The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis

Abstract

BackgroundEgypt has the highest prevalence of hepatitis C virus (HCV) in the world, estimated nationally at 14.7%. Our study’s objective was to delineate the evidence on the epidemiology of HCV infection among the different population groups in Egypt, and to draw analytical inferences about the nature of HCV transmission in this country.MethodsWe conducted a systematic review of all data on HCV prevalence and incidence in Egypt following PRISMA guidelines. The main sources of data included PubMed and Embase databases. We also used a multivariate regression model to infer the temporal trend of HCV prevalence among the general population and high risk population in Egypt.ResultsWe identified 150 relevant records, four of which were incidence studies. HCV incidence ranged from 0.8 to 6.8 per 1,000 person-years. Overall, HCV prevalence among pregnant women ranged between 5-15%, among blood donors between 5-25%, and among other general population groups between 0-40%. HCV prevalence among multi-transfused patients ranged between 10-55%, among dialysis patients between 50-90%, and among other high risk populations between 10% and 85%. HCV prevalence varied widely among other clinical populations and populations at intermediate risk. Risk factors appear to be parenteral anti-schistosomal therapy, injections, transfusions, and surgical procedures, among others. Results of our time trend analysis suggest that there is no evidence of a statistically significant decline in HCV prevalence over time in both the general population (p-value: 0.215) and high risk population (p-value: 0.426).ConclusionsEgypt is confronted with an HCV disease burden of historical proportions that distinguishes this nation from others. A massive HCV epidemic at the national level must have occurred with substantial transmission still ongoing today. HCV prevention in Egypt must become a national priority. Policymakers, and public health and medical care stakeholders need to introduce and implement further prevention measures targeting the routes of HCV transmission.

Prevalence of hepatitis B and C among some high risk groups in Egyptian children attending Benha University hospital.

“…Our study showed increased HCV seropositivity among males (54.5%), rural areas (90.9%) and low class (63.6%), this agreed with Mohamoud et al, who reported higher HCV prevalence in males [23], also in agreement with Mostafa et al, who demonstrated higher prevalence in rural areas [24].…”

Hepatitis C virus exposure rate among health-care workers in rural Lower Egypt governorates

“…HCV prevalence in Egypt increases strongly with age and indicates uneven geographic distribution, with higher HCV prevalence in rural areas compared to urban settings [2][3][4] and in Lower Egypt compared to the rest of the country. [5,4] The cumulative data [6 -10] showed that Egypt has the largest HCV epidemic in the world and the epidemic is ongoing.…”

“…The origin of HCV epidemic is not clear but thought to be due to the past and ongoing iatrogenic exposure [4,5] in the health-care settings. Direct percutaneous exposure to blood represented the primary route of HCV transmission from patients to healthcare providers.…”

Study of Portal Hemodynamic Changes Using Doppler Ultrasound in Egyptian Cirrhotic Patients with Oesophageal Varices Treated By Band Ligation with or Without Beta Blockers

“…[3] It is now well established that HCV is a global health challenge and a leading cause of liver cirrhosis worldwide, with an estimated 130-170 million chronic infections (2-3% of the global population). [4] Measurement of portal hemodynamics can serve as an important tool in the follow-up of patients undergoing endoscopic and/or pharmacologic intervention for secondary prevention of variceal hemorrhage.…”