Home About us Current issue Back issues Submission Instructions Advertise Contact Login   

Search Article 
  
Advanced search 
 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 24 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 
 


 
Table of Contents   
REVIEW ARTICLE  
Year : 2011  |  Volume : 22  |  Issue : 1  |  Page : 1-9
Epidemiology of hepatitis C in the middle east


Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

Click here for correspondence address and email

Date of Web Publication30-Dec-2010
 

   Abstract 

The epidemiology of hepatitis C virus (HCV) infection is not well defined in the Middle East region. A review of the epidemiology and modes of transmission and spread of HCV infection in regions located in the Middle East, including Iran, Bahrain, Iraq, Oman, Qatar, Jordan, Kuwait, Saudi Arabia, United Arab Emirates, Cyprus, Sudan, Egypt, Pakistan, Syria, Turkey, Lebanon, Gaza Strip and West Bank, and Yemen, was undertaken. Public health strategies, well­programmed, population-based and certain HCV infection at-risk surveys, and transmission risk factors' settings detection are insufficient in some countries of this region. Since significant diffe­rences in prevalence and epidemiology of HCV exist among the Middle East countries or even inside the countries, control strategies should take these differences into account.

How to cite this article:
Fallahian F, Najafi A. Epidemiology of hepatitis C in the middle east. Saudi J Kidney Dis Transpl 2011;22:1-9

How to cite this URL:
Fallahian F, Najafi A. Epidemiology of hepatitis C in the middle east. Saudi J Kidney Dis Transpl [serial online] 2011 [cited 2014 Dec 25];22:1-9. Available from: http://www.sjkdt.org/text.asp?2011/22/1/1/74334

   Introduction Top


The Middle East is a geographical region of Africa-Eurasia with no clear definition; it tra­ditionally includes regions in Southwest Asia and parts of North Africa, consisting of Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Leba­non, Oman, Qatar, Saudi Arabia, Syria, Turkey, United Arab Emirates, Yemen, Palestinian Territories and western parts of Pakistan. The inclusion of countries Azerbaijan, Armenia and Georgia, Greece, Cyprus, North Africa and the Maghreb is controversial because they are lo­cated outside the arbitrary geographical boun­daries of the Middle East.

Infections with the hepatitis C virus (HCV) are pandemic, and the World Health Organi­zation (WHO) estimates a world-wide preva­lence of 3%. In Middle Europe, approximately 1% of the population is infected, mostly with genotype 1 (85% in Austria). In developing countries, chronic hepatitis C is the most pro­minent cause for liver cirrhosis, hepatocellular carcinoma and liver transplantation. Transmi­ssion of HCV was predominantly iatrogenic, e.g. by blood transfusions before 1990, by blood products such as coagulation factors in hemophiliacs or anti-D-globulin in rhesus in­compatibility, parenteral anti-schistosomal treat­ment in Egypt, contaminated endoscopes or cardiac surgery. Today, sporadic transmission is more prevalent, mostly in drug addicts via needle sharing, and seldom by needle-stick in­juries in medical personnel, vertical transmi­ssion from mother to baby, tattooing, piercing, or razor sharing. [1]

The World Health Organization (WHO) estimates that there are at least 21.3 million HCV carriers in the Eastern Mediterranean countries, which is close to the number of carriers esti­mated in the Americas and Europe combined. Accumulated data show that there are two main patterns for the distribution of HCV geno­types in the Middle East: in the first pattern, genotype 4 is prevalent in most of the Arab countries, and in the second pattern, genotype 1a or 1b predominates in the non-Arab countries. [2],[3]

Reference sequences for accurate HCV geno­typing are required for optimized treatment, and a better knowledge of the global viral se­quence diversity is necessary to guide vaccines or new drugs effective in the worldwide epi­demic. [4] The epidemiology and modes of trans­mission and spread of HCV infection in the Middle East are reviewed in this article through the published literature about the subject.


   Prevalence and Risk Factors for HCV Infection in the Middle East Top


Iran

The prevalence of HCV infections per 100,000 Iranian blood donations was 0.13% for HCV, and the trends of infection prevalence in blood donations suggest the improvement of the safety measures employed in recent years in Iran. [5],[6] However, in 298 hemodialysis (HD) patients in Guilan province, overall HCV prevalence was 24.8%. Length of time on dialysis and history of rejected kidney transplant were statistically significantly associated with HCV infection. [7] Moreover, in another study, there was no sig­nificant correlation between the number of trans­fusions and HCV seropositivity. [8] Nevertheless, the prevalence of positive HCV antibodies (Ab) in the HD patients decreased over time. [9],[10],[11],[12],[13]

The prevalence of positive HCV Ab among household contacts (1.33%) was not signifi­cantly higher than that in the controls (1%). Intrafamilial transmission of HCV is not the significant transmission route and sexual trans­mission does not seem to play a role in the intrafamilial spread of HCV infection. [14]

The prevalence of HCV infection among the IV drug abusers was elevated [15] and associated with the length of intravenous drug injection habit, length of lifetime incarcerations and a history of being tattooed. [16] Moreover, the rate of HCV infection among HIV-positive cases was significantly higher than in the HIV negative patients. [17],[18],[19] The expansion of services for drug users in Iran such as needle and syringe programs and pharmacotherapy would be effec­tive in reducing the harms associated with opium use and heroin injection. [20]

The highest frequency was for HCV geno­type 1a, followed by genotype 3a and 1b in addition to mixed genotypes, [21],[22],[23] and subtype 1a was frequent in South Iran (70%), while 3a was more prevalent in North-west region (83%). Additionally, genotype 4 was over-represented among HD patients in Tehran. [24]

Bahrain

Among the multi-transfused patients with he­molytic anemia, 40% were seropositive for HCV antibody. [25] Among Bahraini HD patients, the prevalence of HCV was 9.24% and the geno­types were HCV 1a/1b plus HCV 4. [26]

Iraq

The prevalence of anti-HCV antibodies is 7.1% in the general population [27] and 66.0% in HIV-infected hemophilia patients. Four HCV genotypes, 1a, 1b, 4 and 4, mixed with 3a were detected, and HCV-1b was the most frequent genotype. [28],[29]

The anti-HCV seroprevalence in pregnant women was 3.21% and correlated with the number of miscarriages and HCV-1b genotype. [30]

In 1005 samples of refugee Kurds from Iraq and Turkey, one subject was confirmed as po­sitive for anti-HCV (0.1%) and HCV-RNA and analysis showed a 4c/4d genotype. [31]

Oman

In a study, 26.5% of 102 sera from Omani patients on HD, 13.4% of 82 sera from kidney transplant patients and 1% of 103 sera from non-dialyzed, non-transplanted patients with various renal diseases had antibodies to HCV. Among the healthy subjects, none of 134 me­dical students and 0.9% of 564 blood donors were anti-HCV positive. [32]

HCV antibody detection was carried out on 600 seronegative blood donors and 9 (1.5%) were positive; only three antibody-positive samples had detectable HCV RNA. [33]

Qatar

A 6.3 incidence rate of HCV infection was reported in the general population [34] and 44.6% incidence was reported in dialysis patients, significantly correlating with an increased pe­riod on dialysis. [35] Indian workers contributed significantly to HCV and contracted it before traveling to Qatar. [36]

Jordan

HCV is prevalent among regular HD in the south of Jordan (28%) and risk factors include history of blood transfusion, history of kidney transplantation, history of other surgeries, and duration on HD. [37] Similar results were ob­tained in another study and the pre-dominant genotype was HCV la. [38] The prevalence of HCV in the general population was from 0.65 to 6.25%, depending on the sub population studied, [39] and was 40.5% in the multi-trans­fused patients presenting with hereditary hemo­lytic anemia. [40] Furthermore, the incidence den­sity due to incidental needle sticks was highest for the interns followed by staff nurses and environmental workers. [41]

Kuwait

The prevalence of anti-HCV among Kuwaiti national and non-Kuwaiti Arab first-time donors was 0.8 and 5.4%, respectively. [42]

Saudi Arabia

The prevalence of HCV infections is low in the general population, less in children than in adults, and unscreened blood transfusion be­fore 1990 and intravenous drug use are the main modes of infection. [43],[44],[45] The most prevalent genotypes in Saudi Arabia are genotype 4 followed by genotypes 1a and 1b, whereas genotypes 2a/2b, 3, 5 and 6 are rare. HCV core Ag was detected in 94.8% of the Saudi drug abusers. [46],[47]

The prevalence of HCV was between 18-46% in the regular HD patients. [48] However, the application of the universal precautions and de­signated dialysis machines decreased the pre­valence of HCV infection significantly. Fur­thermore, the prevalence of hepatitis C, as well as hepatitis B, is more frequent in HD (29%) than peritoneal dialysis (5%) units. [49] Patients in the groups with the relatively higher patient­to-nurse (P/N) ratio had a significantly higher HCV prevalence and seroconversion rates per year. [50] Among the renal transplant recipients screened for HCV antibodies, 41% were po­sitive and a higher incidence of chronic liver disease (37.5%) was found in this group. [51]

Blood transfusion was found more among HCV positive HD patients had never received blood transfusion. [52],[53]

United Arab Emirates

The prevalence of anti-HCV antibodies was 23%. [54] Increased prevalence of anti-HCV among spouses was detected, with longer duration of marriage being an important risk factor, [55] and infection was passed to children at an early stage of life from infected mothers. [56]

Cyprus

In a study among soldiers from Turkey, blood donors from Northern Cyprus, and soldiers from Northern Cyprus, prevalence of anti-HCV was 0.46%. Prevalence of HCV infection in Nor­thern Cyprus population was similar to that of Turkish population. [57] A study demonstrated a genetic heterogeneity of HCV infection in Cyprus, with five of the six known HCV geno­types on the island, including unclassified iso­lates in genotypes 1 and 4, and also the appa­rent introduction of the 2k/1b recombinant strain in intravenous drug users. [58]

Syria

The overall prevalence of anti-HCV among HD patients was 48.9% with a significant co­rrelation between prevalence of anti-HCV and duration of HD. [59] Genotype 4 was the most frequent genotype followed by genotypes 1 and 5, with no obvious epidemiological reason for prevalence of G5. [60] In another study, the HCV genotype distribution showed 1a, 1b, and 6 4a as the most prevalent genotypes. [61]

The prevalence of HCV antibodies was 60.5% among intravenous drug abusers, 1.96% among the prostitutes group, and 0.95% among blood donors group. [62] Furthermore, the prevalence of HCV antibodies among health care workers was 3%, and in the general population was 1%. [63]

Lebanon

Anti-HCV prevalence rate of 0.6% was re­vealed in blood donors [64] and it was 0.4% among health workers. [65] Cross-contamination unrelated to machines may also occur in HD patients, [66] with seropositivity of 27%. [67] Al­though Lebanon is an area of low endemicity for both HBV and HCV, occult HBV infection is common in HCV-infected patients (16.3%). [68] HCV geno-type 4 was found to be the predo­minant genotype, followed by genotypes 1a and 1b. [69]

Gaza Strip and West Bank

The Gaza Strip borders the southern part of Israel and Egypt. There is a remarkable dif­ference in the prevalence of antibodies to HCV between Israel (0.5%) and Egypt (10%). HCV prevalence in the Gaza Strip was found to be 2.2%, relatively higher than in Israel but lower than in Egypt. The most common genotypes found were type 1b in southern Israel and type 4 in the Gaza Strip, corresponding to the most prevalent genotype in Egypt. [70] Moreover, the incidence of HCV antigen (by PCR) in donors in Gaza was 0 . 1%. [71]

Yemen

The prevalence of antibodies to HCV was 1.7% in healthy volunteers, 2.7% in blood donors, 33.8% in patients on regular HD, and 33.75% in patients with chronic liver diseases. [72] Similar patterns were found in other studies. [73],[74],[75],[76],[77]

Turkey

Anti-HCV were detected in 1.0-2.1% of healthy individuals [78],[79] and 4.5% of multi-trans­fused patients with hemolytic anemia. [80] The most common risk factors among index cases were dental procedures, history of surgery, and blood transfusions. Anti-HCV positivity was established in family contacts, sexual partners, and offsprings of infected patients. [81] HCV ge­notypes other than genotype 1 are quite rare; these are possibly acquired in other coun­tries. [82] Both HBV and HCV infections may constitute occupational hazards for certain pro­fessions such as barbers. [83]

Pakistan

Hospitalization, dental treatment from unqua­lified providers, a large number of therapeutic injections, and re-usable glass syringes were identified as risk factors for HBV and HCV infections and remained unchanged in health­ care facilities. [84]

Hepatitis C infection was detected in 1.8% of pregnant women and in 16% of gynecological patients; unsafe surgery, injections and inade­quately screened blood transfusions were the main underlying causes of infection. [85] More­over, the prevalence of HCV in injecting drug users was 17%. [86] Genotype 3 is the most com­mon genotype in Pakistan. [87]

Sudan

The prevalence of anti-HCV is 2.2-3%. [88],[89] No correlation was found between HCV infec­tion and Schistosoma mansoni infection or pa­renteral antischistosomal therapy. [90] The preva­lence of HCV seropositivity among HD pa­tients was 23.7%, and 17.1% seroconverted to positive in one year. [91] HCV genotype 4 was the major genotype isolated with subtypes 4, 4e and 4c/4d. [92]

Egypt

Seroprevalence of hepatitis C virus in the urban blood donor population was 14.5%, while the seroprevalence was 70.4% in HD patients, 7.7% in health care workers, and 75.6% in tha­lassemic children. Schistomiasis does not seem to play a role in the seroprevalence of this di­sease in Egypt. [93] Moreover, HCV was found in 12.1% of rural primary school children, 18.1% of residents in rural villages, 22.1% of army re­cruits, 16.4% of children with hepatospleno­megaly, 54.9% of hospitalized multi-transfused children, 46.2% of adults on HD, and 47.2% of adults with chronic liver disease or hepatoma. [94]

A consistent increase of seropositivity for HCV antibodies with age was observed, with a peak level of 54.9% in all individuals for the age group 45-49 years. Analysis revealed that age, male sex, marriage, rural residence, living in upper and lower Egypt, injections for bilhar­ziasis and urography were significant in the final equation for the whole group. Blood trans­fusion was significant in the final regression analysis among females in urban living, and hospitalization was significant among males in urban living and females in rural living. [95] HCV genotype 4a was prevalent. [96],[97]

Algeria

Anti-HCV was detected in 0.18% of blood donors and 0.19% of pregnant women. [98]


   Comments Top


There are insufficient data about HCV pre­valence and prevention methods in some areas of the Middle East. Although there are signi­ficant differences in prevalence and epidemio­logy of HCV among the Middle East countries or even different societies within the same country, control strategies should take these specific differences into account.

To establish public health strategies, more well-programmed, population-based and cer­tain HCV infection at-risk surveys are needed in the Middle East countries in addition to edu­cation of people about the risk of HCV infec­tion from contaminated instruments and certain traditional habits. Furthermore, efforts should be continued for HCV screening in intrave­nous drug users (IVDU), those who received transfusions, dialysis patients, those with inci­dental exposures in addition to expatriate wor­kers, gypsies, and occupations such as barbers, fire fighters, health care workers. Finally, better laboratory facilities and investigations should be provided for detection of HCV RNA in high-risk groups negative for HCV antibodies.

 
   References Top

1.Stauber R. Epidemiology and transmission of hepatitic C. Wien Med Wochenschr 2000;150(23-24):460-2.  Back to cited text no. 1
    
2.Ramia S, Eid-Fares J. Distribution of hepatitis C virus genotypes in the Middle East. Int J Infect Dis 2006;10(4):272-7.  Back to cited text no. 2
    
3.Watson JP, Al-Mardini H, Awadh S, Ukabam S, Record CO. Hepatitis C virus genotypes in a cohort of Middle Eastern patients. Ann Saudi Med 1999;19(5):410-2.  Back to cited text no. 3
    
4.Kuntzen T, Berical A, Ndjomou J, et al. A set of reference sequences for the hepatitis C genotypes 4d, 4f, and 4k covering the full open reading frame. J Med Virol 2008;80(8):1370-8.  Back to cited text no. 4
    
5.Kafi-abad SA, Rezvan H, Abolghasemi H, Talebian A. Prevalence and trends of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among blood donors in Iran, 2004 through 2007. Transfusion 2009;49(10): 2214-20.  Back to cited text no. 5
    
6.Khedmat H, Fallahian F, Abolghasemi H, et al. Seroepidemiologic study of hepatitis B virus, hepatitis C virus, human immunodeficiency vi­rus and syphilis infections in Iranian blood do­nors. Pak J Biol Sci 2007;10(24):4461-6.  Back to cited text no. 6
    
7.Amiri ZM, Shakib AJ, Toorchi M. Seropre­valence of hepatitis C and risk factors in haemodialysis patients in Guilan, Islamic Republic of Iran. East Mediterr Health J 2005; 11(3):372-6.  Back to cited text no. 7
    
8.Makhlough A, Jamshidi M, Mahdavi MR. Hepatitis C prevalence studied by polymerase chain reaction and serological methods in haemodialysis patients in Mazandaran, Iran. Singapore Med J 2008;49(11):921-3.  Back to cited text no. 8
    
9.Alavian SM, Bagheri-Lankarani K, Mahdavi­Mazdeh M, Nourozi S. Hepatitis B and C in dialysis units in Iran: Changing the epide­miology. Hemodial Int 2008;12(3):378-82.  Back to cited text no. 9
    
10.Taziki O, Espahbodi F. Prevalence of hepatitis C virus infection in hemodialysis patients. Saudi J Kidney Dis Transpl 2008;19(3):475-8.  Back to cited text no. 10
    
11.Broumand B, Shamshirsaz AA, Kamgar M, et al. Prevalence of hepatitis C infection and its risk factors in hemodialysis patients in tehran: Preliminary report from "the effect of dialysis unit isolation on the incidence of hepatitis C in dialysis patients" project. Saudi J Kidney Dis Transpl 2002;13(4):467-72.  Back to cited text no. 11
    
12.Kheradpezhouh M, Taremi M, Gachkar L, Aghabozorgi S, Khoshbaten M. Presence and significance of transfusion-transmitted virus infection in Iranian patients on maintenance hemodialysis. J Microbiol Immunol Infect 2007; 40(2):106-11.  Back to cited text no. 12
    
13.Ansar MM, Kooloobandi A. Prevalence of hepatitis C virus infection in thalassemia and haemodialysis patients in north Iran-Rasht. J Viral Hepat 2002;9(5):390-2.  Back to cited text no. 13
    
14.Hajiani E, Masjedizadeh R, Hashemi J, Azmi M, Rajabi T. Hepatis C virus transmission and its risk factors within families of patients infected with hepatitis C virus in southern Iran: Khuzestan. World J Gastroenterol 2006;12 (43):7025-8.  Back to cited text no. 14
    
15.Mohtasham Amiri Z, Rezvani M, Jafari Shakib R, Jafari Shakib A. Prevalence of hepatitis C virus infection and risk factors of drug using prisoners in Guilan province. East Mediterr Health J 2007;13(2):250-6.  Back to cited text no. 15
    
16.Zamani S, Ichikawa S, Nassirimanesh B, et al. Prevalence and correlates of hepatitis C virus infection among injecting drug users in Tehran. Int J Drug Policy 2007;18(5):359-63.  Back to cited text no. 16
    
17.Rahimi-Movaghar A, Razaghi EM, Sahimi­Izadian E, Amin-Esmaeili M. HIV, hepatitis C virus, and hepatitis B virus co-infections among injecting drug users in Tehran, Iran. Int J Infect Dis 2010;14(1):e28-33.  Back to cited text no. 17
    
18.Imani R, Karimi A, Rouzbahani R, Rouzbahani A. Seroprevalence of HBV, HCV and HIV infection among intravenous drug users in Shahr-e-Kord, Islamic Republic of Iran. East Mediterr Health J 2008;14(5):1136-41.  Back to cited text no. 18
    
19.Alizadeh AH, Alavian SM, Jafari K, Yazdi N. Prevalence of hepatitis C virus infection and its related risk factors in drug abuser prisoners in Hamedan--Iran. World J Gastroenterol 2005; 11(26):4085-9.  Back to cited text no. 19
    
20.Day C, Nassirimanesh B, Shakeshaft A, Dolan K. Patterns of drug use among a sample of drug users and injecting drug users attending a General Practice in Iran. Harm Reduct J 2006;3:2.  Back to cited text no. 20
[PUBMED]  [FULLTEXT]  
21.Keyvani H, Alizadeh AH, Alavian SM, Ranjbar M, Hatami S. Distribution frequency of hepa­titis C virus genotypes in 2231 patients in Iran. Hepatol Res 2007;37(2):101-3.  Back to cited text no. 21
    
22.Kabir A, Alavian SM, Keyvani H. Distribution of hepatitis C virus genotypes in patients infected by different sources and its correlation with clinical and virological parameters: A preliminary study. Comp Hepatol 2006;5:4.  Back to cited text no. 22
[PUBMED]  [FULLTEXT]  
23.Hosseini-Moghaddam SM, Keyvani H, Kasiri H, et al. Distribution of hepatitis C virus genotypes among hemodialysis patients in Tehran-a multicenter study. J Med Virol 2006; 78(5):569-73.  Back to cited text no. 23
    
24.Samimi-Rad K, Nategh R, Malekzadeh R, Norder H, Magnius L. Molecular epidemio­logy of hepatitis C virus in Iran as reflected by phylogenetic analysis of the NS5B region. J Med Virol 2004;74(2):246-52.  Back to cited text no. 24
    
25.al-Mahroos FT, Ebrahim A. Prevalence of hepatitis B, hepatitis C and human immune deficiency virus markers among patients with hereditary haemolytic anaemias. Ann Trop Paediatr 1995;15(2):121-8.  Back to cited text no. 25
    
26.Qadi AA, Tamim H, Ameen G, et al. Hepatitis B and hepatitis C virus prevalence among dialysis patients in Bahrain and Saudi Arabia: A survey by serologic and molecular methods. Am J Infect Control 2004;32(8):493-5.  Back to cited text no. 26
    
27.Khattab OS. Prevalence and risk factors for hepatitis C virus infection in hemodialysis patients in an Iraqi renal transplant center. Saudi J Kidney Dis Transpl 2008;19(1):110-5.  Back to cited text no. 27
    
28.Al-Kubaisy WA, Al-Naib KT, Habib MA. Pre­valence of HCV/HIV co-infection among haemo­philia patients in Baghdad. East Mediterr Health J 2006;12(3-4):264-9.  Back to cited text no. 28
    
29.Al-Kubaisy WA, Al-Naib KT, Habib M. Sero­prevalence of hepatitis C virus specific anti­bodies among Iraqi children with thalassaemia. East Mediterr Health J 2006;12(1-2):204-10.  Back to cited text no. 29
    
30.Al-Kubaisy WA, Niazi AD, Kubba K. History of miscarriage as a risk factor for hepatitis C virus infection in pregnant Iraqi women. East Mediterr Health J 2002;8(2-3):239-44.  Back to cited text no. 30
    
31.Chironna M, Germinario C, Lopalco PL, Carrozzini F, Barbuti S, Quarto M. Prevalence rates of viral hepatitis infections in refugee Kurds from Iraq and Turkey. Infection 2003; 31(2):70-4.  Back to cited text no. 31
    
32.al-Dhahry SH, Aghanashinikar PN, al-Hasani MK, Buhl MR, Daar AS. Prevalence of antibodies to hepatitis C virus among Omani patients with renal disease. Infection 1993;­21(3):164-7.  Back to cited text no. 32
    
33.Alnaqy A, Al-Harthy S, Kaminski G, Al­Dhahry S. Detection of serum antibodies to hepatitis C virus in 'false-sero-negative' blood donors in Oman. Med Princ Pract 2006;15 (2):111-3.  Back to cited text no. 33
    
34.Bener A, Al-Kaabi S, Derbala M, Al-Marri A, Rikabi A. The epidemiology of viral hepatitis in Qatar. Saudi J Kidney Dis Transpl 2009;20 (2):300-6.  Back to cited text no. 34
    
35.Abboud O, Rashid A, Al-Kaabi S. Hepatitis C virus infection in hemodialysis patients in Qatar. Saudi J Kidney Dis Transpl 1995;6(2):151-3.  Back to cited text no. 35
    
36.Glynn MJ, Rashid A, Antao AJ, et al. Imported epidemic non-A, non-B hepatitis in Qatar. J Med Virol 1985;17(4):371-5.  Back to cited text no. 36
    
37.Al-Jamal M, Al-Qudah A, Al-Shishi KF, Al­Sarayreh A, Al-Quraan L. Hepatitis C virus (HCV) infection in hemodialysis patients in the south of Jordan. Saudi J Kidney Dis Transpl 2009;20(3):488-92.  Back to cited text no. 37
    
38.Bdour S. Hepatitis C virus infection in Jor­danian haemodialysis units: Serological diag­nosis and genotyping. J Med Microbiol 2002; 51(8):700-4.  Back to cited text no. 38
    
39.Quadan A. Prevalence of anti hepatitis C virus among the hospital populations in Jordan. New Microbiol 2002;25(3):269-73.  Back to cited text no. 39
    
40.Al-Sheyyab M, Batieha A, El-Khateeb M. The prevalence of hepatitis B, hepatitis C and human immune deficiency virus markers in multi-transfused patients. J Trop Pediatr 2001; 47(4):239-42.  Back to cited text no. 40
    
41.Khuri-Bulos NA, Toukan A, Mahafzah A, et al. Epidemiology of needlestick and sharp injuries at a university hospital in a developing country: A 3-year prospective study at the Jordan University Hospital, 1993 through 1995. Am J Infect Control 1997;25(4):322-9.  Back to cited text no. 41
    
42.Ameen R, Sanad N, Al-Shemmari S, et al. Prevalence of viral markers among first-time Arab blood donors in Kuwait. Transfusion 2005;45(12):1973-80.  Back to cited text no. 42
    
43.Madani TA. Hepatitis C virus infections reported over 11 years of surveillance in Saudi Arabia. Trans R Soc Trop Med Hyg 2009;103 (2):132-6.  Back to cited text no. 43
    
44.Bashawri LA. Pattern of blood procurement, ordering and utilization in a University Hospital in Eastern Saudi Arabia. Saudi Med J 2002;23(5):555-61.  Back to cited text no. 44
    
45.al Nasser MN. Intra-familial transmission of hepatitis C virus (HCV): A major mode of spread in the Saudi Arabia population. Ann Trop Paediatr 1992;12(2):211-5.  Back to cited text no. 45
    
46.Alzahrani AJ. Simultaneous detection of hepatitis C virus core antigen and antibodies in Saudi drug users using a novel assay. J Med Virol 2008;80(4):603-6.  Back to cited text no. 46
    
47.Osoba AO, Ibrahim M, Abdelaal MA, Al­Mowallad A, Al Shareef B, Hussein BA. Hepatitis C virus genotyping by polymerase chain reaction and DNA enzyme immunoassay among Saudi patients in the Western Province, Saudi Arabia. Ann Saudi Med 2000;20(5-6):394-7.  Back to cited text no. 47
    
48.Karkar A. Hepatitis C in dialysis units: The Saudi experience. Hemodial Int 2007;11(3): 354-67.  Back to cited text no. 48
    
49.Karkar A, Abdelrahman M, Ghacha R, Malik TQ. Prevention of viral transmission in HD units: The value of isolation. Saudi J Kidney Dis Transpl 2006;17(2):183-8.  Back to cited text no. 49
    
50.Saxena AK, Panhotra BR. The impact of nurse understaffing on the transmission of hepatitis C virus in a hospital-based hemodialysis unit. Med Princ Pract 2004;13(3):129-35.  Back to cited text no. 50
    
51.Bernieh B, Mohamed AO, Sirwal IA, Wafa A, Abbade MA, Tabbakh A. Viral hepatitis in renal transplant patients. Saudi J Kidney Dis Transpl 1999;10(2):157-60.  Back to cited text no. 51
    
52.Souqiyyeh MZ, Al-Attar MB, Zakaria H, Shaheen FA. Dialysis centers in the kingdom of saudi arabia. Saudi J Kidney Dis Transpl 2001;12(3):293-304.  Back to cited text no. 52
    
53.Al-Jiffri AM, Fadag RB, Ghabrah TM, Ibrahim A. Hepatitis C virus infection among patients on hemodialysis in jeddah: A single center experience. Saudi J Kidney Dis Transpl 2003;14(1):84-9.  Back to cited text no. 53
    
54.El Shahat YI, Varma S, Bari MZ, Shah Nawaz M, Abdulrahman S, Pingle A. Hepatitis C virus infection among dialysis patients in United Arab Emirates. Saudi J Kidney Dis Transpl 1995;6(2):157-62.  Back to cited text no. 54
    
55.Kumar RM. Interspousal and intrafamilial transmission of hepatitis C virus: A myth or a concern? Obstet Gynecol 1998;91(3):426-31.  Back to cited text no. 55
    
56.Kumar RM, Shahul S. Role of breast-feeding in transmission of hepatitis C virus to infants of HCV-infected mothers. J Hepatol 1998;29 (2):191-7.  Back to cited text no. 56
    
57.Altindis M, Yilmaz S, Dikengil T, Acemoglu H, Hosoglu S. Seroprevalence and genotyping of hepatitis B, hepatitis C and HIV among healthy population and Turkish soldiers in Northern Cyprus. World J Gastroenterol 2006; 12(42):6792-6.  Back to cited text no. 57
    
58.Demetriou VL, van de Vijver DA, Cyprus HCV Network, Kostrikis LG. Molecular epide­miology of hepatitis C infection in Cyprus: Evidence of polyphyletic infection. J Med Virol 2009;81(2):238-48.  Back to cited text no. 58
    
59.Othman B, Monem F. Prevalence of antibodies to hepatitis C virus among hemodialysis patients in Damascus, Syria. Infection 2001;29 (5):262-5.  Back to cited text no. 59
    
60.Antaki N, Haddad M, Kebbewar K, et al. The unexpected discovery of a focus of hepatitis C virus genotype 5 in a Syrian province. Epidemiol Infect 2009;137(1):79-84.  Back to cited text no. 60
    
61.Abdulkarim AS, Zein NN, Germer JJ, et al. Hepatitis C virus genotypes and hepatitis G virus in hemodialysis patients from Syria: Identification of two novel hepatitis C virus subtypes. Am J Trop Med Hyg 1998;59(4): 571-6.  Back to cited text no. 61
    
62.Othman BM, Monem FS. Prevalence of hepatitis C virus antibodies among intravenous drug abusers and prostitutes in Damascus, Syria. Saudi Med J 2002;23(4):393-5.  Back to cited text no. 62
    
63.Othman BM, Monem FS. Prevalence of hepa­titis C virus antibodies among health care workers in Damascus, Syria. Saudi Med J 2001;22(7):603-5.  Back to cited text no. 63
    
64.Irani-Hakime N, Tamim H, Samaha H, Almawi WY. Prevalence of antibodies against hepatitis C virus among blood donors in Lebanon, 1997-2000. Clin Lab Haematol 2001;23(5):317-23.  Back to cited text no. 64
    
65.Irani-Hakime N, Aoun J, Khoury S, Samaha HR, Tamim H, Almawi WY. Seroprevalence of hepatitis C infection among health care personnel in Beirut, Lebanon. Am J Infect Control 2001;29(1):20-3.  Back to cited text no. 65
    
66.Abdelnour GE, Matar GM, Sharara HM, Abdelnoor AM. Detection of anti-hepatitis C­virus antibodies and hepatitis C-virus RNA in Lebanese hemodialysis patients. Eur J Epidemiol 1997;13(8):863-7.  Back to cited text no. 66
    
67.Naman RE, Mansour I, Klayme S, Khalil G. Hepatitis C virus in hemodialysis patients and blood donors in Lebanon. J Med Liban 1996; 44(1):4-9.  Back to cited text no. 67
    
68.Ramia S, Sharara AI, El-Zaatari M, Ramlawi F, Mahfoud Z. Occult hepatitis B virus infec­tion in Lebanese patients with chronic hepatitis C liver disease. Eur J Clin Microbiol Infect Dis 2008;27(3):217-21.  Back to cited text no. 68
    
69.Sharara AI, Ramia S, Ramlawi F, Fares JE, Klayme S, Naman R. Genotypes of hepatitis C virus (HCV) among positive Lebanese patients: Comparison of data with that from other Middle Eastern countries. Epidemiol Infect 2007;135(3):427-32.  Back to cited text no. 69
    
70.Shemer-Avni Y, el Astal Z, Kemper O, et al. Hepatitis C virus infection and genotypes in Southern Israel and the Gaza Strip. J Med Virol 1998;56(3):230-3.  Back to cited text no. 70
    
71.Sarov B, Novack L, Beer N, et al. Feasibility and cost-benefit of implementing pooled scree­ning for HCVAg in small blood bank settings. Transfus Med 2007;17(6):479-87.  Back to cited text no. 71
    
72.Bajubair MA, Elrub AA, Bather G. Hepatic viral infections in Yemen between 2000-2005. Saudi Med J 2008;29(6):871-4.  Back to cited text no. 72
    
73.Haidar NA. Prevalence of hepatitis B and he­patitis C in blood donors and high risk groups in Hajjah, Yemen Republic. Saudi Med J 2002; 23(9):1090-4.  Back to cited text no. 73
    
74.Shidrawi R, Ali Al-Huraibi M, Ahmad Al-Haimi M, Dayton R, Murray-Lyon IM. Sero-preva­lence of markers of viral hepatitis in Yemeni healthcare workers. J Med Virol 2004;73(4): 562-5.  Back to cited text no. 74
    
75.Sallam TA, Tong CY, Cuevas LE, Raja'a YA, Othman AM, Al-Kharsa KR. Prevalence of blood-borne viral hepatitis in different commu­nities in Yemen. Epidemiol Infect 2003;131 (1):771-5.  Back to cited text no. 75
    
76.Scott DA, Constantine NT, Callahan J, et al. The epidemiology of hepatitis C virus antibody in Yemen. Am J Trop Med Hyg 1992;46(1): 63-8.  Back to cited text no. 76
    
77.Yildirim B, Barut S, Bulut Y, et al. Sero-pre­valence of hepatitis B and C viruses in the pro­vince of Tokat in the Black Sea region of Turkey: A population-based study. Turk J Gastroenterol 2009;20(1):27-30.  Back to cited text no. 77
    
78.Akcam FZ, Uskun E, Avsar K, Songur Y. Hepatitis B virus and hepatitis C virus sero­prevalence in rural areas of the southwestern region of Turkey. Int J Infect Dis 2009;13(2): 274-84.  Back to cited text no. 78
    
79.Ocak S, Kaya H, Cetin M, Gali E, Ozturk M. Seroprevalence of hepatitis B and hepatitis C in patients with thalassemia and sickle cell anemia in a long-term follow-up. Arch Med Res 2006;37(7):895-8.  Back to cited text no. 79
    
80.Aykin N, Cevik F, Demirturk N, Demirdal T, Orhan S, Naz H. Anti-HCV positivity in sexual partners and offspring of patient with chronic hepatitis C. Scand J Infect Dis 2008;40(6­7):533-7.  Back to cited text no. 80
    
81.Altuglu I, Soyler I, Ozacar T, Erensoy S. Distribution of hepatitis C virus genotypes in patients with chronic hepatitis C infection in Western Turkey. Int J Infect Dis 2008;12(3): 239-44.  Back to cited text no. 81
    
82.Candan F, Alagozlu H, Poyraz O, Sumer H. Prevalence of hepatitis B and C virus infection in barbers in the Sivas region of Turkey. Occup Med (Lond) 2002;52(1):31-4.  Back to cited text no. 82
    
83.Younus M, Siddiqi AE, Akhtar S. Reassess­ment of selected healthcare associated risk factors for HBV and HCV infections among volunteer blood donors, Karachi, Pakistan. Cent Eur J Public Health 2009;17(1):31-5.  Back to cited text no. 83
    
84.Sami S, Korejo R, Bhutta SZ. Prevalence of hepatitis B and C: A Jinnah Postgraduate Medical Centre experience. J Obstet Gynaecol Res 2009;35(3):533-8.  Back to cited text no. 84
    
85.Vickerman P, Platt L, Hawkes S. Modelling the transmission of HIV and HCV among injecting drug users in Rawalpindi, a low HCV prevalence setting in Pakistan. Sex Transm Infect 2009;85(2):ii23-30.  Back to cited text no. 85
    
86.Jafri W, Subhan A. Hepatitis C in Pakistan: Magnitude, genotype, disease characteristics and therapeutic response. Trop Gastroenterol 2008;29(4):194-201.  Back to cited text no. 86
    
87.Bari A, Akhtar S, Rahbar MH, Luby SP. Risk factors for hepatitis C virus infection in male adults in Rawalpindi-Islamabad, Pakistan. Trop Med Int Health 2001;6(9):732-8.  Back to cited text no. 87
    
88.Mudawi HM, Smith HM, Rahoud SA, et al. Epidemiology of HCV infection in Gezira state of central Sudan. J Med Virol. 2007;79(4):383-5.  Back to cited text no. 88
    
89.El-Amin HH, Osman EM, Mekki MO, et al. Hepatitis C virus infection in hemodialysis patients in Sudan: two centers' report. Saudi J Kidney Dis Transpl 2007;18(1):101-6.  Back to cited text no. 89
    
90.Mudawi HM, Smith HM, Fletcher IA, Fedail SS. Prevalence and common genotypes of HCV infection in Sudanese patients with hepato­splenic schistosomiasis. J Med Virol 2007;79 (9):1322-4.  Back to cited text no. 90
    
91.El Gohary A, Hassan A, Nooman Z, et al. High prevalence of hepatitis C virus among urban and rural population groups in Egypt. Acta Trop 1995;59(2):155-61.  Back to cited text no. 91
    
92.Abdel-Wahab MF, Zakaria S, Kamel M, et al. High seroprevalence of hepatitis C infection among risk groups in Egypt. Am J Trop Med Hyg 1994;51(5):563-7.  Back to cited text no. 92
    
93.Mohamed MK, Hussein MH, Massoud AA, et al. Study of the risk factors for viral hepatitis C infection among Egyptians applying for work abroad. J Egypt Public Health Assoc 1996;71 (1-2):113-47.  Back to cited text no. 93
    
94.Youssef A, Yano Y, Utsumi T, et al. Molecular epidemiological study of hepatitis viruses in Ismailia, Egypt. Intervirology 2009;52(3):123-31.  Back to cited text no. 94
    
95.Elkady A, Tanaka Y, Kurbanov F, et al. Genetic variability of hepatitis C virus in South Egypt and its possible clinical implication. J Med Virol 2009;81(6):1015-23.  Back to cited text no. 95
    
96.Ayed Z, Houinato D, Hocine M, Ranger­Rogez S, Denis F. Prevalence of serum mar­kers of hepatitis B and C in blood donors and pregnant women in Algeria. Bull Soc Pathol Exot 1995;88(5):225-8.  Back to cited text no. 96
    
97.Specht CS, Lewin-Smith MR, Kalasinsky VF, Peterson MR, Mullick FG. The surgical patho­logy and cytopathology of US Persian Gulf War military veterans. Arch Pathol Lab Med 2000;124(9):1299-301.  Back to cited text no. 97
    
98.Spinella PC, Perkins JG, Grathwohl KW, et al. Risks associated with fresh whole blood and red blood cell transfusions in a combat support hospital. Crit Care Med 2007;35(11):2576-81.  Back to cited text no. 98
    

Top
Correspondence Address:
Farahnaz Fallahian
Sina Hospital, Tehran University of Medical Sciences, Tehran-11367-46911
Iran
Login to access the Email id


PMID: 21196607

Get Permissions




This article has been cited by
1 Hepatitis C in the Eastern Mediterranean Region
Esmat, G.
Eastern Mediterranean Health Journal. 2013; 19(7): 587-588
[Pubmed]
2 Infectious diseases in Iran: A birdćs eye view
Askarian, M. and Mansour Ghanaie, R. and Karimi, A. and Habibzadeh, F.
Clinical Microbiology and Infection. 2012; 18(11): 1081-1088
[Pubmed]
3 Infectious diseases in the Arabian Peninsula and Egypt
Shibl, A. and Senok, A. and Memish, Z.
Clinical Microbiology and Infection. 2012; 18(11): 1068-1080
[Pubmed]
4 Hematopoietic stem cell transplantation for thalassemia
Elborai, Y. and Uwumugambi, A. and Lehmann, L.
Immunotherapy. 2012; 4(9): 947-956
[Pubmed]
5 Surveillance system for hepatitis C infection: A practical approach
Jafari, N. and Farajzadegan, Z. and Ataei, B.
International Journal of Preventive Medicine. 2012; 3(4)
[Pubmed]
6 Implication of protein kinase R Gene quantification in hepatitis C Virus Genotype 4 induced Hepatocarcinogenesis
Mohamed, A.A. and Nada, O.H. and El Desouky, M.A.
Diagnostic Pathology. 2012; 7(1)
[Pubmed]
7 Trends in hepatitis B and hepatitis C virus seropositivity among blood donors over 15 years screened in the blood bank of a university hospital
Dilsiz, G. and Yenicesu, T. and Belen, F.B. and Celik, B. and Ozturk, G.
Transfusion and Apheresis Science. 2012; 47(1): 95-100
[Pubmed]
8 Interferon alpha-2b and ribavirin as combined therapy for chronic hepatitis C in Cuba: National Program
Nodarse-Cuní, H. and Arús-Soler, E. and Rivera-Reimón, L.L. and Pérez-Lorenzo, M. and Samada-Suárez, M. and García-Ferrera, W.O. and Sánchez-Rodríguez, Y.A. and Pupo-Oliveros, D. and Obregón-Moreno, A. and Umpierre-García, I. and Martínez-Martínez, O. and Moret-Pérez, A. and González-González, Y. and Bermúdez-Hernández, Y. and García-Iglesias, E. and Lazo-Diago, O.C. and Lopéz-Saura, P.
Biotecnologia Aplicada. 2012; 29(3): 184-188
[Pubmed]
9 Epidemiology of viral hepatitis B and C infections in Ibb City, Yemen
Gacche, R.N. and Kaid, A.M.S.
Hepatitis Monthly. 2012; 12(7): 64-66
[Pubmed]
10 Risk factors for Hepatitis C virus among high-risk populations (Intravenous drug addicts and patients with Thalassemia, Hemophilia, hemodialysis) in Mazandaran
Rafiei, A.R. and Haghshenas, M.R. and Azizi, M.D. and Taheri, S. and Babamahmoudi, F. and Makhlough, A. and Hoseini, S.H.
Journal of Mazandaran University of Medical Sciences. 2011; 20(81): 31-42
[Pubmed]
11 Assessment of human cytomegalovirus co-infection in Egyptian chronic HCV patients
Tabll, A. and Shoman, S. and Ghanem, H. and Nabil, M. and El Din, N.G.B. and El Awady, M.K.
Virology Journal. 2011; 8(343)
[Pubmed]



 

Top
   
 
 
    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  
 


 
    Abstract
    Introduction
    Prevalence and R...
    Comments
    References
 

 Article Access Statistics
    Viewed6126    
    Printed225    
    Emailed0    
    PDF Downloaded1479    
    Comments [Add]    
    Cited by others 11    

Recommend this journal