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Belkacemi M, Merbouh MA. Seroprevalence of Human Immunodeficiency Virus, Hepatitis C Virus, and Hepatitis B Virus Among Blood Donors in Sidi Bel Abbes, West Algeria. Cureus 2023; 15:e47066. [PMID: 38022198 PMCID: PMC10644989 DOI: 10.7759/cureus.47066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Blood transfusions can transmit various viruses. Among them, the most common are hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). These viruses can cause fatal and life-threatening diseases. Worldwide, many people are infected with these viruses. Blood safety has made major progress in recent years. Yet, blood-borne viruses continue to be a major concern for patients, physicians, and policymakers. The aim of this study was to assess the prevalence of HIV, HBV, and HCV in blood donors. Methods A cross-sectional study was performed to assess HIV, HBV, and HCV seropositivity in blood donors. This research was carried out at the blood bank of Sidi Bel Abbes University Hospital. This was a retrospective study based on records of blood donors. All data of 10,386 donors were analyzed from January 2015 to December 2015. Biological screening was performed by enzyme-linked immunosorbent assay (ELISA) using antibodies and/or antigens. The combined HCV and HIV antigen and antibody ELISA test was utilized. To confirm the results, the blood bank and the virology laboratory used the same technique in duplicate. Results The overall seroprevalence of blood-borne viral infections (HIV, HBV, and HCV) in blood donors was 0.8%. The prevalence of HIV was found to be 0.1%, while the prevalence of HBV and HCV was 0.4%. Coinfection was rare with only one case of HBV with HIV. There was a significant difference in seroprevalence rates among blood donors compared to the general population. Significant variations were observed between the prevalence of this study and those conducted in West, East, Central, and South African countries but not with those of neighboring North African countries. The study found no association between seropositivity in blood donors and factors like age, gender, donor status, type of donation, or site. Besides, HIV, HBV, or HCV prevalence was not influenced by ABO and Rhesus blood group. Conclusion The study showed that blood donors in Algeria have a lower prevalence of blood-borne viral infections than the general population. The seropositivity rate of viral markers was similar throughout North African countries. This rate remained low compared to other African countries. Residual risk of infection persists. There is a need to increase blood safety for recipients. This report is the first comprehensive overview of blood-borne viruses among Algerian blood donors. There is a need for further nationwide studies to get a whole picture of the situation.
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Affiliation(s)
- Malika Belkacemi
- Hemobiology and Blood Transfusion, University Hospital Establishment of Oran, Oran, DZA
- Medicine, Oran 1 University, Oran, DZA
| | - Mohammed Amine Merbouh
- Epidemiology and Preventive Diseases, Hassani Abdelkader University Hospital, Sidi Bel Abbes, DZA
- Medicine, Djilali Liabès University, Sidi Bel Abbes, DZA
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Khedhiri M, Ghedira K, Rajhi M, Hammemi W, Sadraoui A, Touzi H, Tebibi K, Chouikha A, Triki H. Overview of the epidemic history of Hepatitis C uncommon subtypes 2i and 4d in Tunisia and in the world. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 105:105375. [PMID: 36241024 DOI: 10.1016/j.meegid.2022.105375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/06/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
The impressive improvements in qua therapy efficacy alone are not sufficient to substantially reduce the Hepatitis C Virus burden because of the usually very long asymptomatic phase of the infection. In turn, this renders prevention of infection of great importance. The value of learning how the virus has spread in the past is that this can provide clues as to what routes the virus likely spreads through today, which can feedback into prevention policy. In Tunisia, HCV subtypes 2i and 4d are minor circulating subtypes. Here, we applied a Bayesian Markov Chain Monte Carlo method for visualization of spatial and temporal spread of HCV-2i and 4d in Tunisia and some other countries in the world. Our analysis included sequences retrieved from Genbank and isolated from several countries in the world; 21 HCV-NS5B subtype 2i genome sequences obtained during the period 2002-2020 and 206 HCV-NS5B-4d sequences detected between 2000 and 2019. Phylogenetic analysis revealed that two geographical clusters could be identified in HCV-2i tree with two clearly distinguished clusters in HCV-4d Tree. The estimated time for the most recent common ancestor suggested that current HCV-2i strains emerged in 1963 [1930, 1995] and current HCV-4d strains emerged in 1992 [1988, 1996] in Tunisia and other countries from the world investigated in the present study.
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Affiliation(s)
- Marwa Khedhiri
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Faculty of Sciences of Tunis, University of Tunis El Manar, Campus Universitaire, El Manar, Tunis 2092, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia.
| | - Kais Ghedira
- Laboratory of Bioinformatics, Biomathematics and Biostatistics - LR16IPT09, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.
| | - Mouna Rajhi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia
| | - Walid Hammemi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia
| | - Amel Sadraoui
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia
| | - Henda Touzi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia
| | - Khadija Tebibi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Faculty of Sciences of Tunis, University of Tunis El Manar, Campus Universitaire, El Manar, Tunis 2092, Tunisia
| | - Anissa Chouikha
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia.
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia; Research Laboratory "Virus, Vectors and Hosts: One Health Approach and Technological Innovation for a Better Health", LR20IPT02, Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University of Tunis El Manar (UTM), Tunis 1002, Tunisia.
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3
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Chouikha A, Ghrabi A, Ghodbane A, Hammemi W, Khedhiri M, Sadraoui A, Touzi H, Hassine HB, Maatoug S, Bensaoud C, Abdelhak S, Bouarrouj S, Gdoura M, Chaouachi H, Triki H. Distribution of HCV Genotypes Among People Who Inject Drugs in Tunisia: New Evidence for Scaling Up Prevention and Treatment Toward National Elimination Goal. Front Microbiol 2021; 12:697859. [PMID: 34385988 PMCID: PMC8353188 DOI: 10.3389/fmicb.2021.697859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
Little is known about the distribution of hepatitis C virus (HCV) genotypes among people who inject drugs (PWID) in North African countries, including Tunisia. This study aims to describe HCV genotypes circulating among Tunisian PWID. A cross-sectional study was conducted, and 128 HCV-positive PWID were recruited between 2018 and 2019 from community-based harm reduction centers. After informed consent, sociodemographic characteristics and risk behavior data were obtained using an interviewer-administrated questionnaire. Blood samples were collected for further serological and molecular testing. Overall, five women and 123 men were included. The median age was 39.5 years. The majority of PWID (56.3%) had less than a secondary level of education, were single (57%), were unemployed (65.6%), were incarcerated at least once (93.0%), and had a history of residency in at least one foreign country (50.8%). During the previous 12 months, 82.0% reported having reused syringes at least once, 43.8% shared syringes at least once, while 56.2% had at least one unprotected sexual relation, and 28.1% had more than two different sexual partners. Tattooing was reported among 60.2%. All positive results for HCV-infection by rapid testing were confirmed by enzyme-linked immunosorbent assay (ELISA). HCV-RNA was detectable in 79.7%. Genotyping showed a predominance of genotype 1 (52%) followed by genotype 3 (34%) and genotype 4 (10%). Four patients (4%) had an intergenotype mixed infection. Subtyping showed the presence of six different HCV subtypes as follows: 1a (53.2%), 1b (6.4%), 3a (33.0%), 4a (3.2%), and 4d (4.3%). This is the first study describing circulating HCV genotypes among PWID in Tunisia. The distribution of HCV genotypes is distinct from the general population with a predominance of subtypes 1a and 3a. These findings can be used to guide national efforts aiming to optimize the access of PWID to relevant HCV prevention and treatment measures including pangenotypic regimens for patients infected with HCV genotype 3.
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Affiliation(s)
- Anissa Chouikha
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Amine Ghrabi
- Association Tunisienne d'Information et d'Orientation sur le SIDA et la Toxicomanie (Tunisian Association for Information and Orientation on HIV/AIDS and Toxicomania - ATIOST), Tunis, Tunisia
| | - Amira Ghodbane
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Walid Hammemi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Marwa Khedhiri
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Amel Sadraoui
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Henda Touzi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | | | - Sonia Maatoug
- Science Shop, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Chaima Bensaoud
- Science Shop, Institut Pasteur de Tunis, Tunis, Tunisia.,Institute of Parasitology, Biology Centre, Czech Academy of Sciences, Ceske Budejovice, Czechia
| | | | - Samir Bouarrouj
- Association Tunisienne d'Information et d'Orientation sur le SIDA et la Toxicomanie (Tunisian Association for Information and Orientation on HIV/AIDS and Toxicomania - ATIOST), Tunis, Tunisia
| | - Mariem Gdoura
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Hedia Chaouachi
- Association Tunisienne d'Information et d'Orientation sur le SIDA et la Toxicomanie (Tunisian Association for Information and Orientation on HIV/AIDS and Toxicomania - ATIOST), Tunis, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, Tunis El Manar University, Tunis, Tunisia
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Focus on hepatitis C virus genotype distribution in Tunisia prior to elimination: a 16-year retrospective study. Arch Virol 2021; 166:501-510. [PMID: 33394169 DOI: 10.1007/s00705-020-04918-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022]
Abstract
With the introduction of direct-acting antiviral treatment (DAA), Tunisia has committed to achieving the international goal of eliminating viral hepatitis. Because the specific DAA prescribed depends on viral genotype, viral genotyping remains of great importance. The aim of the present study was to outline the trends in the distribution of HCV genotypes from 2002 to 2017 in the Tunisian general population in order to guide authorities towards the most appropriate therapeutic strategies for preventing HCV infection. A total of 2532 blood samples were collected over a 16-year period and from all regions of Tunisia. Genotyping showed that genotype 1 (subtype 1b) was the most prevalent genotype in the country (n = 2012; 79.5%), followed by genotype 2 (n = 339; 13.3%). Genotypes 3, 4 and 5 were detected in 4.8%, 2.2% and 0.1% of the country's population, respectively. Mixed infections with different HCV genotypes were detected in 0.1% of the population (one case each of genotypes 1b + 4, 1b + 2 and 2 + 4). Interestingly, a significant increase in genotypes 2, 3 and 4 was observed over time (p = 0.03). Sixteen different subtypes were detected over the study period, most of which were subtypes of genotype 2, and some of these subtypes appeared to be new. Patients infected with genotypes 1a, 3 and 4 were significantly younger than those infected with genotypes 1b and 2 (p < 0.01). Furthermore, genotypes 1b and 2 were detected more often in women than men, while genotypes 1a and 3 were detected mostly in men (P < 0.01). Our study confirms a large predominance of genotype1/subtype1b in Tunisia and shows a significant increase in the prevalence of other genotypes over time. These findings reinforce the need for an additional HCV genotype survey to improve the design of treatment strategies in Tunisia.
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Tran L, Nhu Y M, Le Ba Nghia T, Hendam A, Vuong NL, Alzalal E, Sayed AM, Hussain MM, Sharma A, Tieu T, Mathenge PG, Hirayama K, Alexander N, Huy NT. Frequent inappropriate use of unweighted summary statistics in systematic reviews of pathogen genotypes or genogroups. J Clin Epidemiol 2019; 119:26-35. [PMID: 31740320 DOI: 10.1016/j.jclinepi.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/11/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Our study aimed to systematically assess and report the methodological quality used in epidemiological systematic reviews (SRs) and meta-analysis (MA) of pathogen genotypes/genogroups. STUDY DESIGN AND SETTING Nine electronic databases and manual search of reference lists were used to identify relevant studies. The method types were divided into three groups: 1) with weighted pooling analysis (which we call MA), (2) unweighted analysis of the study-level measures (which we call summary statistics), and (3) without any data pooling (which we call SR only). Characteristics were evaluated using Assessment of Multiple Systematic Reviews (AMSTAR), Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Risk Of Bias In Systematic reviews (ROBIS) tools. The protocol was registered in PROSPERO with CRD42017078146. RESULTS Among 36 included articles, 5 (14%) studies conducted SR only, 16 (44%) performed MA, and 15 (42%) used summary statistics. The univariable and multivariable linear regression of AMSTAR and PRISMA scores showed that MA had higher quality compared with those with summary statistics. The SR only and summary statistics groups had approximately equal scores among three scales of AMSTAR, PRISMA, and ROBIS. The methodological quality of epidemiological studies has improved from 1999 to 2017. CONCLUSION Despite the frequent use of unweighted summary statistics, MA remains the most suitable method for reaching rational conclusions in epidemiological studies of pathogen genotypes/genogroups.
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Affiliation(s)
- Linh Tran
- Institute of Research and Development, Duy Tan University, Danang 550000, Vietnam
| | - Mai Nhu Y
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Thai Le Ba Nghia
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam
| | - Abdulrahman Hendam
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nguyen Lam Vuong
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ebrahim Alzalal
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Medicine, Menofia University, Shebin Elkom, Egypt
| | - Ahmed M Sayed
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mustafa Mushtaq Hussain
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Akash Sharma
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Thuan Tieu
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Peterson Gitonga Mathenge
- Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, 70000, Vietnam; Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan.
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Subgenotyping and genetic variability of hepatitis C virus in Palestine. PLoS One 2019; 14:e0222799. [PMID: 31589628 PMCID: PMC6779298 DOI: 10.1371/journal.pone.0222799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/06/2019] [Indexed: 12/13/2022] Open
Abstract
Hepatitis C virus (HCV) is a major cause of liver cirrhosis and hepatocellular carcinoma. Genotyping of HCV is crucial for successful therapy. To determine the HCV subgenotypes circulating in Palestine and to study the genetic variability of their core, we collected 84 serum samples which had tested positive for anti-HCV antibodies. Thirty-seven of these samples came from hemodialysis patients. Serum samples were subjected to viral RNA isolation and amplification of the HCV core gene. Thirty-three of the samples (39%) tested positive for HCV RNA. The HCV subgenotypes circulating in Palestine included 1a, 3a, and 4a, detected in 38%, 25%, and 22% of the samples, respectively. Furthermore, subgenotype 1b was present in three samples (9%), while the rare subgenotype 4v was present in two samples (6%). We identified a number of substitutions in the retrieved HCV core sequences, such as HCV 1b substitutions R70Q and M91L, which some studies have associated with hepatocellular carcinoma risk and poor virological response. In contrast to two previous studies reporting that HCV genotype 4 was predominant in the Gaza strip (present in just over 70% of samples), genotype 4 was detected in only 31% of the samples in our current study, whereas genotype 1 and 3 were present in 69% of samples. These differences may relate to the fact that many of our samples came from the West Bank and East Jerusalem. The co-circulation of different HCV genotypes and subgenotypes in Palestine suggests that subgenotyping prior to treatment is crucial in Palestinian patients.
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Chikhi Y, Cheraitia S, Ould Gougam R, Lounes F, Zemmouchi C, Belal N, Bendaoud M, Ait Younes S, Bensalem A, Berkane S, Asselah H, Pineau P, Lahcene M. Wide Sexual Dimorphism of Hepatocellular Carcinoma Presentation in Algeria. Gastrointest Tumors 2019; 6:122-136. [PMID: 31768356 DOI: 10.1159/000501453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 06/09/2019] [Indexed: 12/14/2022] Open
Abstract
Hepatocellular carcinoma (HCC) represents a worrying public health problem in North Africa and particularly in Egypt. The situation is unclear in western North Africa where HCC has been rarely submitted to careful scrutiny. We decided to analyze demographic, biochemical, virological, and clinical data of a series of HCC from Algerian patients to establish the landscape of this tumor in the country. In the present work, we described 337 cases of primary liver cancer from Bologhine Hospital in Algiers, the capital of Algeria. The mean age of patients was 63.8 ± 11.4 years with a male:female sex ratio of 1.5. The most prevalent risk factors were hepatitis C, hepatitis B, and metabolic pathologies (type 2 diabetes and obesity). The mean BMI was 25.6 ± 4.7 at tumor diagnosis. A strong duality of risk factors and tumor presentation between male and female patients was apparent. Women tended to be older (mean 65.4 vs. 62.7 years, p = 0.039) and either seropositive for anti-HCV (60.0 vs. 41.6%, p = 0.0018) resulting primarily from tattoos and/or scarification (47.2 vs. 25.7%, p = 1.0 × 10<sup>-4</sup>) or more often affected by metabolic disorders (mean BMI 26.1 ± 0.7 vs. 25.1 ± 0.5, p = 0.0248) commonly associated with personal antecedents of cholecystectomy (21.2 vs. 5.8%, p = 4.4 × 10<sup>-5</sup>). By contrast, men were younger, poorer survivors (mean 9.3 vs. 13.3 months, p = 0.005), more frequently HBsAg carriers (27.8 vs. 10.5%, p = 4.8 × 10<sup>-5</sup>), and more exposed to lifestyle risk factors such as smoking (39.4 vs. 3.0%, p = 3.9 × 10<sup>-16</sup>) or alcohol use (19.1 vs. 0.7%, 1.5 × 10<sup>-8</sup>). Finally, geographic disparities throughout Algeria were reminiscent of the situation of chronic hepatitis C in the country. A significant excess of cases originated from the region of Batna, Eastern Algeria, already known for its high rate of hepatitis C. Our results suggest that due to culture or sex-dependent biological differences, the tumor process affecting the liver is drastically different between sexes in Algeria.
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Affiliation(s)
- Yazid Chikhi
- Department of Internal medicine and Gastroenterology, EPH Bologhine, Algiers, Algeria
| | - Salima Cheraitia
- Department of Internal medicine and Gastroenterology, EPH Bologhine, Algiers, Algeria
| | - Rachid Ould Gougam
- Department of Internal medicine and Gastroenterology, EPH Bologhine, Algiers, Algeria
| | - Fadila Lounes
- Department of Internal medicine and Gastroenterology, EPH Bologhine, Algiers, Algeria
| | - Chahrazed Zemmouchi
- Department of Internal medicine and Gastroenterology, EPH Bologhine, Algiers, Algeria
| | - Nassila Belal
- Department of Radiology, Hôpital Central de l'Armée, Ain Naadja, Algiers, Algeria
| | | | | | - Aicha Bensalem
- Laboratory of Virology, Institut Pasteur d'Algérie, Sidi Ferruch, Algiers, Algeria
| | - Saadi Berkane
- Department of Gastroenterology, CHU Mustapha, Algiers, Algeria
| | - Hocine Asselah
- Department of Internal medicine and Gastroenterology, EPH Bologhine, Algiers, Algeria
| | - Pascal Pineau
- Unité "Organisation nucléaire et oncogenèse", INSERM U993, Institut Pasteur, Paris, France
| | - Mustapha Lahcene
- Department of Internal medicine and Gastroenterology, EPH Bologhine, Algiers, Algeria
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8
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Abounouh K, Aitraise I, Benabou A, Boussakri I, Doumir MA, El Boussairi C, El Idrissi S, El Mahdaoui C, Qouar DE, Ennahal A, Fathi S, Hafidi M, Lachker L, Ratib C, Tanouti IA, Maaroufi A, Benjelloun S, Guessous F, Pineau P, Ezzikouri S. Virus-associated human cancers in Moroccan population: From epidemiology to prospective research. INFECTION GENETICS AND EVOLUTION 2019; 75:103990. [PMID: 31386915 DOI: 10.1016/j.meegid.2019.103990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/25/2019] [Accepted: 08/02/2019] [Indexed: 12/24/2022]
Abstract
Eight human viruses have been classified by the International Agency for Research on Cancer as carcinogenic or probably carcinogenic for humans. Infection with high risk human papillomaviruses, hepatitis B and C viruses, Epstein-Barr virus (EBV), human T-Cell Lymphotropic Virus Type 1 (HTLV-1), Human herpesvirus 8 (HHV-8), Merkel cell polyomavirus and human immunodeficiency virus-1 (HIV1) alone or in combination with other agents are the main etiologic factors of many cancers. This review highlights some aspects of virus-associated human cancers, potentially responsible for >14,000 malignancies per year in Morocco. Given that not all individuals infected with these viruses develop cancer, somatic alterations, genetic predisposition, and lifestyle or environmental factors obviously play potentializing roles modulating viral activity. These viral, host genetic signatures and lifestyle interactions may represent a reservoir of biomarkers for early detection, prevention of cancer and rationale-based therapy.
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Affiliation(s)
- Karima Abounouh
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco; Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Imane Aitraise
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Anas Benabou
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | | | | | | | | | | | - Dalal El Qouar
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Afaf Ennahal
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Sofia Fathi
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Maria Hafidi
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Lamyae Lachker
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Chorouk Ratib
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | | | - Abderrahmane Maaroufi
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Soumaya Benjelloun
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Fadila Guessous
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Pascal Pineau
- Unité Organisation Nucléaire et Oncogenèse, INSERM U993, Institut Pasteur, Paris, France
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco.
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9
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Khedhiri M, Ghedira K, Chouikha A, Touzi H, Sadraoui A, Hammemi W, Triki H. Tracing the epidemic history of hepatitis C virus genotype 1b in Tunisia and in the world, using a Bayesian coalescent approach. INFECTION GENETICS AND EVOLUTION 2019; 75:103944. [PMID: 31260787 DOI: 10.1016/j.meegid.2019.103944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Marwa Khedhiri
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia; Research Laboratory: "Transmission Controle et Immunobiologie des Infections" (LR11-IPT02), Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia; Faculty of Sciences of Tunis, University Tunis El Manar, Tunis, Tunisia.
| | - Kais Ghedira
- Laboratory of Bioinformatics, Biomathematics and Biostatistics - LR16IPT09, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.
| | - Anissa Chouikha
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia; Research Laboratory: "Transmission Controle et Immunobiologie des Infections" (LR11-IPT02), Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.
| | - Henda Touzi
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Amel Sadraoui
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Walid Hammemi
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia; Research Laboratory: "Transmission Controle et Immunobiologie des Infections" (LR11-IPT02), Pasteur Institute of Tunis, Tunisia; Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
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10
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Bettaieb J, Chouikha A, Khedhiri M, Kharroubi G, Badreddine M, Bel Hadj Hmida N, Gharbi A, Hammemi W, Sadraoui A, Ben Yahia A, Meddeb Z, Ben Salah A, Triki H. Hepatitis C virus epidemiology in Central-West Tunisia: a population-based cross-sectional study. Arch Virol 2019; 164:2243-2253. [PMID: 31179516 DOI: 10.1007/s00705-019-04308-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/09/2019] [Indexed: 12/18/2022]
Abstract
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.
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Affiliation(s)
- Jihene Bettaieb
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Anissa Chouikha
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia. .,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia. .,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.
| | - Marwa Khedhiri
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ghassen Kharroubi
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Malek Badreddine
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Nabil Bel Hadj Hmida
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Adel Gharbi
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Walid Hammemi
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Amel Sadraoui
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ahlem Ben Yahia
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Zina Meddeb
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Afif Ben Salah
- Department of Medical Epidemiology, Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.,Department of Community and Family Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Henda Triki
- Laboratory of Clinical Virology, Pasteur Institute of Tunis, University Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia.,Research Laboratory: "Transmission, Controle et Immunobiologie des Infections" (LR11-IPT02), Tunis, Tunisia.,Clinical Investigation Center (CIC), Pasteur Institute of Tunis, University Tunis El Manar, Tunis, Tunisia.,Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
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11
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Marchio A, Dhifallah I, Bahri O, Pineau P. Circulating Aflatoxin B1-Related TP53 Mutation Detected by Digital PCR in Tunisian Patients with and Without Hepatocellular Carcinoma. HEPATITIS MONTHLY 2019; In Press. [DOI: 10.5812/hepatmon.85775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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12
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Chaabna K, Cheema S, Abraham A, Alrouh H, Lowenfels AB, Maisonneuve P, Mamtani R. Systematic overview of hepatitis C infection in the Middle East and North Africa. World J Gastroenterol 2018; 24:3038-3054. [PMID: 30038471 PMCID: PMC6054949 DOI: 10.3748/wjg.v24.i27.3038] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/10/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the quality of and to critically synthesize the available data on hepatitis C infections in the Middle East and North Africa (MENA) region to map evidence gaps. METHODS We conducted an overview of systematic reviews (SRs) following an a priori developed protocol (CRD42017076736). Our overview followed the preferred reporting items for systematic reviews and meta-analyses guidelines for reporting SRs and abstracts and did not receive any funding. Two independent reviewers systematically searched MEDLINE and conducted a multistage screening of the identified articles. Out of 5758 identified articles, 37 SRs of hepatitis C virus (HCV) infection in populations living in 20 countries in the MENA region published between 2008 and 2016 were included in our overview. The nine primary outcomes of interest were HCV antibody (anti-) prevalences and incidences in different at-risk populations; the HCV viremic (RNA positive) rate in HCV-positive individuals; HCV viremic prevalence in the general population (GP); the prevalence of HCV co-infection with the hepatitis B virus, human immunodeficiency virus, or schistosomiasis; the HCV genotype/subtype distribution; and the risk factors for HCV transmission. The conflicts of interest declared by the authors of the SRs were also extracted. Good quality outcomes reported by the SRs were defined as having the population, outcome, study time and setting defined as recommended by the PICOTS framework and a sample size > 100. RESULTS We included SRs reporting HCV outcomes with different levels of quality and precision. A substantial proportion of them synthesized data from mixed populations at differing levels of risk for acquiring HCV or at different HCV infection stages (recent and prior HCV transmissions). They also synthesized the data over long periods of time (e.g., two decades). Anti-HCV prevalence in the GP varied widely in the MENA region from 0.1% (study dates not reported) in the United Arab Emirates to 2.1%-13.5% (2003-2006) in Pakistan and 14.7% (2008) in Egypt. Data were not identified for Bahrain, Jordan, or Palestine. Good quality estimates of anti-HCV prevalence in the GP were reported for Algeria, Djibouti, Egypt, Iraq, Morocco, Pakistan, Syria, Sudan, Tunisia, and Yemen. Anti-HCV incidence estimates in the GP were reported only for Egypt (0.8-6.8 per 1000 person-year, 1997-2003). In Egypt, Morocco, and the United Arab Emirates, viremic rates in anti-HCV-positive individuals from the GP were approximately 70%. In the GP, the viremic prevalence varied from 0.7% (2011) in Saudi Arabia to 5.8% (2007-2008) in Pakistan and 10.0% (2008) in Egypt. Anti-HCV prevalence was lower in blood donors than in the GP, ranging from 0.2% (1992-1993) in Algeria to 1.7% (2005) in Yemen. The reporting quality of the outcomes in blood donors was good in the MENA countries, except in Qatar where no time framework was reported for the outcome. Some countries had anti-HCV prevalence estimates for children, transfused patients, contacts of HCV-infected patients, prisoners, sex workers, and men who have sex with men. CONCLUSION A substantial proportion of the reported outcomes may not help policymakers to develop micro-elimination strategies with precise HCV infection prevention and treatment programs in the region, as nowcasting HCV epidemiology using these data is potentially difficult. In addition to providing accurate information on HCV epidemiology, outcomes should also demonstrate practical and clinical significance and relevance. Based on the available data, most countries in the region have low to moderate anti-HCV prevalence. To achieve HCV elimination by 2030, up-to-date, good quality data on HCV epidemiology are required for the GP and key populations such as people who inject drugs and men who have sex with men.
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Affiliation(s)
- Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Hekmat Alrouh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Albert B Lowenfels
- Department of Surgery and the Department of Family Medicine, New York Medical College, Valhalla, NY 10595, United States
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan 20141, Italy
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
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13
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Fakhir FZ, Lkhider M, Badre W, Alaoui R, Meurs EF, Pineau P, Ezzikouri S, Benjelloun S. Genetic variations in toll-like receptors 7 and 8 modulate natural hepatitis C outcomes and liver disease progression. Liver Int 2018; 38:432-442. [PMID: 28752959 DOI: 10.1111/liv.13533] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 07/18/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS The natural outcomes of hepatitis C virus (HCV) as well as the progression of the liver disease are highly variable and depend primarily on an efficient immune response. As toll-like receptors seven (TLR7) and eight (TLR8) are important effectors of the innate immunity, this study aims to evaluate the association between TLR7 and TLR8 polymorphisms and the HCV infection outcomes in Moroccan subjects. METHODS In this case-control study, 643 subjects including 293 mild chronic hepatitis patients, 119 with advanced liver disease (AdLD), 93 with HCV spontaneous clearance and 138 healthy controls were genotyped using TaqMan SNPs assays. RESULTS Patients carrying TLR7 rs179008-A allele were more likely to clear the virus spontaneously (P = .0001 for women, and P < .001 for men). Besides, carriage of TLR7 rs179009-A allele was associated with a twofold increase in spontaneous viral clearance in female patients (P = .0002), but not in men. In addition, we observed that TLR7 rs179008-T and rs179009-G alleles increased the risk of disease progression in both sexes (P < .05). TLR8 rs3764880-G allele was associated with spontaneous HCV clearance in both sexes (P < .0001) albeit with an apparently stronger association in males (OR = 6.02 for men vs 2.2 for women). In males, TLR8 rs3764879-C and TLR8 rs3764880-A alleles were significantly associated with AdLD status (P < .05). CONCLUSIONS Our results suggest that variations in TLR7 and TLR8 genes modulate the clearance and progression of HCV infection with different magnitudes between sexes. Our results refine, therefore, our understanding of the sex-specific differences observed regarding the susceptibility to chronic hepatitis.
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Affiliation(s)
- Fatima-Zohra Fakhir
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco.,Faculté des Sciences d'El Jadida, Université Chouaib Doukkali, El Jadida, Morocco
| | - Mustapha Lkhider
- Laboratoire des Biosciences, Faculté des Sciences et Techniques de Mohammedia, Université Hassan II de Casablanca, Casablanca, Morocco
| | - Wafaa Badre
- Service de Medicine B, CHU Ibn Rochd, Casablanca, Morocco
| | - Rhimou Alaoui
- Service de Medicine B, CHU Ibn Rochd, Casablanca, Morocco
| | - Eliane F Meurs
- Unit Hepacivirus and Innate Immunity, Department Virology, Institut Pasteur, Paris, France
| | - Pascal Pineau
- Unité Organisation Nucléaire et Oncogenèse, Institut Pasteur, INSERM U993, Paris, France
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Soumaya Benjelloun
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
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14
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Abou Rached A, Yaghi C, Khalil L, Saba J, Ammar W. Prevalence of hepatitis C virus genotypes and subtypes in Lebanese population and major high risk groups. Arab J Gastroenterol 2017; 18:114-117. [PMID: 28579342 DOI: 10.1016/j.ajg.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 03/14/2017] [Accepted: 05/02/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND STUDY AIMS The prevalence of hepatitis C in Lebanon is low. It is estimated at 0.2% of the total population. The aim of our study is to evaluate the exact prevalence of each genotype on a large scale population and in each potential source of infection. PATIENTS AND METHODS We reviewed all the data in the Ministry of Public Health related to patients who have submitted their file for treatment during a period of 9years ranging from January 2005 till December 2013. RESULTS The genotype distribution in 1031 Lebanese patients was as following: Genotype 1 was the most predominant representing 47% followed by genotype 4 representing 34% then genotype 3 representing14%. Concerning sex distribution and routes of infection, there was a male predominance in intravenous drug users (IVDU), whereas approximately equal distribution was noted in haemodialysis and transfusion groups. A female predominance was noted in the "unknown" mode of infection. Concerning age distribution and routes of infection, a mean age of 27 was noted in the IVDU group, whereas mean age of 60 in the transfusion group and 50 in the haemodialysis group. In patients who acquired the infection post transfusion or during haemodialysis, genotype 1 was the most predominant, whereas in IVDU, genotype 3 was the most predominant. Concerning sub-genotyping: subtype 1b was the most predominant (84%) in genotype 1. in genotype 2 subtype b with 75%, all genotype 3 were subtype a, in genotype 4 subtype a represents 50% of genotype followed by subtype e in 30%. CONCLUSION Our data concerning Lebanese population demonstrate that genotype 1 is the most prevalent genotype followed by genotype 4. In IVU, we noted genotype-3 and -1 being the most prevalent in relation to clustering in this high risk group. This distribution differs from most surrounding countries and all other Arab countries.
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Affiliation(s)
- Antoine Abou Rached
- Lebanese University, School of Medicine, Hadath, Lebanon; Ministry of Public Health, Beirut, Lebanon.
| | - Cesar Yaghi
- Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Leda Khalil
- Lebanese University, School of Medicine, Hadath, Lebanon
| | - Jowana Saba
- Lebanese University, School of Medicine, Hadath, Lebanon
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15
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Rebbani K, Ababou M, Nadifi S, Kandil M, Marchio A, Pineau P, Ezzikouri S, Benjelloun S. Myxovirus resistance 1 gene polymorphisms and outcomes of viral hepatitis B and C infections in Moroccan patients. J Med Virol 2016; 89:647-652. [PMID: 27458866 DOI: 10.1002/jmv.24642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 12/15/2022]
Abstract
Host genetic factors may influence the establishment of chronicity or spontaneous clearance in viral hepatitis B and C infections. More light was shed on the role played by interferon-stimulated genes in the innate immunity. Myxovirus resistance 1 (MX1) is one of those key genes that have reported to inhibit several viruses. The present study aims to explore the possible association of -88G/T and -123C/A promoter variants of MX1 with susceptibility to chronic hepatitis B and C and/or with spontaneous clearance in a Moroccan population. The -88G/T and -123C/A SNPs were genotyped by PCR-RFLP in 538 individuals stratified into HBV chronically infected patients (n = 120), HCV-chronically infected patients (n = 115), HBV spontaneously resolved subjects (n = 114), HCV spontaneously resolved group (n = 52), and healthy controls (n = 137). A significant association of -123C allele with HBV spontaneous clearance has been found (P = 0.002, OR = 2.34; 95%CI [1.36-4]). In addition, a significant correlation between the MX1-GC haplotype and HBV spontaneous clearance (P < 0.001) was found. No significant association of -88G/T and -123C/A polymorphisms with regard to HCV infection was observed in this study. Here, we show that for North African patients with chronic hepatitis, MX1 gene variation at position -123 may influence the outcome of HBV infection but not HCV infection. J. Med. Virol. 89:647-652, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Khadija Rebbani
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc., Casablanca, Morocco
| | - Mostafa Ababou
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc., Casablanca, Morocco
| | - Sellama Nadifi
- Laboratoire de génétique médicale et de pathologie moléculaire, Faculté de Médecine et de Pharmacie, Casablanca, Morocco
| | - Mostafa Kandil
- Equipe d'Anthropogénétique et biotechnologies, Faculté des Sciences, Université Chouaïb Doukkali., El Jadida, Morocco
| | - Agnès Marchio
- Unité «Organisation nucléaire et oncogenèse», INSERM U993, Institut Pasteur, Paris, France
| | - Pascal Pineau
- Unité «Organisation nucléaire et oncogenèse», INSERM U993, Institut Pasteur, Paris, France
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc., Casablanca, Morocco
| | - Soumaya Benjelloun
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc., Casablanca, Morocco
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16
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Riou J, Aït Ahmed M, Blake A, Vozlinsky S, Brichler S, Eholié S, Boëlle PY, Fontanet A. Hepatitis C virus seroprevalence in adults in Africa: a systematic review and meta-analysis. J Viral Hepat 2016; 23:244-55. [PMID: 26477881 DOI: 10.1111/jvh.12481] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 08/27/2015] [Indexed: 12/13/2022]
Abstract
With the introduction of more efficient treatments for hepatitis C virus (HCV), improved epidemiological information is required at the country level to allow evidence-based policymaking for elaboration of national strategies and HCV resources planning. We present a systematic review with meta-analysis of HCV seroprevalence data in adults in African countries. We conducted a systematic review of all HCV seroprevalence estimates reported in African countries from 2000 to 2014 in MEDLINE, AJOL and grey literature. We assessed studies performed in the general population and among blood donors, pregnant women and HIV-positive patients. A meta-regression analysis was used to provide adjusted estimates of HCV seroprevalence in the general adult population in each country, accounting for the heterogeneity in sample age structure and population types in the included studies. We identified 775 national-level estimations, among which 184 were included. Estimates of HCV seroprevalence were produced for 38 countries, in addition to the results from nationwide representative surveys available in Egypt and Libya. Next to Egypt, which clearly stands out, the highest levels of seroprevalence were found in Middle Africa (e.g. Cameroon, Gabon and Angola) and some West African countries (e.g. Burkina Faso, Benin), and the largest absolute numbers of infected adults were found in Nigeria, Ethiopia and Democratic Republic of Congo. This study exposes the diversity of HCV epidemiology among African countries. Egypt and several countries of West and Middle Africa present a HCV burden that will require strong governmental commitment to promote efficient preventive and curative interventions.
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Affiliation(s)
- J Riou
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
| | - M Aït Ahmed
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
| | - A Blake
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
| | - S Vozlinsky
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
| | - S Brichler
- Service de Bactériologie, Virologie, Hygiène, laboratoire associé au Centre National de Référence des Hépatites B, C et Delta, Assitance Publique-Hôpitaux de Paris, Université, Sorbonne Paris Cité, Hôpital Avicenne, Bobigny, France.,INSERM U955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - S Eholié
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - P-Y Boëlle
- Sorbonne Universités, Université Pierre et Marie Curie, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - A Fontanet
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France.,Conservatoire National des Arts et Métiers, Chaire Santé et Développement, Paris, France
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17
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Bensalem A, Selmani K, Hihi N, Bencherifa N, Mostefaoui F, Kerioui C, Pineau P, Debzi N, Berkane S. Eastern region represents a worrying cluster of active hepatitis C in Algeria in 2012. J Med Virol 2016; 88:1394-403. [PMID: 26856380 DOI: 10.1002/jmv.24491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2016] [Indexed: 12/19/2022]
Abstract
Algeria is the largest country of Africa, peopled with populations living a range of traditional/rural and modern/urban lifestyles. The variations of prevalence of chronic active hepatitis care poorly known on the Algerian territory. We conducted a retrospective survey on all patients (n = 998) referred to our institution in 2012 and confirmed by us for an active hepatitis C. Half of the hepatitis C virus (HCV) isolates were genotyped. Forty Algerian regions out of the 48 were represented in our study. Three geographical clusters (Aïn-Temouchent/SidiBelAbbes, Algiers, and a large Eastern region) with an excess of active hepatitis C were observed. Patients coming from the Eastern cluster (Batna, Khenchela, Oum el Bouaghi, and Tebessa) were strongly over-represented (49% of cases, OR = 14.5, P < 0.0001). The hallmarks of Eastern region were an excess of women (65% vs. 46% in the remaining population, P < 0.0001) and the almost exclusive presence of HCV genotype 1 (93% vs. 63%, P = 0.0001). The core of the epidemics was apparently located in Khenchela (odds ratio = 24.6, P < 0.0001). This situation is plausibly connected with nosocomial transmission or traditional practices as scarification (Hijama), piercing or tattooing, very lively in this region. Distinct hepatitis C epidemics are currently affecting Algerian population. The most worrying situation is observed in rural regions located east of Algeria. J. Med. Virol. 88:1394-1403, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Aïcha Bensalem
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Karima Selmani
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Narjes Hihi
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Nesrine Bencherifa
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Fatma Mostefaoui
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Cherif Kerioui
- Laboratoire des Hépatites Virales, Institut Pasteur d'Algérie, Sidi Fredj, Algiers, Algeria
| | - Pascal Pineau
- Unité « Organisation nucléaire et oncogenèse », INSERM U993, Institut Pasteur, Paris, France
| | - Nabil Debzi
- Service d'Hépatologie, CHU Mustapha Bacha, Algiers, Algeria
| | - Saadi Berkane
- Service de Gastro-entérologie, CHU Mustapha Bacha, Algiers, Algeria
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Khyatti M, Trimbitas RD, Zouheir Y, Benani A, El Messaoudi MD, Hemminki K. Infectious diseases in North Africa and North African immigrants to Europe. Eur J Public Health 2015; 24 Suppl 1:47-56. [PMID: 25107998 DOI: 10.1093/eurpub/cku109] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The epidemiological transition has reduced infectious diseases mortality in most European countries, yet increased migrant influx risks importing diseases. All reported prevalence rates must be considered on a case-by-case basis depending on the disease in question, respective European Union (EU) country and migratory patterns at work. Tuberculosis has seen a re-emergence in Europe and is concentrated among migrants. Migrants arriving from North Africa (NA) and sub-Saharan Africa (SSA) carry higher rates of hepatitis C and B than the local EU population. The human immunodeficiency virus (HIV) impact of NA migrants to Europe is very low but a hallmark of the HIV epidemic is the penetration and circulation of non-B strains, recombinant forms and HIV-drug-resistant profiles through SSA migrants using NA as a transit point into Europe. Leishmaniasis is a re-emerging zoonotic disease prevalent to Southern Europe although not specifically isolated in migrant groups. Although not endemic in NA countries, malaria represent S: a risk in terms of re-emergence in Europe through transitory migrants arriving from SSA with the destination to Europe. Schistosomiasis has been largely eliminated from NA. High migrant flux into European countries has resulted in changing patterns of communicable disease and collectively requires a continuous surveillance. World Health Organization guidelines recommend targeted screening and preventative vaccination, followed by integration of migrants into the local health-care systems allowing for long-term treatment and follow-up. Finally, effective public health campaigns as a form of prevention are essential for the mitigation of disease dissemination in the migrant pool and for second-generation children of migrants.
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Affiliation(s)
- Meriem Khyatti
- 1 Laboratory of Onco-Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | | | - Yassine Zouheir
- 1 Laboratory of Onco-Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Abdelouaheb Benani
- 1 Laboratory of Onco-Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | | | - Kari Hemminki
- 2 Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Rebbani K, Marchio A, Ezzikouri S, Afifi R, Kandil M, Bahri O, Triki H, El Feydi AE, Dejean A, Benjelloun S, Pineau P. TP53 R72P polymorphism modulates DNA methylation in hepatocellular carcinoma. Mol Cancer 2015; 14:74. [PMID: 25889455 PMCID: PMC4393630 DOI: 10.1186/s12943-015-0340-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 03/11/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is characterized by widespread epidemiological and molecular heterogeneity. Previous work showed that in the western part of North Africa, a region of low incidence of HCC, mutations are scarce for this tumor type. As epigenetic changes are considered possible surrogates to mutations in human cancers, we decided, thus, to characterize DNA methylation in HCC from North-African patients. METHODS A set of 11 loci was investigated in a series of 45 tumor specimens using methylation-specific and combined-bisulfite restriction assay PCR. Results obtained on clinical samples were subsequently validated in liver cancer cell lines. RESULTS DNA methylation at tumor suppressor loci is significantly higher in samples displaying chromosome instability. More importantly, DNA methylation was significantly higher in Arg/Arg when compared to Pro/Pro genotype carriers at codon 72 rs1042522 of TP53 (65% vs 20% methylated loci, p = 0.0006), a polymorphism already known to affect somatic mutation rate in human carcinomas. In vitro experiments in cell lines indicated that enzymes controlling DNA methylation were differentially regulated by codon 72 Arg or Pro isoforms of p53. Furthermore, the Arg72-carrying version of p53 was shown to re-methylate DNA more rapidly than the pro-harboring isoform. Finally, Pro-carrying cell lines were shown to be significantly more resistant to decitabine treatment (two-fold, p = 0.005). CONCLUSIONS Our data suggest that Arg72Pro polymorphism in a WT p53 context may act as a primary driver of epigenetic changes in HCC. It suggests, in addition, that rs1042522 genotype may predict sensitivity to epigenetic-targeted therapy. This model of liver tumorigenesis that associates low penetrance genetic predisposition to epigenetic changes emerges from a region of low HCC incidence and it may, therefore, apply essentially to population living in similar areas. Surveys on populations submitted to highly mutagenic conditions as perinatally-acquired chronic hepatitis B or aflatoxin B1 exposure remained to be conducted to validate our observations as a general model.
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Affiliation(s)
- Khadija Rebbani
- Unité d'Organisation Nucléaire et Oncogenèse, INSERM U993, Institut Pasteur, 28 rue du Docteur Roux, F-75724, Paris, Cedex 15, France. .,Laboratoire des Hépatites Virales, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20360, Casablanca, Morocco.
| | - Agnès Marchio
- Unité d'Organisation Nucléaire et Oncogenèse, INSERM U993, Institut Pasteur, 28 rue du Docteur Roux, F-75724, Paris, Cedex 15, France.
| | - Sayeh Ezzikouri
- Laboratoire des Hépatites Virales, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20360, Casablanca, Morocco.
| | - Rajaa Afifi
- Service de Médecine C-Gastroentérologie, CHU Ibn-Sina, Rabat, Morocco.
| | - Mostafa Kandil
- Equipe d'Anthropogénétique et de Biotechnologies, Faculté des Sciences Chouaib Doukkali, El Jadida, Morocco.
| | - Olfa Bahri
- Laboratoire de Virologie Clinique, Institut Pasteur de Tunis, Tunis, Tunisie.
| | - Henda Triki
- Laboratoire de Virologie Clinique, Institut Pasteur de Tunis, Tunis, Tunisie.
| | | | - Anne Dejean
- Unité d'Organisation Nucléaire et Oncogenèse, INSERM U993, Institut Pasteur, 28 rue du Docteur Roux, F-75724, Paris, Cedex 15, France.
| | - Soumaya Benjelloun
- Laboratoire des Hépatites Virales, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20360, Casablanca, Morocco.
| | - Pascal Pineau
- Unité d'Organisation Nucléaire et Oncogenèse, INSERM U993, Institut Pasteur, 28 rue du Docteur Roux, F-75724, Paris, Cedex 15, France.
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The epidemiology of hepatitis C virus in the Maghreb region: systematic review and meta-analyses. PLoS One 2015; 10:e0121873. [PMID: 25803848 PMCID: PMC4372394 DOI: 10.1371/journal.pone.0121873] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 02/07/2015] [Indexed: 02/06/2023] Open
Abstract
Objective To systematically review and synthesize available epidemiological data on hepatitis C virus (HCV) prevalence and incidence in the Maghreb region and to estimate the country-specific population-level HCV prevalence. Methods We conducted a systematic review of HCV antibody prevalence and incidence in the Maghreb countries as outlined by the PRISMA guidelines. Meta-analyses were conducted using DerSimonian-Laird random-effect models with inverse variance weighting to pool HCV prevalence estimates among general population groups. Results We identified 133 HCV prevalence measures and two HCV incidence measures. Among high risk groups, HCV prevalence ranged between 22% and 94% among people who inject drugs, 20% and 76% among dialysis patients, and 2% and 51% among hemophiliacs. Among intermediate-risk groups, considerable but widely variable HCV prevalence was found. Most common risk factors cited across studies were the duration of dialysis, number of transfusions, and having a history of surgery or dental work. The national HCV prevalence in Algeria was estimated at 0.3% (95%CI: 0.1–0.5), Libya 1.2% (95%CI: 1.1–1.3), Mauritania 1.1% (95%CI: 0–2.3), Morocco 0.8% (95%CI: 0.5–1.2), and Tunisia 0.6% (95%CI: 0.5–0.8). Conclusions HCV prevalence in the Maghreb region of the Middle East and North Africa is comparable to that in developed countries of about 1%. HCV exposures appear often to be linked to medical care and are suggestive of ongoing transmission in such settings. Injecting drug use appears also to be a major, though not dominant, contributor to HCV transmission. Further research is needed to draw a more thorough understanding of HCV epidemiology, especially in the countries with limited number of studies. HCV prevention policy and programming in these countries should focus on the settings of exposure.
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Daw MA, Shabash A, El-Bouzedi A, Dau AA. Seroprevalence of HBV, HCV & HIV co-infection and risk factors analysis in Tripoli-Libya. PLoS One 2014; 9:e98793. [PMID: 24936655 PMCID: PMC4060988 DOI: 10.1371/journal.pone.0098793] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 05/06/2014] [Indexed: 02/06/2023] Open
Abstract
Background In 1998 Libya experienced a major outbreak of multiple blood borne viral hepatitis and HIV infections. Since then, no studies have been done on the epidemic features and risk factors of HBV, HCV, HIV and co-infection among the general population. Methods A prospective study was carried out using a multi-centre clustering method to collect samples from the general population. The participants were interviewed, and relevant information was collected, including socio-demographic, ethnic, and geographic variables. This information was correlated with the risk factors involved in the transmission of HBV, HCV and HIV. Blood samples were collected and the sera were tested for HBsAg, anti-HCV and anti-HIV using enzyme immunoassay. Results A total of 9,170 participants from the nine districts of Tripoli were enrolled. The average prevalence of HBsAg was 3.7%, anti-HCV 0.9%, anti-HIV 0.15% and co-infection 0.02%. The prevalence varied from one district to another. HBV was more prevalent among those aged over 50 years and was associated with family history. Anti-HCV and anti-HIV were more prevalent among those aged 20–40 years. Intravenous drug use and blood transfusion were the main risk factors for HCV and HIV infection. Conclusion HBV, HCV, HIV and co-infection are relatively common in Libya. High prevalence was associated with geographic, ethnic and socioeconomic variability within the community. HCV and HIV infections among the younger age groups are becoming an alarming issue. Regulations and health care education need to be implemented and longer term follow-up should be planned.
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Affiliation(s)
- Mohamed A. Daw
- Department of Medical Microbiology, Faculty of Medicine, Tripoli, Libya
- Department of Surgery, Tripoli Medical Centre, Faculty of Medicine, Tripoli, Libya
- * E-mail:
| | - Amira Shabash
- Department of Medical Microbiology, Faculty of Medicine, Tripoli, Libya
| | | | - Aghnya A. Dau
- Department of Surgery, Tripoli Medical Centre, Faculty of Medicine, Tripoli, Libya
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