The emergence of hepatitis C virus (HCV) and its associated sequelae in Africa is a cause for significant concern. Human immunodeficiency virus (HIV) positive patients are at an increased risk of contracting HCV infection due to similar risk factors and modes of transmission. We investigated the seroprevalence of hepatitis C in hospitalized HIV-positive and HIV-negative patients in Mulago Hospital, an academic hospital in Uganda. Blood samples were first tested for HCV antibodies, and positive tests were confirmed with HCV RNA PCR. We enrolled five hundred patients, half HIV-positive and half HIV negative. Overall, 13/500 patients (2.6%) tested positive for HCV antibodies. There was no difference in HCV antibody detection among HIV-positive and HIV-negative patients. Out of all risk factors examined, only an age greater than 50 years was associated with HCV infection. Traditional risk factors for concurrent HIV and HCV transmission, such as intravenous drug use, were exceedingly rare in Uganda. Only 3 of 13 patients with detectable HCV antibodies were confirmed by HCV RNA detection. This result concurs with recent studies noting poor performance of HCV antibody testing when using African sera. These tests should be validated in the local population before implementation. 1. Background Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality worldwide; however, the prevalence and burden of HCV in sub-Saharan Africa have received little attention. World Health Organization data gathered from more than 130 countries estimated that more than 170 million people are currently infected with HCV, contributing to a worldwide prevalence of 3% [1]. The prevalence of HCV infection in the general population in sub-Saharan Africa is estimated at 3% to 5.3% [2].Despite this high prevalence, active surveillance for HCV is rarely performed. This is due partly to resource constraints, unreliability of available serological tests, the high cost of nucleic acid testing (PCR) and confirmatory testing, and unaffordable cost of treatment [3, 4]. Studies of HCV prevalence in Uganda have yielded inconsistent results [5]. The earliest study showed a 2.5% prevalence by antibody testing. Two studies of HCV in HIV-infected patients gave an HCV prevalence of 0.6% and 2.9% [6, 7]. However, none of these studies confirmed antibody positivity by testing for HCV RNA or a recombinant immunoblot assay (RIBA). A study of Ugandan blood donors reported an initial HCV antibody prevalence of 4.0%, but only 0.6% after RIBA confirmation [3].Another study among
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