Hepatitis C Virus RNA Viremia in Central Africa.To the Editor: Epidemiologic serosurveys have demonstrated high prevalence (6%-15%) of hepatitis C virus
abbr. hepatitis C virus HCV 1 Hepatitis C virus, see there 2. Human coronavirus. See Coronavirus. ) infection in adults in sub-Saharan Africa (1-4). Although possible false-positive HCV serologic test results have been reported in Africa, HCV prevalence rates suggest a high rate of chronic infection among persons with anti-HCV antibodies (5,6). We have focused on HCV RNA RNA: see nucleic acid. RNA in full ribonucleic acid One of the two main types of nucleic acid (the other being DNA), which functions in cellular protein synthesis in all living cells and replaces DNA as the carrier of genetic infectivity of blood from donors attending the National Blood Center in Bangui, Central African Republic Central African Republic, republic (2005 est. pop. 3,800,000), 240,534 sq mi (622,983 sq km), central Africa. The landlocked nation is bordered by Chad (N), Sudan (E), Congo (Kinshasa) and Congo (Brazzaville) (S), and Cameroon (W). . We prospectively tested all blood donors between February and April 1998 for serum anti-HCV antibodies by both an HCV third-generation enzyme-linked immunosorbent assay enzyme-linked immunosorbent assay n. ELISA. Enzyme-linked immunosorbent assay (ELISA) A diagnostic blood test used to screen patients for AIDS or other viruses. (ELISA ELISA (e-li´sah) Enzyme-Linked Immuno-Sorbent Assay; any enzyme immunoassay using an enzyme-labeled immunoreactant and an immunosorbent. ELISA n. ) (Abbott HCV EIA (Electronic Industries Alliance, Arlington, VA, www.eia.org) A membership organization founded in 1924 as the Radio Manufacturing Association. It sets standards for consumer products and electronic components. 3.0 test, Abbott, Chicago, IL, USA), which was chosen as a reference test for immunoglobulin (Ig) G antibodies to HCV, and by a simple membrane immunoassay Immunoassay An assay that quantifies antigen or antibody by immunochemical means. The antigen can be a relatively simple substance such as a drug, or a complex one such as a protein or a virus. system (Ortho HCV Ab Quik Pack, Ortho Diagnostic Systems Inc., Tokyo, Japan) (7). Anti-HCV-positive serum samples were further subjected to qualitative detection of HCV RNA by reverse transcription-polymerase chain reaction (AMPLICOR-HCV, Roche Diagnostic Systems, Inc., Branchburg, NJ, USA) (8). Of 163 serum samples (mean age [+ or -] standard deviation, 30 [+ or -] 8 years), 155 were from male blood donors, 83 (51%) from first-time donors, and 125 (77%) from donors in the recipient's family. Fifteen (9.2%; 95% confidence interval [CI] 5%-15%) samples contained IgG to HCV by ELISA. Of the ELISA-positive samples, 14 were positive by the Quik Pack assay (sensitivity, 93.0%); of the 148 remaining ELISA-negative samples, 147 were negative by the Quik Pack assay (specificity, 99.3%). The agreement between the results of the two methods was 98.7%. Of the 163 samples, 10 (6.1%; CI 95%: 3%-11%) were positive for HCV antibodies (by ELISA and rapid test) and for HCV RNA. We confirmed a high prevalence of HCV-seropositivity among blood donors in Bangui and the subsequent high rate of HCV RNA viremic blood donations. To offset the major risk for transfusion-acquired HCV in Central Africa we recommend screening donated blood for anti-HCV. When laboratory facilities to perform ELISA are not available, the Quik Pack system, a simple reliable method for detecting anti-HCV antibodies in human serum that requires neither complex reagent preparation nor expensive instrumentation, could prove useful. References (1.) Ndumbe PM, Skalsky J. Hepatitis C virus infection in different populations in Cameroon. Scand J Infect Dis 1993;25:689-92. (2.) Xu LZ, Larzul D, Delaporte E, Brechot C, Kremsdorf D. Hepatitis C virus genotype 4 highly prevalent in Central Africa (Gabon). J Gen Virol 1994;75:2393-8. (3.) Fretz C, Jeannel D, Stuyver L, Herve V, Lunel F, Boudifa A, et al. HCV Infection in a rural population of Central African Republic (CAR): evidence for three additional subtypes of genotype 4. J Med Virol 1995;47:435-7. (4.) Pawlotsky JM, Belec L, Gresenguet G, Desforges L, Bouvier Bouvier refers to several things:
(5.) Aceti A, Taliani D. Hepatitis C virus testing in African sera. Ann Intern Med 1992;116:427. (6.) Callahan JD, Constantine NT, Kataaha P, Zhang X, Hyams KC, Bansal J. Second generation hepatitis C virus assays: performance when testing African sera. J Med Virol 1993;41:35-8. (7.) Kodama T, Ichiyama S, Sato K, Nada T, Nakashima N. Evaluation of a membrane filter assay system, Ortho HCV Ab Quik Pack, for detection of anti-hepatitis C virus antibody. J Clin Microbiol 1998;36:1439-40. (8.) Young KKY KKY Kappa Kappa Psi (college band fraternity) , R. Resnick RM, Myers TW. Detection of hepatitis C virus RNA by a combined reverse transcription-polymerase chain reaction assay. J Clin Microbiol 1993;31:882-6. Nicole Cancre,(*) Gerard Gresenguet,([dagger]) Francois-Xavier Mbopi-Keou, ([double dagger]) Alain Kozemaka,([dagger]) Ali Si Mohamed,(*) Mathieu Matta,(*) Jean-Jacques Fournel,([sections]) and Laurent Belec(*) (*) Universite Pierre et Marie Curie Curie (kürē`), family of French scientists. Pierre Curie, 1859–1906, scientist, and his wife, Marie Sklodowska Curie, 1867–1934, chemist and physicist, b. , Hopital Broussais, Paris, France; ([dagger]) Centre National de Transfusion Sanguine, Bangui, Republique Centrafricaine; ([double dagger]) London School of Hygiene and Tropical Medicine, London, United-Kingdom; and ([sections]) Hopital de la Pitie-Salpetriere, Paris, France |
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