Sero-Molecular Epidemiology and Risk Factors of Viral Hepatitis in Urban Yemen

Abstract

Viral hepatitis is an acute or chronic neglected disease that affects predominantly the liver. This study aimed to determine the sero prevalence and risk factors for viral hepatitis and HCV genotypes in urban areas of Yemen. In a prospective, cross-sectional, analytical and community-based study and following informed consent, 501 volunteers were randomly recruited. Demographic and clinical data was collected. Screening for HBV, HDV and HCV was carried out using ELISA. HBV/HCV viral loads and HCV genotyping were carried out using COBAS TaqMan48 Analyzer (Roche Diagnostics Gmbh, Germany). The mean age of study population was 25.9±10.6 years with a male: female ratio of 1. HBV sero prevalence was similar in Sana'a, Taiz and Aden (p = 0.2). Evidence of past HBV infection was significantly high in Aden and Taiz (14.1 and 18.8%, respectively) compared to Sana’a (5.4%) (p = 0.002). HBV DNA Viral loads were widely variable (1350 and 6320 copies mLG). HCV sero prevalence was low and not significantly different in the study cities (p = 0.4). HCV Viral loads were widely variable between samples (657300-1630000 copies mLG). HCV Genotypes 4 and 1a were the most predominant genotypes. Blood transfusion (19%), renal dialysis (18.6%), history of cupping (18.1%), surgical operation (17.4%) and dental treatment (15.4%) were the most common risk factors for HBV and HCV sero reactivity. In conclusion, HBV sero prevalence is variable among different geographical areas in Yemen. Past exposure to HBV is high. Blood transfusion and contaminated surgical instruments are important infection risks for viral hepatitis. HCV genotypes 4 and 1a are the most prevalent.