Fever Hospitals case-control studies

Analyses of these data were performed on several occasions (2008 (see Figure below), 2010 and 2012). Iatrogenic factors consistently identified in these studies were intravenous injections, intravenous infusions, medical stitches / surgery, and gum treatment (Paez Jimenez et al., PLoS One, 2009; Paez Jimenez et al., Gut, 2010). Risk associated with obstetric procedures was elevated, but of borderline statistical significance due to too few number of cases. Similarly, no association was found with blood transfusion or endoscopy, since very few cases or controls were exposed to these procedures, so that it is unlikely that these procedures would play an important role in HCV spread at the population level due to their relative rarity. Altogether, 30 to 50% of all infections could be attributed to iatrogenic procedures in this study population (the overall contribution of iatrogenic procedures to transmission could be higher, yet we were not able to document all instances). Remarkably, illicit injection drug use (IDU) emerged as an important risk factor, and was quite prevalent (2-3%) in the control population, and on the rise throughout the study period (2002-2012). Finally, illiteracy was consistently found associated with increased risk of HCV infection, a finding also observed in the 2008 DHS study.


Figure risk factors


We were also interested to explore intra-familial transmission, defined as transmission from one family (household) member to another. For this purpose, we tested family members of 100 acute hepatitis C cases. Out of these, 18 had viremic HCV-infected household members. Sequencing of the viral isolates and phylogenetic analysis were possible for 12 of these households. Three married couples were infected with virtually identical sequences. They were all long-married (>15 years) and none of the three recently infected index patients reported any exposure at risk (see Figure below). 


Figure intrafamilial transmission


Main conclusion of these studies: iatrogenic factors, and particularly intravenous injections and infusions were consistently identified as important risk factors for HCV infection in this underprivileged population of Cairo. Intra-familial transmission, i.e. transmission from one family member to another one contributed to 5-10% of all infections. No specific route of transmission could be identified in this context. Illicit injection drug use has become an important risk factor for HCV in Cairo and is on the rise.


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Introduction of Sofosbuvir in Egypt

In July 2014, Gilead and the Egyptian government signed an agreement for a treatment expansion of Sovaldi® (Sofosbuvir). Read more

Scientific Advisory Board Meeting

The Scientific Advisory Board Meeting was held in Paris February 15-16, 2013.

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