A lack of knowledge surrounding the transmission and progression of hepatitis C virus infection in West African countries may be contributing to the spread of the disease, results of a study published in Clinical Infectious Diseases indicate.

“This is a small study conducted at a blood bank in a teaching hospital in Ghana,” explained Jennifer Layden, MD, PhD, of Loyola University in Chicago, Ill., in a press release. “The goal is to further understand whom is affected by hepatitis C and to identify specific next steps in intervention and prevention.”

More than 180 million people have hepatitis C. In developed countries, hepatitis C infection is often transmitted through intravenous (IV) drug use, but this may not be the case in West Africa, noted the investigators.

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“In West Africa, we believe that there are many transmission modes and they are not through IV drug use, but through cultural and every day practices,” said Layden.

Reports that suggest high rates of serologic false positives and low levels of viremia have contributed to uncertainty regarding the burden of active hepatitis C infection, added the investigators.

To identify the level of active infection and risk factors for infection, the scientists recalled 363 past blood donors who were rapid screen assay (RSA) positive (n=180) or RSA negative (n=183) at the time of donation at a teaching hospital in Kumasi, Ghana. The participants underwent repeat blood testing and were answered questionnaires on risk factors.

The frequency of hepatitis C virus active infection ranged from 74.4% to 88% depending on the criteria used to define serologically positive cases. The patients with active disease had biochemical evidence of liver inflammation and median viral loads of 5.7 log copies/mL.

Participants from the northern and upper regions of Ghana had greater risks of infection compared with participants from other areas, reported the researchers.  Additional risk factors included traditional circumcision, home birth, trial scarring, and hepatitis B co-infection.

“These data also suggest that several transmission modes are likely contributing to the current HCV epidemic in Ghana and that the distribution of these practices may result in substantial regional variation in prevalence,” concluded the study authors.


  1. Layden J et al. Clin Infect Dis. 2015; doi: 10.1093/cid/ciu965