Case-control study of non-Hodgkin's lymphoma and hepatitis C virus infection in Egypt

Cowgill, Karen D.; Loffredo, Christopher A.; Eissa, Saad; Mokhtar, Nadia; Abdel‐Hamid, Mohamed; Fahmy, Ahmed; Strickland, G. Thomas

doi:10.1093/ije/dyh183

Cited by 46 publications

(38 citation statements)

References 33 publications

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“…The number of patients with non‐Hodgkin's lymphoma (NHL) attributed to HCV was based on published data and age‐standardised incidence rates (ASR) of NHL in Egypt 10, 11, 12, 13. The age and gender distribution of NHL was obtained from the Gharbia cancer registry 14.…”

Section: Methodsmentioning

confidence: 99%

Economic burden of hepatitis C in Egypt: the future impact of highly effective therapies

Estes

Abdel-Kareem²,

Abdel-Razek³

et al. 2015

Aliment Pharmacol Ther

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SummaryBackgroundThe prevalence of hepatitis C virus (HCV) infection in Egypt is the highest in the world, yet the total economic burden has not been quantified. Improved understanding of costs and the impact of treatment strategies will provide for better allocation of resources to reduce HCV disease and economic burden.AimA modelling approach was used to quantify the current HCV‐infected population, future disease progression and associated costs in Egypt.MethodsDirect healthcare costs were calculated from a nationally representative hospital and a disability adjusted life year (DALY) template was used with monetary value assigned to lost life years. Three scenarios were considered: (i) Historical treatment scenario: 50% SVR; 65 000 treated annually, (ii) Current treatment scenario: 90% sustained virologic response (SVR); 65 000 treated annually, (iii) Increased treatment scenario: 90% SVR; 325 000 treated annually by 2018.ResultsCumulative DALYs (2015–2030) under Scenario 1 were estimated at 7.88 million and cumulative costs estimated at $89.07 billion. Annual DALYs increased 16% during 2015–2030 while annual costs more than doubled. Scenario 2 reduced cumulative DALYs and costs by 7% and 4%, respectively. Under Scenario 3, total costs declined 73% to $1047 million during 2015–2030. As compared to Scenario 1, cumulative DALYs and costs decreased 37% and 35%, respectively.ConclusionsThis is the first estimate of the total economic burden of HCV in Egypt. Extraordinary measures are necessary to substantially reduce HCV disease and cost burden. With newer therapies, strategies to reduce disease burden are feasible and cost‐effective.

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Section: Methodsmentioning

confidence: 99%

Economic burden of hepatitis C in Egypt: the future impact of highly effective therapies

Estes

Abdel-Kareem²,

Abdel-Razek³

et al. 2015

Aliment Pharmacol Ther

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“…555 Similarly, other studies have not reported increased NHL risk in association with HCV infection, [555][556][557][558][559][560][561] whereas numerous other studies have reported positive associations. 561,[562][563][564][565][566][567][568][569][570][571][572][573][574][575][576][577][578][579] Gisbert et al 580 conducted a meta-analysis of studies that compared the prevalence of HCV infection in B-cell lymphoma cases with that in controls. An excess risk (meta-OR 5 10.82, 95% CI, 7.34-15.94) of NHL was reported across 10 studies that provided odds ratios.…”

Section: Interactions With Environment and Lifestyle Factorsmentioning

confidence: 99%

The non-Hodgkin lymphomas: A review of the epidemiologic literature

et al. 2007

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“…Egyptian patients with NHL were 2.3 times more likely to have HCV-RNA in their sera than matched controls. 33 …”

Section: Magnitude Of Hcv-caused Chronic Liver Disease In Egyptmentioning

confidence: 99%

Liver disease in Egypt: Hepatitis C superseded schistosomiasis as a result of iatrogenic and biological factors

2006

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In Egypt, schistosomiasis was traditionally the most important public health problem and infection with Schistosoma mansoni the major cause of liver disease. From the 1950s until the 1980s, the Egyptian Ministry of Health (MOH) undertook large control campaigns using intravenous tartar emetic, the standard treatment for schistosomiasis, as community-wide therapy. This commendable effort to control a major health problem unfortunately established a very large reservoir of hepatitis C virus (HCV) in the country. By the mid-1980s, the effective oral drug, praziquantel, replaced tartar emetic as treatment for schistosomiasis in the entire country. This both reduced schistosomal transmission and disease and interrupted the "occult" HCV epidemic. It was evident when diagnostic serology became available in the 1990s that HCV had replaced schistosomiasis as the predominant cause of chronic liver disease. Epidemiological studies reported a high prevalence and incidence of HCV, particularly within families in rural areas endemic for schistosomiasis. Clinical studies showed 70% to 90% of patients with chronic hepatitis, cirrhosis, or hepatocellular carcinoma had HCV infections. Co-infections with schistosomiasis caused more severe liver disease than infection with HCV alone. Schistosomiasis was reported to cause an imbalance in HCV-specific T-cell responses leading to increased viral load, a higher probability of HCV chronicity, and more rapid progression of complications in co-infected persons. As complications of HCV usually occur after 20 years of infection, the peak impact of the Egyptian outbreak has not yet occurred. Efforts have been initiated by the Egyptian MOH to prevent new infections and complications of HCV in the estimated 6 million infected persons. (HEPATOLOGY 2006;43:915-922.)

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Case-control study of non-Hodgkin's lymphoma and hepatitis C virus infection in Egypt

Abstract: These data support the hypothesis that NHL is a malignant outcome of chronic HCV infection.

Cited by 46 publications

References 33 publications

Economic burden of hepatitis C in Egypt: the future impact of highly effective therapies

Economic burden of hepatitis C in Egypt: the future impact of highly effective therapies

The non-Hodgkin lymphomas: A review of the epidemiologic literature

Liver disease in Egypt: Hepatitis C superseded schistosomiasis as a result of iatrogenic and biological factors

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