Background. Egypt has the highest prevalence of HCV infection worldwide. (is project aimed at identifying the role of HCV
transmission among household contacts to index cases in the persistent high incidence of HCV infection in Egypt. Methods. (is
cross-sectional study recruited 70 Egyptian cases with chronic liver diseases and their household contacts (140 contacts) from
Qalubeyia Governorate. An interview questionnaire was used to collect information on sociodemographic characteristics and risk
factors to HCV infection. HCV-RNA was tested using real-time polymerase chain reaction (PCR). Univariate and multivariate
analyses were carried out to estimate the risk of HCV infection among contacts. Results. HCV viremia was detected in 85.7% of cases
and 20% of contacts. HCV-RNA was detected in higher proportion of household contacts to cases than the general population.
Contacts to HCV-positive cases were unlikely exposed to used syringe (P � 0.02) and unlikely to have history of Bilharziasis
(P � 0.001) compared to contacts to HCV-negative cases. HCV-positive contacts were more likely older (P < 0.001) and married
(P � 0.008) and had higher crowding index (P � 0.04) than HCV-negative contacts. Also, HCV-positive contacts were more likely
exposed to blood transfusion (P � 0.008) and shaving at community barber (P � 0.04) and had history of Bilharziasis (P � 0.01).(e
strongest predictors for HCV infection among contacts were old age (OR, 95% CI: 1.08, 1.02 to 1.15; P � 0.01) and blood transfusion
(8.08, 1.75 to 37.3; P � 0.007). Conclusion. Nonetheless, household contacts to HCV cases are exposed to increased risk of HCV
infection, and environmental exposure particularly blood transfusion remained a major source of HCV infection.