Epidemiological Aspects of Intrafamilial Spread of HCV Infection in Egyptian Population: A Pilot Study


Aim: Liver disease is a leading cause of morbidity and mortality among Egyptians. The major cause is infection with HCV, with 70 000 up to 140 000 newly reported cases annually. The objectives of this study were to determine the prevalence of anti-HCV antibodies among household contacts of HCV index cases and to identify the possible risk factors of transmission of HCV among Egyptian families. Material and Methods: The present external pilot study (double centre study) was performed on a convenient sample of 125 index cases and their 321 household family contacts recruited from Mansoura & Cairo University where 2 questionnaires were used to collect data from the index & their related contacts. The all were exposed to clinical examinations, routine laboratory testing & screening for the prevalence of Anti-HCV antibodies. Results: The prevalence of anti-HCV seropositivity among household contacts of index cases was found to be 13.7% which husbands of female index cases ranked first followed by wives of male index cases (36.36% versus 17.86% respectively, P < 0.0001) while sons & daughter followed later (6.84% & 4.94% respectively). When the distribution of household contacts by risky behaviour towards index cases was investigated, it was found that significant prevalence of anti-HCV antibodies positivity was detected between household contacts reporting their index cases having haematemsis &/or bleeding wound (P < 0.05), and household contacts giving IV injection to their index cases (P < 0.05) & household contacts visiting the same dentist as the index cases (P < 0.01) when compared to household contacts not exposed to the same risk factors. Conclusion: Transmission might occur during family contact and sexual behavior.

Share and Cite:

El-Bendary, M. , Esmat, G. , Neamatallah, M. , Kamel, E. , Besheer, T. , Elalfy, H. , El-Setouhy, M. and Omran, D. (2014) Epidemiological Aspects of Intrafamilial Spread of HCV Infection in Egyptian Population: A Pilot Study. Open Journal of Gastroenterology, 4, 228-236. doi: 10.4236/ojgas.2014.45034.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Lehman, E.M. and Wilson, M.L. (2009) Epidemic Hepatitis C Virus Infection in Egypt: Estimates of Past Incidence and Future Morbidity and Mortality. Journal of Viral Hepatitis, 16, 650-658.
[2] Khattab, M.A., Eslam, M., Sharwae, M.A. and Hamdy, L. (2010) Seroprevalence of Hepatitis C and B among Blood Donor Egypt: Minya Governorate, 2000-2008. American Journal of Infection Control, 38, 640-641.
[3] Tibbs, C.J. (1995) Methods of Transmission of Hepatitis C. Journal of Viral Hepatitis, 2, 113-119.
[4] Minola, E., Baldo, V., Baldovin, T., Trivello, R. and Floreani, A. (2006) Intrafamilial Transmission of Hepatitis C Virus Infection. European Journal of Epidemiology, 21, 293-927.
[5] Akhtar, S. and Moatter, T. (2007) Multilevel Modeling of Intra-Household Spread of Hepatitis C Virus Infection, Karachi, Pakistan. American Journal of Tropical Medicine& Hygine, 76, 446-449.
[6] Hoofnagle, J.H. (2002) Course and Outcome of Hepatitis C. Hepatology, 36, S21-S29.
[7] Khawaja, Z.A., Gibney, L., Ahmed, A.J. and Vermund, S.H. (1997) HIV/AIDS and Its Risk Factors in Pakistan. AIDS, 11, 843-848.
[8] Miller, F.D. and Abu-Raddad, L.J. (2010) Evidence of Intense Ongoing Endemic Transmission of Hepatitis C Virus in Egypt. Proceedings of the National Academy of Sciences of the United States of America, 107, 14757-14762.
[9] Ackerman, Z., Ackerman, E. and Paltiel, O. (2000) Intrafamilial Transmission of Hepatitis C Virus: A Systematic Review. Journal of Viral Hepatitis, 7, 93-103.
[10] La Torre, G., Miele, L., Mannocci, A., Chiaradia, G., Berloco, F., Gabrieli, M.L., et al. (2006) Correlates of HCV Seropositivity among Familial Contacts of HCV Positive Patients. BMC Biomed central Public Health, 6, 237-242.
[11] Memon, M.I. and Memon, M.A. (2002) Hepatitis C: An Epidemiological Review. Journal of Viral Hepatitis, 9, 84-100.
[12] Nakayama, H., Sugai, Y., Ikeya, S., Inoue, J., Nishizawa, T. and Okamoto, H. (2005) Molecular Investigation of Interspousal Transmission of Hepatitis C Virus in Two Japanese Patients Who Acquired Acute Hepatitis C after 40 or 42 Years of Marriage. Journal of Medical Virolology, 75, 258-266.
[13] Norder, H., Bergström, A., Uhnoo, I., Aldén, J., Weiss, L., Czajkowski, J., et al. (1998) Confirmation of Nosocomial Transmission of Hepatitis C Virus by Phylogenetic Analysis of the NS5-B Region. Journal of Clinical Microbiology, 36, 3066-3069.
[14] Nyamathi, A., Robbins, W.A., Fahey, J.L., Wiley, D., Pekler, V.A., Longshore, D., et al. (2002) Presence and Predictors of Hepatitis C Virus RNA in the Semen of Homeless Men. Biological Research for Nursing, 4, 22-30.
[15] Bourlet, T., Levy, R., Maertens, A., Blachier, S., Bocket, L., Cassuto, G., et al. (2002) Detection and Characterization of Hepatitis C Virus RNA in Seminal Plasma and Spermatozoon Fractions of Semen from Patients Attempting Medically Assisted Conception. Journal of Clinical Microbiology, 40, 3252-3255.
[16] Ferreiro, M.C., Dios, P.D. and Scully, C. (2005) Transmission of Hepatitis C Virus by Saliva? Oral Diseases, 11, 230-235.
[17] Vandelli, C., Renzo, F., Romanò, L., Tisminetzky, S., De Palma, M., Stroffolini, T., Ventura, E. and Zanetti, A. (2004) Lack of Evidence of Sexual Transmission of Hepatitis C among Monogamous Couples: Results of a 10-Year Prospective Follow-Up Study. American Journal of Gastroenterology, 99, 855-859.
[18] Marincovich, B., Castilla, J., Del Romero, J., Garcia, S., Hernando, V., Raposo, M. and Rodríguez, C. (2003) Absence of Hepatitis C Virus Transmission in a Prospective Cohort of Heterosexual Serodiscordant Couples. Sexually Transmitted Infections, 79, 160-162.
[19] Tahan, V., Karaca, C. and Yildrim, B. (2005) Sexual Transmission of HCV between Spouses. American Journal of Gastroenterology, 100, 821-824.
[20] Mohamed, M.K., Abdel-Hamid, M., Mikhail, N.N., Abdel-Aziz, F., Medhat, A., Magder, L.S., Fix, A.D. and Strickland, G.T. (2005) Intrafamilial Transmission of Hepatitis C in Egypt. Hepatology, 42, 683-687.
[21] Chang, T.T., Liou, T.C., Young, K.C., Lin, X.Z., Lin, C.Y., Shin, J.S. and Wu, H.L. (1994) Intrafamilial Transmission of Hepatitis C Virus: The Important Role of Inapparent Transmission. Journal of Medical Virology, 42, 91-96.
[22] Wang, C.C., Cook, L., Tapia, K.A., Holte, S., Krows, M., Bagabag, A., Santos, A., Corey, L. and Jerome, K.R. (2011) Cervicovaginal Shedding of Hepatitis C Viral RNA Is Associated with the Presence of Menstrual or Other Blood in Cervicovaginal Fluids. Journal of Clinical Virology, 50, 4-7.
[23] Meisel, H., Reip, A., Faltus, B., Lu, M., Porst, H., Wiese, M., Lu, M. and Roggendorf, M. (1995) Transmission of Hepatitis C Virus to Children and Husbands by Women Infected with Contaminated Anti-D Immunoglobulin. Lancet, 345, 1209-1211.
[24] Kao, J.H., Hwang, Y.T., Chen, P.J., Yang, P.M., Lai, M.Y., Wang, T.H. and Chen, D.S. (1996) Transmission of Hepatitis C Virus between Spouses: The Important Role of Exposure Duration. American Journal of Gastroenterology, 91, 2087-2090.
[25] Cavalheiro, N.P., De La Rosa, A., Elagin, S., Tengan, F.M., Araújo, E.S. and Barone, A.A. (2009) Epidemiological and Phylogenetic Analysis of Hepatitis C Virus in 24 Infected Couples. Revista da Sociedade Brasileira de Medicina Tropical, 42, 239-244.
[26] Terrault, N.A., Dodge, J.L., Murphy, E.L.,Tavis, J.E., Kiss, A., Levin, T.R., et al. (2013) Sexual Transmission of Hepatitis C Virus among Monogamous Heterosexual Couples: The HCV Partners Study. Hepatology, 57, 881-889.
[27] Nishiguchi, S., Fukuda, K., Shiomi, S., Isshiki, G., Kuroki, T., Nakajima, S., Murata, R. and Kobayashi, K. (1992) Familial Clustering of Hepatitis C Virus. Lancet, 339, 1486. (Letter)
[28] Nakashima, K., Ikematsu, H., Hayashi, J., Kioshihara, Y., Mitsutake, A. and Kashiwagi, S. (1995) Intrafamilial Transmission of Hepatitis C Virus among the Population of an Endemic Area of Japan. Journal of the American Medical Association, 274, 1459-1461.
[29] Hayashi, J., Kishihara, Y., Yamaji, K., Yoshimura, E., Kawakami, Y., Akazawa, K. and Kashiwagi, S. (1995) Transmission of Hepatitis C Virus by Health Care Workers in a Rural Area in Japan. American Journal of Gastroenterology, 90, 794-799.
[30] Noguchi, S., Sata, M., Suzuki, H., Mizokami, M. and Tanikawa, K. (1997) Routes of Transmission of Hepatitis C Virus in an Endemic Rural Area of Japan. Scandinavian Journal of Infectious Diseases, 29, 23-28.
[31] Napoli, N., Fiore, G., Vella, F., Fera, G. and Schiraldi, O. (1993) Prevalence of Antibodies to Hepatitis C Virus among Family Members of Patients with Chronic Hepatitis C. European Journal of Epidemiology, 9, 629-632.
[32] Demelia, L., Vallebona, E., Poma, R., Sanna, G., Masia, G. and Coppola, R.C. (1996) Hepatitis C Virus Transmission in Family Members of Subjects with HCV-Related Chronic Liver Disease. European Journal of Epidemiology, 12, 45-50.
[33] Kim, Y.S., Ahn, Y.O. and Kim, D.W. (1994) Familial Clustering of Hepatitis B and C Viruses in Korea. Journal of Korean Medical Science, 9, 444-449.
[34] Mohamed, M.K., Magder, L.S., Abdel-Hamid, M., El-Daly, M., Mikhail, N.N. and Abdel-Aziz, F. (2006) Transmission of Hepatitis C Virus between Parents and Children. American Journal of Tropical Medicine and Hygiene, 75, 16-20.
[35] Cecere, A., Marotta, F., Lucariello, A., Tancredi, L., Vangieri, B. and Gattoni, A. (2003) High Prevalence of Hepatitis C Virus Infection in a Southern Italian Rural Region. Clinical Aspects and Evidence of Inapparent Parenteral Exposure. Panminerva Medica, 45, 253-259.
[36] Arafa, N., El Hoseiny, M., Rekacewicz, C., Bakr, I., El-Kafrawy, S., El Daly, M., Aoun, S., Marzouk, D., Mohamed, M.K. and Fontanet, A. (2005) Changing Pattern of Hepatitis C Virus Spread in Rural Areas of Egyptian. Journal of Hepatology, 43, 418-424.
[37] Akhtar, S. and Moatter, T. (2004) Intra-Household Clustering of Hepatitis C Virus Infection in Karachi, Pakistan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 98, 535-539.
[38] Bessa, M., Rodart, I.F., Menezes, G.B.L., Carmo, T.M.A., Athanazio, D.A. and Reis, M.G. (2009) Limited Evidence of HCV Transmission in Stable Heterosexual Couples from Bahia, Brazil. Brazilian Journal of Infectious Diseases, 13, 262-265.
[39] Caporaso, N., Ascione, A., D’Antonio, M., DiCostanzo, G.G., Galeota Lanza, A., Tremolada, F., et al. (1995) Prevalence of Anti-HCV among Spouses and Offspring of Anti-HCV Positive Subjects: An Italian Multicentre Study. Italian Journal of Gastroenterology, 27, 5-7.
[40] Matyla-Radzewska, A. and Wysocki, J. (2005) Natural Course of Infection in Children and Familial Transmission of C Viral Hepatitis. Przeglad Epidemiologiczny, 59, 475-481.
[41] Medhat, A., Fix, A., Shehata, M., Mikhail, N., Abdel-Baki, L., Nafeh, M., Abdel-Hamid, M., Strickland, G.T. and Fix, A.D. (2002) Hepatitis C in a Community in Upper Egypt: Risk Factors for Infection. American Journal of Tropical Medicine and Hygiene, 66, 633-638.
[42] Habib, M., Mohamed, M., Abdel-Aziz, F., Magder, L.S., Abdel-Hamid, M., Gamil, F., Madkour, S., Mikhail, N.N., Anwar, W., Strickland, G.T., Fix, A.D. and Sallam, I. (2001) Hepatitis C Virus Infection in a Community in the Nile Delta: Risk Factors for Seropositivity. Hepatology, 33, 248-253.
[43] Pagliaro, L., Pasta, L., D’Amico, G., Madonia, S. and Pietrosi, G. (2002) Familial Clustering of (Mostly) HCV-Related Cirrhosis. A Case-Control Study. Journal of Hepatology, 37, 762-766.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.