West African inhabitants have recurrent occasions for exposure to the hepatitis C virus (HCV), according to the findings of a recent review conducted by a team of Loyola University Medical Center and Loyola University Chicago Stritch School of Medicine researchers. The study, “Next-Generation Sequencing Reveals Frequent Opportunities for Exposure to Hepatitis C Virus in Ghana,” was published in the journal Plos ONE.

Although intravaneous drug use is not very common in sub-Saharan Africa, HCV infection is highly prevalent in this region, so the mechanisms for viral transmission are uncertain.

In Ghana, there is a high prevalence of HCV infection among blood donors, suggesting the mechanisms responsible for HCV transmission are sustainable and efficient. Exposures to infected blood and blood products through unsafe injection practices, transfusion of untested blood, unsterile medical and dental procedures, and traditional medical and cosmetic procedures such as scarification are major risk factors for HCV transmission.

West Africa has been noted as the geographic origin of two HCV genotypes, but little is known about the genetic composition of HCV populations in many countries in the region.

“The most intriguing finding from this analysis is the frequency with which these donors have had opportunities to be infected with more than one HCV strain,” the authors said in a news release. “Exposures to infected blood and blood products through traditional circumcision, home birth, tribal scarring and hepatitis B virus co-infection are major risk factors associated with HCV infection among blood donors in Ghana.”

Researchers used conventional and next-generation sequencing (NGS) to identify and genetically illustrate 65 HCV strains circulating among HCV-positive blood donors in Kumasi, Ghana. The team categorized the variants of HCV in genotype 1 and genotype 2, and further confirmed the prevalence of a substantial genetic diversity of HCV-2 in Ghana. Additionally, three cases of co- or super-infections as well as a transmission link between two of these cases were found, suggesting recurrent chances for HCV exposure among blood donors. These findings are consistent with the high prevalence of HCV.

According to the authors, the conditions for an efficient HCV-2 transmission have existed for several centuries, and collectively, these results point to a very long and complex endemic history of HCV-2 in Ghana.