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Abdelwahab Sayed; Hashem, Mohamed; El-Kamary, Samer; Rewisha, Eman; Strickland, G. Thomas; Waked, Imam
JAIDS Journal of Acquired Immune Deficiency Syndromes: January 2016
doi: 10.1097/01.qai.0000479720.15587.03
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To date, there is no licensed Hepatitis C Virus (HCV) vaccine and what constitutes a protective immune response or correlate of protection against HCV infection is still vague. The Egyptian case of HCV is unique with a prevalence of ∼15% among the general population and ∼90 of the isolates belonging to genotype 4. This constitutes a great risk for Egyptian healthcare workers (HCW). The National Liver Institute (NLI) is a teaching hospital that focuses its clinical practice and research on liver diseases with ∼1500 employees. The NLI receives ∼125,000 outpatient visits and admits ∼15,000 patients/year. Over 85% of the adult patients attending the facility have anti-HCV antibodies, and 65%–75% of them are also viremic. HCV spontaneous clearance occurs in 15%–50% of infected subjects indicating that natural resistance to chronic infection exists. The mechanisms behind successful HCV clearance suggest the coordination of multiple arms of the immune system, with cell-mediated immunity (CMI) playing a crucial role in this process. We reported an anti-HCV prevalence of 16.6% among the NLI HCW and 72.1% of them were viremic. HCV incidence was 2.04/1000 person-years and incidence was high (4.8%) among needle-stick injury subjects. Interestingly, >25% of these HCW demonstrated strong HCV multi-specific CMI without viremia or seroconversion, suggesting clearance of low HCV infection(s). IL28B. rs12979860 predicted the outcome of HCV infection among these HCW (p0.05). In conclusion, the Egyptian HCW could be ideal subjects for HCV vaccine trials and correlates of protection could be closely monitored among them.

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