‘also reactive for HIV antibody. In Zambia, the prevalence of hepatitis B is high; 6.5% of pregnant women were positive for hepatitis B surface antigen (HBsAg) (OSHITANI et al., in press), and HIV is also highly endemic. The present study indicates that the prevalence of HCV infection in Lusaka is low in spite of the high endemicity of hepatitis B and HIV. There seems to be a great difference in HCV prevalence between African countries. However, the precise mechanism of transmission in highly endemic areas is still unknown. Further studies are thus necessary to define the geographical distribution of HCV in Africa and the risk factors for HCV transmission in high prevalence areas. Acknowledgements
We thank Dr G. Muyinda, the blood bank staff at UTH, and Mr Lishoma for their assistance.This studv is Dart of the Infectious Disease Project, a technical co-operatibn between the Zambian and Japanese governments supported by JICA (the
JapanInternationalCo-operationAgency). References
Delaporte, E., Thiers, V., Dazza, M. C., Romeo, R., Mlika-Cabanne, N., Aptel, I., Schrijvers? D., Brechot, C. & Larouze, B. (1993). Hieh level of heoatitis C endemicitv in Gabon. equatorial Af&a. Transactiok of the Royal Socie& of Tropical Medicine and Hygiene, 87,636-637.
Develoux, M., Meynard, D. & Delaporte, E. (1992). Low rate of hepatitis C virus antibodies in blood donors and pregnant women from Niger. Transactions of the Royal Societyof Tropical Medicine and Hygiene, 86,553.
Ellis, L. A., Brown, D., Conradie, J. D., Paterson, A., Sher, R., Millo, J., Theodossiadou, E. & Dusheiko, G. M. (1990). Prevalence of hepatitis C in South Africa: detection of anti HCV in recent and stored serum. Journal of Medical Virology, 32,249-25 1. Louis, F. J., Maubert, B:, Le Hesran, J. Y., Kemmegne, J., Delaporte, E. & LOUIS, J. P. (1994). High prevalence of anti-hepatitis C virus antibodies in a Cameroon rural forest area. Transactions of the Royal Society of Tropical Medicine and Hygiene, 88,53-54.
Numata, N., Ohori, H., Hayakawa, Y., Saitoh, Y., Tsunoda, A. & Kanno, A. (1993). Demonstration of hepatitis C genome in saliva and urink of patients with type C hepatitis: usefulness of the single round polymerase chain reaction method for detection of the HCV genome. Journal of Medical Virology, 41, 120-128. Oshitani, H., Kasolo, F., Mpabalwani, M., Mizuta, K., Luo, N. l?., Suzuki, H. & Numazaki, Y. (in press). Epidemiology of hepatitis B in Zambia. JapaneseJournal of Tropical Medicine and Hygiene.
Received 12 December 1994; accepted for publication Janua y 1995
17
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE (1995) 89, 380
[Report1 Low prevalence of hepatitis infection in Lusaka, Zambia
C virus
H. Oshitanil, F. Kasolol, N. P. Luol, M. Mpabalwanil, K. Mizutal, N. Numata2, H. Suzuki3 and Y. Numazamkis and 1Virology Laboratory, University Teaching Hospital, Lusaka, Zambia; IDepartment of Microbiology, Sendai Municipal Institute of Public Health, Sendai, Japan; 3Virus Research Centre, Sendai National Hospital, Sendai, Japan Keywords:
hepatitisC, prevalence,Zambia
Although the prevalence of hepatitis B virus infection has been reported to be generally high in sub-Saharan Africa, that of hepatitis C virus (HCV) infection in this region shows wide variation: 0.5% in Niger (DEVELOUX et al., 1992), 1.2% among Black blood donors in South Africa (ELLIS et al., 1990), 6.5% in Gabon (DELAPORTE et al., 1993), and 12.5% in Cameroun (LOUIS et al., 1994). The present study was carried out at the University Teaching Hospital (UTH) in Lusaka to investigate the prevalence of HCV infection in Zambia. We tested serum samples from 3 adult groups: group (i), blood donors; group (ii), hospital patients with jaundice; and group (iii), hospital patients without jaundice. Samples were tested for hepatitis C antibody using the passive haemagglutination test (Abbott PHA HCV@ Second Generation, Dainabot, Tokyo, Japan). Reactive samples were tested for virus ribonucleic acid by the polymerase chain reaction (PCR) as described by NUMATA et al. (1993). Human immunodeficiency virus (HIV) antibody tests were also carried out on someof the hospital patients without jaundice, using an enzymelinked immunosorbent assay (Wellcozyme@ Recombinant HIV 1, VK56/57, Wellcome Diagnostics). A total of 735 samples was tested for HCV antibody: 240 in group (i), 152 in group (ii) and 343 in group (iii).
Of these, only 3 samples (0.41%) were positive for HCV antibody: 01240in group (i), 21152(1.3%) in group (ii) and 11343(0.3%) in group (iii). The 2 positive patients in group (ii) were clinically diagnosed as having liver carcinoma and chronic hepatitis respectively; clinical details for the other positive patient, in group (iii), were not available. HCV infections were confirmed by PCR in all
Address for correspondence: H. Oshitani, Ml?, Virus Research Centre, Sendai National Hospital, 2-8-8 Miyagmo Miyagmo-ku, Sendal, 983, Japan.
3 positive samples. HIV antibody tests were done on 301 samnles in groun (iii). and 182 were nositive (60.5%). The-one H& p&iv; sample in group (iii) was‘also reactive for HIV antibody. In Zambia, the prevalence of hepatitis B is high; 6.5% of pregnant women were positive for hepatitis B surface antigen (HBsAg) (OSHITANI et al., in press), and HIV is also highly endemic. The present study indicates that the prevalence of HCV infection in Lusaka is low in spite of the high endemicity of hepatitis B and HIV. There seems to be a great difference in HCV prevalence between African countries. However, the precise mechanism of transmission in highly endemic areas is still unknown. Further studies are thus necessary to define the geographical distribution of HCV in Africa and the risk factors for HCV transmission in high prevalence areas. Acknowledgements
We thank Dr G. Muyinda, the blood bank staff at UTH, and Mr Lishoma for their assistance.This studv is Dart of the Infectious Disease Project, a technical co-operatibn between the Zambian and Japanese governments supported by JICA (the
JapanInternationalCo-operationAgency). References
Delaporte, E., Thiers, V., Dazza, M. C., Romeo, R., Mlika-Cabanne, N., Aptel, I., Schrijvers? D., Brechot, C. & Larouze, B. (1993). Hieh level of heoatitis C endemicitv in Gabon. equatorial Af&a. Transactiok of the Royal Socie& of Tropical Medicine and Hygiene, 87,636-637.
Develoux, M., Meynard, D. & Delaporte, E. (1992). Low rate of hepatitis C virus antibodies in blood donors and pregnant women from Niger. Transactions of the Royal Societyof Tropical Medicine and Hygiene, 86,553.
Ellis, L. A., Brown, D., Conradie, J. D., Paterson, A., Sher, R., Millo, J., Theodossiadou, E. & Dusheiko, G. M. (1990). Prevalence of hepatitis C in South Africa: detection of anti HCV in recent and stored serum. Journal of Medical Virology, 32,249-25 1. Louis, F. J., Maubert, B:, Le Hesran, J. Y., Kemmegne, J., Delaporte, E. & LOUIS, J. P. (1994). High prevalence of anti-hepatitis C virus antibodies in a Cameroon rural forest area. Transactions of the Royal Society of Tropical Medicine and Hygiene, 88,53-54.
Numata, N., Ohori, H., Hayakawa, Y., Saitoh, Y., Tsunoda, A. & Kanno, A. (1993). Demonstration of hepatitis C genome in saliva and urink of patients with type C hepatitis: usefulness of the single round polymerase chain reaction method for detection of the HCV genome. Journal of Medical Virology, 41, 120-128. Oshitani, H., Kasolo, F., Mpabalwani, M., Mizuta, K., Luo, N. l?., Suzuki, H. & Numazaki, Y. (in press). Epidemiology of hepatitis B in Zambia. JapaneseJournal of Tropical Medicine and Hygiene.
Received 12 December 1994; accepted for publication Janua y 1995
17