Hepatitis C virus in Zimbabwe.

BACKGROUND

Hepatitis B is a common cause of chronic liver disease in Zimbabwe but other viral infections are also important. The prevalence of viral hepatitis C has not been previously described in healthy rural Zimbabwean adults.

OBJECTIVES

To determine the prevalence of seropositivity to hepatitis C in rural healthy adults in Zimbabwe, and to determine if there is evidence of active liver disease in subjects who are seropositive.

STUDY

DESIGN

Cross sectional descriptive study.

SETTING

Rural communities around different parts of Zimbabwe, as part of a larger study into the prevalence and genetic pattern of iron overload.

SUBJECTS: An initial 150 rural Zimbabweans over the age of 12 years.

MAIN OUTCOME MEASURES: Presence of the following serological markers: hepatitis B surface antigen; antibodies to hepatitis C, B surface and B core antigens; hepatic enzymes and iron status determined on the basis of serum ferritin and transferrin saturation.

RESULTS

11 (7.7%) of the subjects were positive for antibodies to hepatitis C and they had significant elevations in hepatic enzymes and serum iron levels suggesting substantial hepatocellular damage. Twenty (14.1%) of the subjects were positive for hepatitis B surface antigen, but they did not have significant elevations in hepatic enzymes or indirect measures of iron status.

CONCLUSION

Seropositivity for hepatitis C is common and is approximately half the prevalence of hepatitis B chronic carrier status. Chronic hepatitis C may be more damaging to the liver than chronic hepatitis B and, therefore, may be an important cause of liver disease in rural Zimbabwe.