Towards hepatitis C virus elimination: Egyptian experience, achievements and limitations

Abstract

Worldwide, more than one million people die each year from hepatitis C virus (HCV) related diseases, and over 300 million people are chronically infected with hepatitis B or C. Egypt used to be on the top of the countries with heavy HCV burden. Some countries are making advances in elimination of HCV, yet multiple factors preventing progress; remain for the majority. These factors include lack of global funding sources for treatment, late diagnosis, poor data, and inadequate screening. Treatment of HCV in Egypt has become one of the top national priorities since 2007. Egypt started a national treatment program intending to provide cure for Egyptian HCV-infected patients. Mass HCV treatment program had started using Pegylated interferon and ribavirin between 2007 and 2014. Yet, with the development of highly-effective direct acting antivirals (DAAs) for HCV, elimination of viral hepatitis has become a real possibility. The Egyptian National Committee for the Control of Viral Hepatitis did its best to provide Egyptian HCV patients with DAAs. Egypt adopted a strategy that represents a model of care that could help other countries with high HCV prevalence rate in their battle against HCV. This review covers the effects of HCV management in Egyptian real life settings and the outcome of different treatment protocols. Also, it deals with the current and future strategies for HCV prevention and screening as well as the challenges facing HCV elimination and the prospect of future eradication of HCV.

Modelling the potential prevention benefits of a treat‐all hepatitis C treatment strategy at global, regional and country levels: A modelling study

“…However, PWID comprise only a fraction of the overall HCV burden globally, and a very small fraction of both incidence and prevalence for some countries such as Nigeria. Therefore, any elimination strategy must also target other groups, such as those with a history of receiving blood transfusions, especially in settings with high rates of infection due to nosocomial factors, such as Pakistan and Egypt . Additionally, if HCV prevalence is high among PWID then no infections may be averted from moderate treatment levels among PWID, due to high re‐infection rates.…”

The clinical significance of serum miRNA-224 expression in hepatocellular carcinoma

“…Nevertheless, our study had a few other limitations. Despite the fact that about 92.5% of Egyptian patients are infected with HCV genotype 4 [2] and that genotyping is therefore not routinely done in Egypt, the current study should have conducted a more detailed analysis of the possible relation between serum miRNA-224 and several viral characteristics such as genotypes and HCV viral load.…”

“…According to a national Egyptian health survey in 2015, Egypt possesses one of the highest recorded prevalences of hepatitis C virus (HCV) in the world. Among the 15 to 59-year age group, the prevalence of positive HCV antibodies was 10% and that of positive HCV RNA was 7%, where 92.5% of patients are infected with genotype 4 [1,2]. HCV is one of the main risk factors for developing hepatocellular carcinoma (HCC).…”

The Rising Threat of Hepatocellular Carcinoma in the Middle East and North Africa Region: Results From Global Burden of Disease Study 2017

“…HCV antiviral therapy using direct‐acting antiviral agents is available in most MENA countries . Egypt and Qatar are the pioneer countries on track to achieving the elimination of hepatitis C by 2030 in the MENA region . State‐funded screening and antiviral therapy of hepatitis C in Qatar have resulted in the diagnosis of 4,400 cases between 2010 and 2016 .…”