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.
PIP: 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.