Hepatitis C virus epidemiology in Central-West Tunisia: a population-based cross-sectional study
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This study aimed to assess the seroprevalence, viraemia and genotype distribution of hepatitis C virus (HCV) in a region in Central-West Tunisia. A door-to-door cross-sectional study was conducted on a randomly selected sample. A total of 3178 individuals aged 5 to 74 years and members of 935 families were investigated. Seroprevalence of HCV was assessed using ELISA tests. The viral load was determined by real-time RT-PCR, and HCV genotyping was conducted by amplification and sequencing in the NS5b genomic region. The global prevalence of HCV antibodies was 3.32% (95% confidence interval [CI]: 2.72-4.00). It was significantly higher in women: 4.47% vs. 2.16% in men, p = 0.001. Seroprevalence increased with age, and the highest rates were found in the 50- to 59-year-old age group (12.90%, 95% CI: 9.45-16.86), suggesting a cohort effect with very low contribution of intrafamilial transmission. Genotyping showed a predominance of subtype 1b (84.6%), with cocirculation of subtypes 2c (9.6%), 1a (1.9%), 1d (1.9%) and 2k (1.9%), similar to the previously reported genotype distribution in Tunisia and with no genetic clusters specific to the study region. These results indicate a higher endemicity of HCV infection when compared to the previously reported nationwide surveillance data. This study provides valuable data that can contribute to current strategies to eliminate hepatitis C.
We thank the regional directorates of health of Kasserine for their assistance in the field. Special thanks to our fieldworkers for their dedication, and to the residents of the study community, who generously agreed to participate in this study. The Ministry of Health and the Ministry of Higher Education and Scientific Research co-funded the study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
This study was partially funded by the Ministry of Health and the Ministry of Higher Education and Scientific Research (PRF-4; CIC2016IPT02).
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