Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
Liver Int. 2015 Feb;35(2):489-501. doi: 10.1111/liv.12617. Epub 2014 Jul 8.
BACKGROUND & AIMS: The prevention and control of HCV infection is complex and challenging in terms of describing risk factors and modes of transmission. This meta-analysis was conducted to summarize the best available data on HCV risk factors worldwide and in Egypt.
Through exhaustive literature searches (1989-2013) of HCV risk factors, 357 original eligible articles were included in this study.
The highest detected risk was intravenous drug users (IDUs) (OR = 9.6) followed by HIV infection (OR = 4.9), having an IDU partner (OR = 4.1), HBV infection (OR = 3.5), Caesarean section (CS) (OR = 3.35), blood transfusion (OR = 3.2) and having an HCV+ partner (OR = 3). Organ transplantation, hospital admission, haemodialysis and having a sexually transmitted infection carry 2.96, 2.4, 2.18 and 2 risks of having HCV respectively. Other significant risk factors included poor education, older age, sharing sharp or blunt objects, MSM, tattooing, hijama, body piercing, minor operations and medical procedures. Some risks showed a decrease over the previous decade, including blood transfusion, organ transplantation, IDUs, IDU partner and CS. Others showed rising risks, including having an HCV+ partner, MSM and suffering from STI. In Egypt, male gender, rural residence, acupuncture and receiving parenteral antischistosomal treatment were significant risks, while neither HIV nor HBV were found to carry a risk of HCV infection.
Blood transfusion, organ transplantation, CS, IDUs, haemodialysis, minor operations and medical procedures are established risk factors. Attention and urgent intervention should be given to the sexual route of transmission, as well as that through minor operations and medical procedures.
丙型肝炎病毒（HCV）感染的预防和控制在描述危险因素和传播途径方面较为复杂和具有挑战性。本研究通过荟萃分析对全球和埃及的 HCV 危险因素的最佳可用数据进行了总结。
通过对 HCV 危险因素的全面文献检索（1989-2013 年），本研究纳入了 357 篇原始合格文章。
静脉吸毒者（IDUs）的感染风险最高（OR=9.6），其次是 HIV 感染（OR=4.9）、有 IDU 伴侣（OR=4.1）、HBV 感染（OR=3.5）、剖宫产（OR=3.35）、输血（OR=3.2）和有 HCV+伴侣（OR=3）。器官移植、住院、血液透析和性传播感染分别具有 2.96、2.4、2.18 和 2 倍的 HCV 感染风险。其他重要的危险因素包括教育程度低、年龄较大、共用锐器或钝器、男男性行为（MSM）、纹身、拔罐、身体穿孔、小手术和医疗程序。一些危险因素在过去十年中有所下降，包括输血、器官移植、IDUs、IDU 伴侣和剖宫产。其他危险因素的风险则有所上升，包括有 HCV+伴侣、MSM 和性传播感染。在埃及，男性、农村居住、针灸和接受驱虫治疗是显著的危险因素，而 HIV 和 HBV 均未被发现与 HCV 感染有关。
输血、器官移植、剖宫产、IDUs、血液透析、小手术和医疗程序是确定的危险因素。性传播途径以及小手术和医疗程序途径应该引起重视和紧急干预。
