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Hepatitis C virus infection in chronic liver disease in Somalia
1Institute of the Clinic of Tropical and Infectious Disease, La Sapienza University, Rome, Italy.
Insights
Hepatitis C virus (HCV) plays a minor role in hepatitis B-positive liver disease in Somalia. However, HCV may be a significant factor in hepatitis B-negative chronic liver disease, warranting further investigation.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Hepatitis C virus (HCV) is a significant global health concern.
- The prevalence and role of HCV in liver disease in Somalia remain understudied.
Purpose of the Study:
- To determine the prevalence of antibodies to HCV (anti-HCV) in various populations in Somalia.
- To assess the specific role of HCV in chronic liver disease, differentiating between HBsAg-positive and HBsAg-negative cases.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA) were used to detect anti-HCV.
- Study populations included patients with chronic liver disease, healthy adults, institutionalized individuals, and children.
Main Results:
- Anti-HCV was detected in 0.97% of healthy adults and 2.2% of institutionalized individuals.
- Prevalence was 4.8% in HBsAg-positive chronic liver disease and 20.6% in HBsAg-negative chronic liver disease.
- A significant proportion of ELISA-positive results were not confirmed by RIBA, suggesting false positives, especially at low ELISA values.
Conclusions:
- HCV appears to be a minor contributor to HBsAg-positive liver disease in Somalia.
- HCV may be an important etiological factor in HBsAg-negative chronic liver disease in the region.
- The study highlights the importance of confirmatory testing (RIBA) for accurate HCV diagnosis.
Abstract:
To assess the role of hepatitis C virus (HCV) in liver disease in Somalia, antibody to HCV (anti-HCV) was studied by enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA) in 110 patients with chronic liver diseases, in 309 healthy adults, in 179 institutionalized subjects with a high prevalence of intestinal parasites and Schistosoma haematobium, and in 287 children with diseases other than hepatitis. According to the RIBA test, anti-HCV was present in three healthy adults (0.97%), in four institutionalized individuals (2.2%), but in none of the children. The prevalence of anti-HCV was 4.8% in patients with hepatitis B surface antigen (HBsAg)-positive chronic liver diseases and 20.6% in patients with HBsAg-negative chronic liver diseases. Thus, HCV infection appears to play a minor role in HBsAg-positive liver disease in Somalia but may be an important factor in HBsAg-negative chronic liver disease. The low anti-HCV prevalence in individuals with no hepatic disorders is consistent with the fact that HCV does not spread by nonpercutaneous transfer. We found also a large proportion of both patients with hepatic disease and institutionalized individuals who tested positive by ELISA but not confirmed by RIBA. However, the likelihood of a true positive result increases proportionally with the ELISA value; thus, in most cases a low ELISA value probably represents a false-positive reaction, while a high ELISA value probably represents a true positive reaction.