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.
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.