Published online Sep 28, 2014. doi: 10.3748/wjg.v20.i36.12734
Revised: February 20, 2014
Accepted: May 28, 2014
Published online: September 28, 2014
The Middle East and North Africa (MENA) region has endured several major events of infection parenteral transmission. Recent work has established the utility of using hepatitis C virus (HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus (HIV) parenteral transmission. In this review, we use data on the prevalence of HCV infection antibody (seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission.
Core tip: The Middle East and North Africa (MENA) region has witnessed several major events of parenterally transmitted infections. Recent studies of hepatitis C virus (HCV) epidemiology established the utility of using HCV as a proxy biomarker for assessing the potential for human immunodeficiency virus (HIV) parenteral transmission. Building on these novel ideas, we used HCV antibody prevalence data to assess the potential for substantial and/or sustainable HIV parenteral transmission in MENA. We found that HCV prevalence levels are consistent with limited potential for parenteral HIV transmission, but that there could be still opportunities for localized and isolated HIV outbreaks, particularly in formal and informal healthcare settings.