Hepatitis C virus (HCV) infection is thought to mostly become chronic and rarely resolves. HCV infection was serologically screened in 4,984 samples from Ghanaian blood donors, and 1.3% prevalence was found. At least 53% of confirmed anti-HCV carriers had no detectable viral RNA and were considered to have cleared the virus and recovered from the infection. Confirmation was authenticated by the presence of antibodies specific to at least two viral antigens, mostly NS3 and E2. Reactivity to HCV core antigens was lower in Ghanaian than United Kingdom blood donors. The minority of chronically infected donors carried a viral load significantly lower than an unselected comparative group of United Kingdom blood donors (2.5 × 105 versus 2.9 × 106 IU/ml; P = 0.004). HCV genotype 2 was largely predominant (87%). Sequence clustering was similarly broad in the E1/E2 and NS5 regions. The phylogenetic diversity and the incapacity to distinguish subtypes within genotype 2 in our and others' West African strains suggested that West Africa may be the origin of HCV genotype 2. The genetic diversity extended to the identification of strains clearly separated from known subtypes of genotype 2 and genotype 1. One strain appears to be part of a new HCV genotype. HCV infection in Ghana is characterized by a high rate of recovery and the predominance of broadly divergent genotype 2 strains.

Frequent recovery and broad genotype 2 diversity characterize hepatitis C virus infection in Ghana, West Africa

Hepatitis C (HCV) is the disease that has affected around 200 million people globally. HCV is a life threatening human pathogen, not only because of its high prevalence and worldwide burden but also because of the potentially serious complications of persistent HCV infection. Chronicity of the disease leads to cirrhosis, hepatocellular carcinoma and end-stage liver disease. HCV positive hepatocytes vary between less than 5% and up to 100%, indicating the high rate of replication of viral RNA. HCV has a very high mutational rate that enables it to escape the immune system. Viral diversity has two levels; the genotypes and Quasiaspecies. Major HCV genotypes constitute genotype 1, 2, 3, 4, 5 and 6 while more than 50 subtypes are known. All HCV genotypes have their particular patterns of geographical distribution and a slight drift in viral population has been observed in some parts of the globe.

An overview about hepatitis C: A devastating virus

Prevalence of infection with hepatitis B and C virus and coinfection with HIV in medical inpatients in Malawi

Background and Objectives: West Africa is a highly endemic area for viral infections. The prevalence of five viral markers was determined in Ghanaian blood donors. Materials and Methods: Replacement and volunteer blood donors were screened using enzyme immunoassays (EtAs) for hepatitis 8 surface antigen (HBsAg) human immunodeficiency virus antibodies (anti-HIV) HIV p24 antigen human T-cell lymphocytotrophic virus-l and -n antibodies (anti-HI1.V-I/ll) and hepatitis C virus antibodies (anti-HCV). Results: HBsAg was present at an equally high frequency (15%) in young volunteer (median age 18 years) and older replacement (median age 33 years) blood donors. In contrast the prevalence of anti-HIV and anti-HCV was significantly higher in replacement blood donors (2.4 and 0.3%) respectively P < 0.001). HCV RNA was detected in 74 or 55% of seropositive donors depending on the confirmatory criteria used. No p24 antigen-positive/anti-HIV-negative donations were found. The prevalence of Hl1.V-I/D was generally low (0.5%). Conclusion: All blood donations should be screened for hepatitis 8 virus (HBV) HIV and HCV markers. (authors)

Screening for viral markers in volunteer and replacement blood donors in West Africa

This retrospective study investigated the prevalence of hepatitis B virus (HBV) in 192 stored sera from human immunodeficiency virus (HIV) positive South African patients initiating antiretroviral therapy (ART), and explored the implications of HBV-HIV co-infection on laboratory diagnosis of HBV. HBV serology (HBsAg, anti-HBs and anti-HBc) and nested HBV PCR assays targeting the HBV polymerase gene were performed, with HBV DNA positive samples being quantified with Cobas Taqman HBV test 48 assay (Roche Diagnostics). The study found that 63% (121/192) of patients had past or present HBV infection, and 40.6% (78/192) had detectable HBV DNA. Also, 22.9% (44/192) of patients were HBsAg positive and HBV DNA positive, while 23% (34/148) of HBsAG negatives had occult HBV infections. Of the 78 HBV DNA positive samples, 62.8% had viral loads ranging from 10(2) to > or =10(8) IU/ml, and 37.2% had HBV viral loads or =10(8) IU/ml, compared to only 5.9% (2/34) of HBsAg negatives (relative risk: 4.64; 95% confidence interval: 1.11, 19.35; chi-square P-value = 0.015). The study shows that the majority of HIV/AIDS patients initiating ART have either acute or chronic HBV infections, and further confirms that HIV remains a risk factor for occult HBV infections in South African patients as previously shown. The findings strongly support HBV screening in all HIV-positive patients initiating ART in South Africa, considering that current ART regimens include drugs with anti-HBV activity (e.g., lamivudine).

Increased detection of HBV DNA in HBsAg‐positive and HBsAg‐negative South African HIV/AIDS patients enrolling for highly active antiretroviral therapy at a Tertiary Hospital

The seroprevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus type 1 (HIV-1) markers was evaluated in a group of 2042 subjects from a rural area in the Republic of Equatorial Guinea, to obtain a better understanding of the transmission patterns of these viruses. Antibodies to HIV-1 were detected in 12 subjects (0·6%); the seroprevalence did not differ significantly by age or gender. Overall seroprevalence for HCV was 1·7% (in patients aged >40 years, 5·6%). Hepatitis B surface antigen was detected in 8·8% of subjects, with the higher seroprevalence in children aged ⩽18 years of 13·4% contrasting with the higher seroprevalence of HCV in older subjects of the Equatoguinean studied population. These results indicate differences in the distribution of the viruses and, probably, different routes of transmission. The study demonstrates the existence of a high HBV carrier rate in children, concluding that hepatitis B vaccine should be incorporated into the Expanded Programme on Vaccination in Equatorial Guinea.

Seroprevalence of hepatitis B and C, and human immunodeficiency type 1 viruses in a rural population from the Republic of Equatorial Guinea.

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Seroprevalence of hepatitis B and C, and human immunodeficiency type 1 viruses in a rural population from the Republic of Equatorial Guinea.