Towards a hepatitis free Egypt: is this achievable?

Doss, Wahid; Hermez, Joumana; Atta, Hoda; Jabbour, Jean

doi:10.26719/2018.24.7.609

Cited by 16 publications

(13 citation statements)

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“…Egypt has the highest HCV burden in the world [ 26 – 28 ]. Since the introduction of DAAs, the Egyptian government has initiated a large campaign under supervision of NCCVH for mass screening and treatment of HCV and put 2030 as an expected end point to announce “Egypt free of HCV.” In the period between 2014 and 2018, about 1.8 million patients have been successfully treated [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Impact of Hepatitis C Virus Eradication on Liver Stiffness in Egyptian Patients

Zakareya

Elhelbawy

Elzohry

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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Background/Objectives. Liver fibrosis is the inevitable end result of chronic hepatitis C (HCV) infection and is responsible for almost all liver-related complications. After the big advancement in therapeutics of HCV, liver fibrosis would expectedly improve after viral clearance. Many studies showed significant improvement of liver fibrosis shortly after successful treatment with direct acting antiviral agents (DAAs); however, the long-term changes have been scarcely addressed in the literature. We aimed to trace dynamical changes in liver stiffness 1, 3, and 5 years after HCV eradication. Methods. Liver stiffness measurements (LSM) have been serially assessed 1, 3, and 5 years after HCV clearance in 655 patients who have been treated with DAAs. Results. The mean age was 51.44 ± 10 years. 73% of patients were males. 48% were cirrhotics. In noncirrhotics, the mean LSM was significantly decreased from 8.29 ± 2.3 kPa to 4.03 ± 1.0 kPa p < 0.0001 at the end of the follow-up. Likewise, LSM decreased in cirrhotics from 29.66 ± 14.25 kPa to 22.50 ± 11.16 kPa p < 0.0001 . The proportions of F1, F2, F3, and F4 patients at the baseline were 17.7%, 17.9%, 16.6%, and 47.8%, which became 56.5%, 4.1%, 4.9%, and 34.5%, respectively, with a substantial reversal of cirrhosis in 87 patients (27.7%) at the end of follow-up. Conclusions. There was an overall significant regression of liver stiffness in all patients after sustained HCV eradication. Liver stiffness reflecting mild fibrosis (F0–F2) usually improves shortly after treatment, while measurements reflecting advanced fibrosis (F3–F4) take a longer time to regress to lower fibrosis stages.

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Section: Discussionmentioning

confidence: 99%

Long-Term Impact of Hepatitis C Virus Eradication on Liver Stiffness in Egyptian Patients

Zakareya

Elhelbawy

Elzohry

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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“…For example, compulsory licenses can allow local production or importation of generic products (31) from other countries for the domestic market without the consent of the patent holder, and against royalty payments; however, this has only been used twice for hepatitis products. (45) Direct negotiations with pharmaceutical and diagnostic companies has enabled reduced prices in Australia, (46) and Egypt (47,48) and others. Ensuring hepatitis C medicines and diagnostics are included in the national Essential Medicines List (EML), (49) and Essential In Vitro Diagnostics List,(50) will be critical as many countries continue to expand their UHC packages.…”

Section: Key Elimination Activitiesmentioning

confidence: 99%

Global hepatitis C elimination: an investment framework

Pedrana

Howell

Scott

et al. 2020

The Lancet Gastroenterology & Hepatology

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“…There are two known types of OCI: seronegative OCI (anti-HCV antibodynegative and serum HCV-RNA-negative); seropositive OCI (anti-HCV antibody-positive and serum HCV-RNA-negative) [2]. Egypt has one of the highest global burdens of HCV infections with estimated prevalence ranges from 4.5% to 6.7% [3]. In a recent meta-analysis based on HCV prevalence and genotype studies, HCV genotypes 1 and 3 were found to be the most common causes of HCV infections worldwide (44% and 25% respectively), but in Egypt genotype 4 was the commonest [4].…”

Section: Introductionmentioning

confidence: 99%

Occult HCV infection in liver transplanted patients: frequency and consequences

Saad¹,

Ghany²,

Khalifa³

et al. 2022

ceh

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Aim of the study: Occult hepatitis C virus (HCV) infection (OCI) is a potential source of relapse after liver transplantation with subsequent graft damage. The aim of the study was to detect OCI in patients with living donor liver transplantation (LDLT) who achieved sustained virological response (SVR) after sofosbuvir-based antiviral treatment, and to detect risk factors associated with the development of OCI as well as to determine the effect of direct acting antiviral (DAA) therapy after liver transplantation. Material and methods: 41 patients with living donor liver transplantation who did not receive DAAs before with recurrent HCV infection who achieved a SVR with sofosbuvir-based therapy for 12-24 weeks were recruited. These patients were tested for OCI by HCV-RNA in peripheral blood mononuclear cells (PBMNCs). Those patients with OCI were followed up every 6 months with alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum HCV-RNA by PCR for 2 years. Results: 92.7% of treated patients achieved HCV SVR 12 weeks. OCI was detected in 4 patients. After follow-up for 18 months, 3 patients continued to have OCI, but one patient presented with progressive elevation of liver enzymes and developed overt HCV infection with positive HCV-RNA PCR in the serum. This patient was retreated with sofosbuvir 400 mg + ledipasvir 90 mg for 12 weeks with resultant negative HCV-RNA PCR in both serum and PBMNCs in addition to normalization of liver enzymes. Conclusions:Occult HCV infection is a potential source of HCV relapse after liver transplantation which should be investigated for in PBMNCs or liver biopsy.

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Towards a hepatitis free Egypt: is this achievable?

Cited by 16 publications

References 0 publications

Long-Term Impact of Hepatitis C Virus Eradication on Liver Stiffness in Egyptian Patients

Long-Term Impact of Hepatitis C Virus Eradication on Liver Stiffness in Egyptian Patients

Global hepatitis C elimination: an investment framework

Occult HCV infection in liver transplanted patients: frequency and consequences

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