Abstract
The seroprevalence of antibody to hepatitis C virus (anti-HCV) and the possible modes of transmission of HCV were investigated in Gizan, southern Saudi Arabia. The sample size chosen to give an adequate estimate of the seroprevalence, about 1500, was based on the assumption that 5% of the population in Gizan were anti-HCV-positive. Sera from 1482 subjects (705 males, 777 females; aged ⩾ 10 years) were initially screened for anti-HCV using a commercial, ubiquitin-based enzyme immunoassay. Repeatedly reactive sera were confirmed positive using second-generation immunoassays. Serum samples were also tested by ELISA for hepatitis B surface antigen (HbsAg) and antibodies to this antigen and to the hepatitis B core antigen. Of the subjects tested, 27 (1·8%) were anti-HCV-positive. Exposure to HCV was generally similar in both sexes, age-prevalence curves for anti-HCV peaking in males aged >49 years (6·2%) and in females aged 40-49 years (5·0%). In the youngest subjects, those aged 10-19 years, the HbsAg carrier rate was significantly higher in males (10·4%) than in females (3·6%). Exposure to the hepatitis B virus was similar in both sexes (31·0% in males v. 28·6% in females). Some 7·4% and 14·8% of the 27 anti-HCV-positive cases had histories of schistosomiasis and blood transfusion, respectively. The corresponding values for the 1455 anti-HCV-negative cases investigated, 1·1% for schistosomiasis and 3·5% for blood transfusion, were much lower. The spouses and other family members of eight anti-HCV-positive index cases were investigated but none was anti-HCV-positive. The results indicate that the prevalence of anti-HCV in the Gizan population was no different from that in other regions of Saudi Arabia and that HCV is mainly community-acquired, the intrafamilial route having little if any role in spreading the virus. In contrast to hepatitis E virus (HEV), the enteric route does not seem to play a major role in transmission of HCV. Efforts should be made to investigate other possible modes of transmission of the virus in the community.