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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Active surveillance for acute viral hepatitis in rural villages in the Nile Delta
Clinical Infectious Diseases, Volume 42, No. 5, Year 2006
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Description
Background. Acute viral hepatitis is less frequent in Egypt than serum antibody levels suggest. Because acute viral hepatitis has a wide clinical spectrum, we tested the hypothesis that many cases are undetected because of mild illness caused by initial, early-childhood exposure to hepatitis viruses. Methods. During active case detection among 20,000 inhabitants of rural villages in Egypt, we screened 1715 symptomatic patients for serum alanine aminotransferase (ALT) levels. Viral hepatitis markers were tested in 47 subjects who had ALT levels that were least twice the normal level. Results. Of the 47 individuals tested, 4 children aged 3-5 years had immunoglobulin M (IgM) antibodies to hepatitis A virus (anti-HAV IgM). One also had a possible false-positive result to a test for IgM antibodies to hepatitis E virus. None had serological evidence of acute hepatitis B virus (HBV) infection or hepatitis C virus (HCV) infection. However, 33 of the remaining 43 had active HCV infection, having both antibodies to HCV (anti-HCV) and HCV RNA. Four others anti-HCV without HCV RNA, and 2 others had seroconversion to anti-HCV during follow-up. Two patients who were positive for hepatitis B surface antigen had chronic HBV infection. Only 3 with elevated ALT levels had no evidence of acute or chronic infections with known hepatitis viruses. Immunoglobulin G antibodies to hepatitis E virus was detected in 40 patients. Conclusion. Active surveillance covering ∼50,000 person-years detected only 4 cases of acute HAV infection. Almost all persons with mild symptoms and elevated ALT levels had serological evidence of chronic viral hepatitis, most often associated with HCV. Many of these cases were probably "flare-ups" of HCV infection or incidental illness in patients with chronic HCV infection, but some could have been caused by difficult-to-confirm initial HCV infections. Although serological evidence for exposures was highly prevalent, hepatitis viruses seldom caused acute viral hepatitis in these communities. © 2006 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Meky, Fatma A.
Egypt, Cairo
Ain Shams University
Egypt, Cairo
National Hepatology and Tropical Medicine Research Institute
Stoszek, Sonia Karolina
United States, Baltimore
University of Maryland School of Medicine
Abdel-Hamid, Mohamed A.
Egypt, Cairo
National Hepatology and Tropical Medicine Research Institute
United States, Baltimore
University of Maryland School of Medicine
Selim, Sahar M.
Egypt, Menofia
National Liver Institute
Abdel-Wahab, Ayman
Egypt, Menofia
National Liver Institute
NNH Mikhail, Nabiel N.H.
Egypt, Cairo
National Hepatology and Tropical Medicine Research Institute
A El-Kafrawy, Sherif Aly
Egypt, Cairo
National Hepatology and Tropical Medicine Research Institute
Egypt, Menofia
National Liver Institute
El-Daly, Maï Mohamed
Egypt, Cairo
National Hepatology and Tropical Medicine Research Institute
Egypt, Menofia
National Liver Institute
Abdel-Aziz, Fatma
Egypt
Center for Field and Applied Research
Sharaf, Soraya A.
Egypt, Menofia
National Liver Institute
Mohamed, Mostafa K.
Egypt, Cairo
Ain Shams University
Engle, Ronald E.
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Emerson, Suzanne U.
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Purcell, Robert H.
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Fix, Alan D.
United States, Baltimore
University of Maryland School of Medicine
Strickland, George Thomas
United States, Baltimore
University of Maryland School of Medicine
Statistics
Citations: 62
Authors: 16
Affiliations: 6
Identifiers
Doi:
10.1086/500133
ISSN:
10584838
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Egypt