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  • Title: Low risk of sexual transmission of hepatitis C virus in Somalia.
    Author: Watts DM, Corwin AL, Omar MA, Hyams KC.
    Journal: Trans R Soc Trop Med Hyg; 1994; 88(1):55-6. PubMed ID: 8154002.
    Abstract:
    The prevalence in Somalia of antibody to hepatitis C virus (anti-HCV) was determined in a survey of 236 female prostitutes, 80 sexually transmitted disease (STD) clinic patients, 79 male soldiers, and 43 tuberculosis patients. Of 98 (22%) serum samples repeatedly anti-HCV reactive by first and second generation enzyme-linked immunosorbent assay kits, only 8 (1.8%) were anti-HCV positive by immunoblot assay (RIBA-2). Anti-HCV seropositivity by immunoblot assay was not associated with any risk group or with positive syphilis serology (found in 18% of subjects) or antibody to human immunodeficiency virus 1 (in 1.4% of subjects). These data indicate that sexual transmission of hepatitis C virus is not common in Somalia among sexually active populations, including female prostitutes and other groups at high risk of STDs and the acquired immune deficiency syndrome. In Somalia in 1990, health workers collected blood samples from 486 people at high risk of sexually transmitted diseases (STDs) and HIV-1 infection, who lived in Mogadishu, Merca, and Chismayu, so the Ministry of Health could determine the prevalence of the antibody to hepatitis C virus (anti-HCV). The population consisted of 236 female prostitutes, 80 STD clinic patients, 79 male soldiers, and 43 tuberculosis patients. 1st and 2nd generation enzyme-linked immunosorbent assays (ELISAs) detected 98 (22%) anti-HCV positive serum samples which were repeatedly positive. Yet, the immunoblot assay (RIBA-2) detected only 8 (1.8%) anti-HCV positive serum samples, suggesting considerable false positive anti-HCV ELISA results. 18% (79) of all subjects tested positive for syphilis, with all but 6 being prostitutes. 30.9% of the prostitutes had syphilis. Prostitutes made up almost all HIV-1 infected subjects (5 of 6), which comprised 1.4% of all study subjects. When the researchers analyzed just the 8 RIBA-2 confirmed anti-HCV positive samples, HCV infection was not associated with age, sex, risk group, positive syphilis serology, or HIV-1 infection. None of the subjects with HCV infection tested positive for HIV-1. Just 3 of the 8 HCV-infected patients tested positive for syphilis. Subjects positive for anti-HCV were older than other study subjects (32 years vs. 28 years). These results show that HCV has a low likelihood of being transmitted sexually among Somalis, even in those populations at high risk of STDs. They also indicate that HIV-1 infection was rather rare in 1990 in Somalia, perhaps due to low trade activity between Somalia and the rest of Africa.
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