Hepatitis C virus acquisition among Egyptians: analysis of a 10‐year surveillance of acute hepatitis C

Objective To identify current risk factors for hepatitis C virus (HCV) acquisition among Egyptians. Methods Patients with acute HCV were identified through a surveillance system of acute hepatitis in four fever hospitals in Egypt between 2002 and 2012. Case–control analysis was conducted, cases being incident acute symptomatic HCV and controls being acute hepatitis A identified at the same hospitals. The questionnaire covered iatrogenic, community and household exposures to HCV in the 1–6 months prior to onset of symptoms. Multivariate models were built to identify risk factors associated with HCV acquisition among non‐drug users and drug users separately. Results Among non‐drug users, hospital admission was independently associated with acute HCV infection (OR = 4.2, 95% CI = 1.7–10.5). Several iatrogenic procedures, for example admission in a surgery unit, sutures, IV injections and IV infusions, highly correlated with hospital admission, were also associated with acute HCV infection and could have been used in the final model instead of hospital admission. Among drug users, identified risk factors were multiple sexual relations (OR = 4.0, 95% CI = 1.1–14.7), intravenous drug use (OR = 3.9, 95% CI = 1.2–13.0) and shaving at the barbershops (OR = 8.7, 95% CI = 2.4–31.4). Illiteracy and marriage were significant risk factors in both groups. Conclusion Invasive medical procedures are still a major risk for acquiring new HCV infections in Egypt, as is illicit drug use in spreading HCV infection. Objectif Identifier les facteurs de risque actuels pour l'acquisition du virus de l'hépatite C (VHC) chez les Egyptiens. Méthodes Les patients atteints du VHC aiguë ont été identifiés grâce à un système de surveillance de l'hépatite aiguë dans quatre hôpitaux de la fièvre en Egypte entre 2002 et 2012. Une analyse cas‐témoins a été réalisée, les cas étant des incidents symptomatiques de VHC aiguë et les témoins, des cas d'hépatite A aiguë identifiés dans les mêmes hôpitaux. Le questionnaire portait sur les expositions iatrogènes, familiales et communautaires au VHC entre un à six mois avant l'apparition des symptômes. Des modèles multivariés ont été construits pour identifier les facteurs de risque associés à l'acquisition du VHC chez les non‐toxicomanes et les toxicomanes séparément. Résultats Parmi les non‐toxicomanes, l'admission à l'hôpital était indépendamment associée à l'infection aigüe par le VHC (OR = 4,2; IC95% = 01,07 à 10,05). Plusieurs procédures iatrogèn