Arafa Naglaa, El Hoseiny Mostafa, Rekacewicz Claire, Bakr Iman, El-Kafrawy Sherif, El Daly Mai, Aoun Saeed, Marzouk Diaa, Mohamed Mostafa K, Fontanet Arnaud
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Hepatol. 2005 Sep;43(3):418-24. doi: 10.1016/j.jhep.2005.03.021.
BACKGROUND/AIMS: To identify patterns of HCV spread in the Nile Delta of Egypt.
Residents in a Nile Delta village were invited to participate in a cohort study of HCV infection. Risk factors for past or current infection were identified at cohort intake using generalized estimated equations models. Attributable fractions were calculated for all independent risk factors.
The prevalence of HCV antibodies increased from 2.7% in those <20 years of age to more than 40% in males aged 40-54 years. The peak in HCV prevalence in the 40-54 year age group corresponds to the aging of the cohort of children infected through schistosomiasis intravenous treatments in the 1960s-70s (accounting for 12.4% of all HCV infections observed today among adults). Following this initial founding event, the HCV epidemic has spread in the community through iatrogenic factors, and particularly injections (37.9% of the overall attributable fraction in adults). In children, however, no iatrogenic factors were associated with increased risk of infection, suggesting a change in the pattern of HCV spread.
While HCV infections in adults could be attributed to iatrogenic factors, and particularly injections, infections in children could not be explained by similar routes of transmission.
背景/目的：确定埃及尼罗河三角洲地区丙型肝炎病毒（HCV）的传播模式。
邀请尼罗河三角洲一个村庄的居民参与一项HCV感染队列研究。在队列入组时，使用广义估计方程模型确定过去或当前感染的危险因素。计算所有独立危险因素的归因分数。
HCV抗体的患病率从20岁以下人群中的2.7%上升至40 - 54岁男性中的40%以上。40 - 54岁年龄组中HCV患病率的峰值与20世纪60 - 70年代通过血吸虫病静脉治疗感染的儿童队列的老龄化相对应（占如今在成年人中观察到的所有HCV感染的12.4%）。在这一初始感染事件之后，HCV疫情通过医源性因素，尤其是注射（占成年人总体归因分数的37.9%）在社区中传播。然而，在儿童中，没有医源性因素与感染风险增加相关，这表明HCV传播模式发生了变化。
虽然成年人中的HCV感染可归因于医源性因素，尤其是注射，但儿童中的感染无法用类似的传播途径来解释。
