Published August 26, 2021 | Version v1
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Seroprevalence and Genotype Distribution of Hepatitis C Virus in Mogadishu, Somalia: A Comprehensive Study

Creators

  • 1. Department of Infectious Disease and Clinical Microbiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 2. Department of Medical Microbiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 3. Department of Internal Medicine, Gastroenterology, Sancaktepe Şehit Profesör İlhan Varank Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • 4. Department of Medical Microbiology, Gulhane Medical Faculty, University of Health Sciences, Ankara, Turkey.
  • 5. College of Medicine & Health Science, Abrar University, Centre of Liver Disease, SomGastro Clinic, Mogadishu, Somalia.
  • 6. Department of Public Health, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 7. Department of Internal Medicine, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 8. Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
  • 9. Department Medical Biochemistry, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.

Description

Abstract

Liver cancer is the second-most common form of cancer among men in Somalia. However, data on the epidemiology of hepatitis C virus (HCV) infections are limited. This study aimed to examine the basic epidemiological characteristics of HCV infections, in Mogadishu, Somalia. In this study, anti-HCV seropositivity was investigated in participants who applied to a tertiary care hospital in Mogadishu between 2015 and 2019 using an Architect anti-HCV immunoassay. HCV genotype determinations were performed in two different accredited external laboratories located in Turkey. A total of 115,659 tests were included the study reported for 102,601 different individuals and anti-HCV seropositivity were found for 1,447 different patients (1.41%). Seropositivity was found as 0.26% among healthy individuals (20/7,789), which is a subgroup of the study population. Furthermore, seropositivity was found in 0.26% (55/20,784) of individuals under the age of 20 years and 6.2% (424/6,837) of aged >70 years. Finally, seropositivity was significantly more prevalent among men than among women (1.64% and 1.15%, respectively; p<0.0001). Seventy-three HCV genotypes were determined in 71 patients, including Genotype 1a (5.48%), Genotype 1b (10.96%), Genotype 3 (31.5%), Genotype 4 (49.3%), and Genotype 5 (2.74%). Mixed genotypes (Genotypes 3 and 4) were detected in two patients. This study is the most comprehensive epidemiological study carried out in Somalia since the discovery of HCV, and also it is the first study to investigate HCV genotypes among Somali residents. We believe that the data presented herein will contribute to the development of preventive health policies.

Özet

Karaciğer kanseri, Somali'de erkekler arasında en yaygın ikinci kanser türüdür. Ancak, hepatit C virusu (HCV) enfeksiyonlarının epidemiyolojisine ilişkin veriler sınırlıdır. Bu çalışma, Somali Mogadişu’da HCV enfeksiyonlarının temel epidemiyolojik özelliklerini incelemeyi amaçlamıştır. Bu çalışmada 2015-2019 yılları arasında Mogadişu'da üçüncü basamak bir hastaneye başvuran katılımcılarda Architect anti-HCV immunoassay ile anti-HCV seropozitifliği araştırılmıştır. HCV genotip tayinleri Türkiye'de bulunan iki ayrı akredite dış laboratuvarda gerçekleştirilmiştir. Çalışmaya 102.601 farklı birey için rapor edilen toplam 115.659 test dahil edilmiş ve 1.447 farklı hastada (%1.41) anti-HCV seropozitifliği bulunmuştur. Çalışma popülasyonunun bir alt grubu olan sağlıklı bireylerde seropozitiflik %0.26 (20/7.789) olarak bulundu. Seropozitiflik ayrıca 20 yaş altı bireylerde %0.26 (55/20.784) ve 70 yaş üstü bireylerde %6.2 (424/6.837) olarak saptandı. Son olarak, seropozitiflik erkeklerde kadınlara göre anlamlı derecede daha yüksekti (sırasıyla %1.64 ve %1.15; p<0,0001). Genotip 1a (%5.48), Genotip 1b (%10.96), Genotip 3 (%31.5), Genotip 4 (%49.3) ve Genotip 5 (%2.74) olmak üzere 71 hastada 73 HCV genotipi belirlendi. İki hastada çoklu genotip (Genotip 3 ve 4) varlığı tespit edildi. Bu çalışma, HCV'nin keşfinden bu yana Somali'de yürütülen en kapsamlı epidemiyolojik çalışma olup, Somali’de yerleşik halk arasında HCV genotiplerini araştıran ilk çalışmadır. Burada sunulan verilerin koruyucu sağlık politikalarının geliştirilmesine katkı sağlayacağına inanıyoruz.

Notes

Mogadişu, Somali'de Hepatit C Virusu Seroprevalansı ve Genotip Dağılımı: Kapsamlı Bir Çalışma

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References

  • 1. Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, Houghton M. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 1989; 244(4902): 359-62.
  • 2. Cebeci İ, Tanoğlu A, Şahiner F, Özel M, Öncü K, Yazgan Y, et al. Evaluation of the parameters that can be effective on the response to antiviral treatment in patients with chronic hepatitis C. Gulhane Med J 2015; 57(4): 373-7.
  • 3. Zingaretti C, De Francesco R, Abrignani S. Why is it so difficult to develop a hepatitis C virus preventive vaccine? Clin Microbiol Infect 2014; 20 Suppl 5: 103-9.
  • 4. Wilkins T, Akhtar M, Gititu E, Jalluri C, Ramirez J. Diagnosis and Management of Hepatitis C. Am Fam Physician 2015; 91(12): 835-42.
  • 5. World Health Organization (WHO), Geneva, Switzerland. Global Hepatitis Report, 2017. Available at: https://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/ [Accessed November 11, 2020].
  • 6. World Health Organization (WHO), Geneva, Switzerland. Hepatitis C. Available at: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c [Accessed November 11, 2020].
  • 7. Zoulim F, Liang TJ, Gerbes AL, Aghemo A, Deuffic-Burban S, Dusheiko G, et al. Hepatitis C virus treatment in the real world: optimising treatment and access to therapies. Gut 2015; 64(11): 1824-33.
  • 8. Bailey JR, Barnes E, Cox AL. Approaches, Progress, and Challenges to Hepatitis C Vaccine Development. Gastroenterology 2019; 156(2): 418-30.
  • 9. Bartenschlager R, Baumert TF, Bukh J, Houghton M, Lemon SM, Lindenbach BD, et al. Critical challenges and emerging opportunities in hepatitis C virus research in an era of potent antiviral therapy: Considerations for scientists and funding agencies. Virus Res 2018; 248: 53-62.
  • 10. Franco RA, Galbraith JW, Overton ET, Saag MS. Direct-acting antivirals and chronic hepatitis C: towards elimination. Hepatoma Res 2018; 4: 74.
  • 11. WHO. Global health sector strategies on viral hepatitis 2016-2021. Available from: https://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/. [Accessed November 28, 2018].
  • 12. Hill AM, Nath S, Simmons B. The road to elimination of hepatitis C: analysis of cures versus new infections in 91 countries. J Virus Erad 2017; 3(3): 117-23.
  • 13. Cloherty G, Talal A, Coller K, Steinhart C, Hackett J Jr, Dawson G, Rockstroh J, Feld J. Role of Serologic and Molecular Diagnostic Assays in Identification and Management of Hepatitis C Virus Infection. J Clin Microbiol 2016; 54(2): 265-73.
  • 14. Shah H, Bilodeau M, Burak KW, Cooper C, Klein M, Ramji A, et al; Canadian Association for the Study of the Liver. The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver. CMAJ 2018; 190(22): E677-E687.
  • 15. Ha J, Park Y, Kim HS. Signal-to-cutoff ratios of current anti-HCV assays and a suggestion of new algorithm of supplementary testing. Clin Chim Acta 2019; 498: 11-15.
  • 16. Palayew A, Razavi H, Hutchinson SJ, Cooke GS, Lazarus JV. Do the most heavily burdened countries have the right policies to eliminate viral hepatitis B and C? Lancet Gastroenterol Hepatol 2020; 5(10): 948-53.
  • 17. Chaabna K, Kouyoumjian SP, Abu-Raddad LJ. Hepatitis C Virus Epidemiology in Djibouti, Somalia, Sudan, and Yemen: Systematic Review and Meta-Analysis. PLoS One 2016; 11(2): e0149966.
  • 18. Chaabna K, Mohamoud YA, Chemaitelly H, Mumtaz GR, Abu-Raddad LJ. Protocol for a systematic review and meta-analysis of hepatitis C virus (HCV) prevalence and incidence in the Horn of Africa sub-region of the Middle East and North Africa. Syst Rev 2014; 3: 146.
  • 19. World Health Organization (WHO), Geneva, Switzerland. AIDS and sexually transmitted diseases: Epidemiology of hepatitis C virus in the WHO Eastern Mediterranean Region. Available at: http://www.emro.who.int/asd/asd-infocus/epidemiology-of-hepatitis-c-virus-in-the-who-eastern-mediterranean-region.html [Accessed November 13, 2020].
  • 20. Hassan-Kadle MA, Osman MS, Ogurtsov PP. Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study. World J Gastroenterol 2018; 24(34): 3927-57.
  • 21. Şahiner F, Gümral R. Laboratory Diagnosis of Hepatitis C Infections, Difficulties and Current Diagnostic Algorithm. Flora 2020; 25(2): 139-53.
  • 22. Alter MJ, Kuhnert WL, Finelli L; Centers for Disease Control and Prevention. Guidelines for laboratory testing and result reporting of antibody to hepatitis C virus. Centers for Disease Control and Prevention. MMWR Recomm Rep 2003; 52(RR-3): 1-13.
  • 23. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA. Interim U.S. Morbidity and Mortality Weekly Report (MMWR): Testing for HCV Infection: An Update of Guidance for Clinicians and Laboratorians. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6218a5.htm [Accessed November 11, 2020].
  • 24. Kim S, Kim JH, Yoon S, Park YH, Kim HS. Clinical performance evaluation of four automated chemiluminescence immunoassays for hepatitis C virus antibody detection. J Clin Microbiol 2008; 46(12): 3919-23.
  • 25. Shire AM, Sandhu DS, Kaiya JK, Oseini AM, Yang JD, Chaiteerakij R, et al. Viral hepatitis among Somali immigrants in Minnesota: association of hepatitis C with hepatocellular carcinoma. Mayo Clin Proc 2012; 87(1): 17-24.
  • 26. Faustini A, Franco E, Saitto C, Cauletti M, Zaratti L, Papini P, et al. Hepatitis A, B, C and D in a community in Italy of immigrants from NE Africa. J Public Health Med 1994; 16(1): 71-8.
  • 27. Abid K, Quadri R, Veuthey AL, Hadengue A, Negro F. A novel hepatitis C virus (HCV) subtype from Somalia and its classification into HCV clade 3. J Gen Virol 2000; 81(Pt6): 1485-93.
  • 28. Adair R, Nwaneri O. Communicable disease in African immigrants in Minneapolis. Arch Intern Med 1999; 159(1): 83-5.
  • 29. Watts DM, Corwin AL, Omar MA, Hyams KC. Low risk of sexual transmission of hepatitis C virus in Somalia. Trans R Soc Trop Med Hyg 1994; 88(1): 55-6.
  • 30. Elwir S, Anugwom C, Connor EK, Giama NH, Ndzengue A, Menk J, et al. Barriers in Hepatitis C Treatment in Somali Patients in the Direct Acting Antiviral Therapy Era. J Natl Med Assoc 2018; 110(6): 556-9.
  • 31. Tahtabasi M, Mohamud Abdullahi I, Kalayci M, Gedi Ibrahim I, Er S. Cancer Incidence and Distribution at a Tertiary Care Hospital in Somalia from 2017 to 2020: An Initial Report of 1306 Cases. Cancer Manag Res 2020; 12: 8599-611.
  • 32. Bile K, Aden C, Norder H, Magnius L, Lindberg G, Nilsson L. Important role of hepatitis C virus infection as a cause of chronic liver disease in Somalia. Scand J Infect Dis 1993; 25(5): 559-64.
  • 33. World Health Organization (WHO), Geneva, Switzerland. Cancer Today: Estimated age-standardized incidence rates (World) in 2018. Available at: https://gco.iarc.fr/today/home [Accessed November 13, 2020].
  • 34. Daw MA, El-Bouzedi A, Ahmed MO, Dau AA, Agnan MM; In association with the Libyan Study Group of Hepatitis & HIV. Epidemiology of hepatitis C virus and genotype distribution in immigrants crossing to Europe from North and sub-Saharan Africa. Travel Med Infect Dis 2016; 14(5): 517-26.
  • 35. Messina JP, Humphreys I, Flaxman A, Brown A, Cooke GS, Pybus OG, et al. Global distribution and prevalence of hepatitis C virus genotypes. Hepatology 2015; 61(1): 77-87. [Crossref