Prevalence and Risk Factors for Transmission and Genotype of HCV in Iraqi Patients

BACKGROUND: Hepatitis C virus (HCV) infection is a serious public health problem in the world, and about 170 million patients are chronically infected with HCV. Worldwide; different epidemiologic patterns of HCV infection have been identified.

AIM OF THE STUDY: By this study, we try to know the prevalence and risk factors for HCV transmission in Iraqi patients and genotype distribution of the disease.

PATIENTS & METHODS: In a cross sectional study of 355898 persons, 232645 males & 123253 females; had been enrolled for the study in Baghdad teaching hospital, Iraqi blood bank, Al-Yarmouk teaching hospital, Al-Nu'man teaching Hospital and Al-Basrah teaching hospital from February 2017 to February 2019. Positive patients for hepatitis C antibody were further studied for way of transmission and viral load and genotype. History had been taken about the possible risk factor for HCV transmission which included (15) risk factors.

RESULTS: A total of 355898 persons, 232645 males & 123253 females their Mean age at diagnosis was 47.3 (± 15.6) years, Ranged (19–78) years. The mean body mass index (BMI) of the study sample was 22.9 (± 3) kg/m2, studied all screen for hepatitis C antibody 1155 discovered to be positive 650 were males and 505 were females, further study done for viral load in 746 patients and genotype in 633 patients: 356 (48%) with high viral load, 390 (52%)with low viral load and 345 (52.8%) with genotype V and 301 (46.2%) with genotype IV, while genotype II was 2 (0.3%) and III 7 (0.5%), The most common possible ways of transmission of the disease by history in this study was blood transfusion 53%, dental procedure 42%, hemodialysis 36%, caesarean section 34.5%, while injured male during shaving 33%, patient who have surgical operation 24%, Tattooing in 8%, cupping in 6.6%, IV injection in 4% heterosexual seen in 2%, renal transplant in 2%, and only 1% in needle stick injury. while the more frequent genotype is 1 then 4. Hemodialysis and improper use of IV medication had been found to be more significant in HCV male patients .The relation between possible risk factor for transmission of HCV and residence, viral load were not significant.

CONCLUSION: The most common probable risk factors as single risk factor for the male was blood transfusion, and for female was caesarean section. While for two risk factors for male were Blood transfusion and Hemodialysis and for female were Caesarean section & Dental procedure and for both gender were hemodialysis & dental procedure.

While for three risk factors for both gender were surgery, barbers, and dental procedure. In our study we had found the prevalence of HCV in our Iraqi big sample was relatively low. The most common genotype was genotype I then genotype IV with rarity of genotype III 0 and genotype II.