Prior to the Oral Therapy, What Do We Know About HCV-4 in Egypt

Abstract

Hepatitis C virus (HCV) affects over 180 million people worldwide and it's the leading cause of chronic liver diseases and hepatocellular carcinoma. HCV is classified into seven major genotypes and a series of subtypes. In general, HCV genotype 4 (HCV-4) is common in the Middle East and Africa, where it is responsible for more than 80% of HCV infections. Although HCV-4 is the cause of approximately 20% of the 180 million cases of chronic hepatitis C worldwide, it has not been a major subject of research yet. The aim of the current study is to survey the morbidities and disease complications among Egyptian population infected with HCV-4 using data mining advanced computing methods mainly and other complementary statistical analysis.Six thousand six hundred sixty subjects, aged between 17 and 58 years old, from different Egyptian Governorates were screened for HCV infection by ELISA and qualitative PCR. HCV-positive patients were further investigated for the incidence of liver cirrhosis and esophageal varices. Obtained data were analyzed by data mining approach.Among 6660 subjects enrolled in this survey, 1018 patients (15.28%) were HCV-positive. Proportion of infected-males was significantly higher than females; 61.6% versus 38.4% (P = 0.0052). Around two-third of infected-patients (635/1018; 62.4%) were presented with liver cirrhosis. Additionally, approximately half of the cirrhotic patients (301/635; 47.4%) showed degrees of large esophageal varices (LEVs), with higher variceal grade observed in males. Age for esophageal variceal development was 47 ± 1. Data mining analysis yielded esophageal wall thickness (>6.5 mm), determined by conventional U/S, as the only independent predictor for esophageal varices.This study emphasizes the high prevalence of HCV infection among Egyptian population, in particular among males. Egyptians with HCV-4 infection are at a higher risk to develop cirrhotic liver and esophageal varices. Data mining, a new analytic technique in medical field, shed light in this study on the clinical importance of esophageal wall thickness as a useful predictor for risky esophageal varices using decision tree algorithm.

Efficacy and safety of sofosbuvir–ledipasvir for treatment of a cohort of Egyptian patients with chronic hepatitis C genotype 4 infection

“… 3 – 5 In Egypt, 15% of an estimated population of 85 million are HCV positive, of whom >90% are infected with genotype 4 (GT 4). 6 , 7 The rapid emergence of the epidemic in Egypt was initially fueled by the mass treatment of schistosomiasis using the injectable drug tartar emetic at some stage during the 1960s and 1970s. 8 …”

Management of hepatitis C genotype 4 in the directly acting antivirals era

“… 6 The bulk of the G4 disease burden resides in the Middle East, Northern Africa and Sub-Saharan Africa with the largest single G4 population (and arguably the best characterised cohort) residing in Egypt where 15% of an estimated population of 80 million are HCV positive, of which 93% are infected with G4. 6 10 The cause of these high seroprevalence rates are likely multifactorial; however, the widespread use of parenteral antihelminthics to combat schistosomiasis is believed to be predominately responsible for the scale of the epidemic. In 55–59 year olds (a population that is likely to have a higher burden of fibrosis due to the length of infection), the prevalence rate approaches 40%.…”

“…Indeed, a recent study that screened 6600 participants aged between 17 and 58 years of age found 1018 (15.42%) participants positive for HCV, and among these, 62.4% had evidence of liver cirrhosis. 10 Other estimates put the numbers of compensated and decompensated cirrhotics in Egypt at 630 000 and 138 000, respectively. 11 Such a large burden of advanced disease puts a considerable strain on the already overstretched health resources of the country.…”

Association between Acute Coronary Syndrome and Helicobacter Pylori Chronic Infection? What data mining tells us?

“…For our knowledge there is no study have used data mining analysis of such big data related ACS and Pylori, that artificial intelligence of Rapid I used in the current study can find the accurate or possible situation associations, hence according to our results only ACS of long duration of intermittent typical chest pain may becaused by Pylori chronic infection [8][9][10][11][12][13][14][15][16][17][18][19][20]. Data mining is the breakthrough in economy, biology, trading, business, astronomy and medicine [21][22][23]. Data mining can predict disease related-mortality and morbidity that will influence the overall medical progress [24][25][26].…”