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IJE Advance Access published online on January 12, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyh370
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IJE © International Epidemiological Association 2004; all rights reserved.
Accepted September 14, 2004

Original paper

Estimation of the risk of transmission of hepatitis C between spouses in Egypt based on seroprevalence data

Laurence S. Magder 1*, Alan D. Fix 1, Nabiel N. H. Mikhail 2, Mostafa K. Mohamed 3, Mohamed Abdel-Hamid 4, Fatma Abdel-Aziz 5, Ahmed Medhat 6, and G. Thomas Strickland 1

1 Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
2 National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; Assiut University Cancer Institute, Assiut, Egypt
3 National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
4 Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
5 Center for Field and Applied Research, Qalubyia, Egypt
6 Assiut University Faculty of Medicine, Assiut, Egypt

* To whom correspondence should be addressed.
Laurence S. Magder, E-mail: lmagder{at}epi.umaryland.edu


  Abstract

Background Transmission of hepatitis C virus (HCV) between spouses could be due to sexual contact, sharing needles, or other routes. There is uncertainty regarding the degree to which HCV is transmitted between spouses.

Methods Data from a 1997 cross-sectional serological survey of HCV in two communities in Egypt were used to estimate the risk of transmission between spouses by simultaneously modelling the probabilities of community acquisition and spousal transmission of HCV as functions of known predictors.

Results We estimate that the probability of wife-to-husband transmission was 34% (95% CI: 15-49%) and 10% (95% CI: 0-26%) for anti-HCV-positive wives with and without detectable HCV RNA, respectively. The probability of husband-to-wife transmission was estimated to be 3% (95% CI: 0-13%) and 0% (95% CI: 0-9%) for husbands with and without detectable HCV RNA, respectively, at the time of the survey. There was moderate evidence that the probability of wife-to-husband transmission differed from that of husband-to-wife transmission (P = 0.076), and there was greater risk of transmission from those with detectable RNA at the time of the survey (P = 0.046). We estimate that 6% of those infected acquired HCV from their spouse.

Conclusion Our study results support the possibility that HCV is transmitted between spouses in Egypt. Further research is needed to identify the exact routes of transmission so that preventive measures can be instituted.

Keywords: Disease transmission; Egypt; hepatitis C virus; partner studies; sexually transmitted diseases.
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