Hepatitis C infection in Egypt: prevalence, impact and management strategies

Abstract

Hepatitis C virus (HCV) infection is a major public health burden in Egypt, where it bears the highest prevalence rate in the world. Estimates for prevalence are based upon data reported from the 2008 and 2015 Egypt Demographic Health Surveys. In this review, we demonstrate the prevalence results of both surveys and analyze the difference in the results. The overall HCV prevalence is estimated to be declining. However, the clinical impact of chronic HCV infection is expected to grow considerably. A mathematical model shows that by increasing the rate of treatment, the expected number of patients will decline significantly in 2030. The current and expected future burden of chronic HCV infection to the Egyptian economy, including direct and indirect costs due to disability and loss of lives, has been estimated and discussed in this review. The economic burden will continue to grow, but a model shows that the introduction of highly effective therapies will result in a significant reduction in the cumulative total economic burden of HCV by 2030. In recognition of the HCV tremendous health and economic burden, the Egyptian government established the National Committee for Control of Viral Hepatitis to implement an integrated nationwide strategy to provide patient care and ensure global treatment access. This review illustrates the epidemiological and disease burden aspects of HCV in Egypt in addition to introducing the national plan and program for managing HCV, which has been successful so far in treating a large number of patients, with the aim of achieving disease control and eventual elimination in Egypt.

Keywords: HCV burden; hepatitis C in Egypt; prevalence; treatment strategy.

Figure 1

Percent of men and women with hepatitis C antibody by age in Egypt in (A) 2008 and (B) 2015. Abbreviation: HCV, hepatitis C virus.

Figure 2

The age prevalence of anti-HBc and anti-HCV Abs in males and females. Abbreviations: HCV, hepatitis C virus; Abs, antibodies; HBc, Hepatitis B core antibody.

Figure 3

Real-life SVR12 results with different DAA treatment regimens in the Egyptian national program. Note: El Raziky et al and Doss et al., Abbreviations: SVR, sustained virologic response; DAA, direct-acting antivirals; SOF, sofosbuvir; PEG, pegylated interferon; RBV, ribavirin; SMV, simeprevir; DCV, daclatasvir.