Acute sporadic non-A, non-B hepatitis and blood transfusion in Makkah province, Saudi Arabia

Abstract

Non-A, non-B hepatitis (NANBH) is a disease of worldwide distribution. It represents an important public health problem in terms of morbidity and mortality throughout the world. The present study investigates the association between blood transfusion and acute NANBH and identifies other risk factors for NANBH using a hospital-based case-control study design. By using the first generation anti-HCV test, it also reports the frequency of hepatitis C virus (HCV) infection among acute NANBH cases and describes and compares the characteristics of HCV infection with those of other types of viral hepatitis. Risk factor information questionnaires concerning blood transfusion and other risk factors were completed for 97 acute NANBH cases and 194 controls, 13 years of age and older. After adjusting for both living or travelling into more endemic areas and contact with a jaundiced person, a history of blood transfusion was associated with about a 4-fold increase in risk for acute NANBH. Although this association was statistically nonsignificant, a significant dose-response effect was observed as a 3.5-fold increase in risk per transfusion. The two adjustment variables were the only ones among many risk factors which persisted in showing a significant association with the risk of acquiring acute NANBH throughout the analyses. Antibody to hepatitis C virus was found in 8 of the 97 acute NANBH cases for whom various characteristics including possible risk factors have been defined. In conclusion, commonly recognized risk factors (except parenteral drug abuse) for acquiring various types of viral hepatitis were present in 70% of acute NANBH cases. When compared to controls, NANBH cases did not significantly differ in frequency of parenteral exposures. On the contrary, the enterical route of transmission was more likely in NANBH cases who significantly differed from controls in reporting a history of both living or travelling into more endemic areas, especially the Indian subcontinent, and contact with a jaundiced person. Exposure to persons with subclinical infection or asymptomatic chronic carriers could account for the 30% of cases in which no specific risk factors could be identified. Early identification and implementation of preventive measures to reduce the disease incidence is recommended for high risk groups.