Hepatitis C risk score as a tool to identify infected individuals: A demonstration study in Egypt

Abstract

Hepatitis C virus (HCV) infection is a global health challenge. By the end of 2021, WHO estimated that less than quarter of global HCV infections were diagnosed. There is a need for a public health tool that can facilitate identification of infected persons and linking them to testing and treatment. We derived and validated a risk score to identify infected persons in Egypt and provided a demonstration of its utility. The 2008 and 2014 Egypt Demographic and Health Surveys were used to derive two risk scores using multivariable logistic regression. Both scores showed similar dependence on sex, age, and type of place of residence. Both risk scores demonstrated high and similar areas under the curve of 0.77 (95% CI: 0.76-0.78) and 0.78 (95% CI: 0.77-0.80), respectively. For the 2008 Risk Score, sensitivity was 73.7%, specificity was 68.5%, positive predictive value (PPV) was 27.8%, and negative predictive value (NPV) was 94.1%. For the 2014 Risk Score, sensitivity was 64.0%, specificity was 78.2%, PPV was 22.2%, and NPV was 95.7%. Each score was validated by applying it to a different survey database than the one used to derive it. Implementation of HCV risk scores is an effective strategy to identify carriers of HCV infection and to link them to testing and treatment at low cost to national programs.