HCV burden of infection in Egypt: Results from a nationwide survey

Institut Pasteur, Unité d'épidémiologie des maladies émergentes, Paris, France.
Journal of Viral Hepatitis (Impact Factor: 3.91). 08/2012; 19(8):560-7. DOI: 10.1111/j.1365-2893.2011.01576.x
Source: PubMed


Egypt is the country with the largest hepatitis C virus (HCV) epidemic in the world. In 2008, a Demographic Health Survey (DHS) was carried out in Egypt, providing for the first time a unique opportunity for HCV antibody testing on a nationwide representative sample of individuals. Consenting individuals answered a questionnaire on socio-demographic characteristics and iatrogenic exposures, before providing a blood sample for HCV antibody testing by enzyme-linked immunosorbent assay. Factors independently associated with HCV infection were examined through multivariate logistic regression models. Of 12 780 eligible subjects aged 15-59 years, 11 126 (87.1%) agreed to participate and provided a blood sample. HCV antibody prevalence nationwide was 14.7% (95% CI 13.9-15.5%) in this age group. HCV antibody prevalence gradually increased with age, reaching, in the 50-59 years age group, 46.3% and 30.8% in males and females, respectively. It was higher in males compared to females (17.4% versus 12.2%, respectively, P < 0.001), and in rural compared to urban areas (18.3% versus 10.3%, respectively, P < 0.001). In multivariate analysis, age, male sex, poverty, past history of intravenous anti-schistosomiasis treatment, blood transfusion, and living outside of the Frontier Governorates were all significantly associated with an increased risk of HCV infection. In addition, in urban areas, lack of education and being circumcised for females were associated with an increased risk of HCV infection. This study confirmed on a nationwide representative sample the very high HCV antibody prevalence in Egypt. It stresses the urgent need for strengthening prevention efforts, and bringing down the costs of antiviral drugs for countries like Egypt, where the people in the most precarious situations are also those most likely to be infected by the virus.

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    • "In Egypt, over 90% of the hepatitis have been reported to be HCV (Ruane et al., 2015; Wantuck et al., 2014). While for hepatitis B virus, Egypt is also considered as a destination which has an intermediate risk for hepatitis B (van Genderen et al., 2012; Guerra et al., 2012). The spread of hepatitis infection in Egypt occurs through iatrogenic sources as blood transfusions, injections, and dental care (Frank et al., 2000; Darwish et al., 2001). "

    International Journal of Advanced Research 10/2015; · 4.59 Impact Factor
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    • "Hepatitis C virus (HCV) is a major cause of a widespectrum of liver diseases ranging from chronichepatitis to cirrhosis and hepatocellular carcinoma (HCC).It infects almost 3% of the world's population. Egypt has the highest prevalence of HCV worldwide (15%) with genotype-4a accounting for almost 90% of infections (Guerra et al., 2012). Egypt has an estimated annual incidence of HCV about 150,000 cases (Galal et al., 2014). "
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    ABSTRACT: Immunoregulatory cytokines have an influence on hepatitis C virus (HCV) infection outcome. This study aimed to determine whether single nucleotide polymorphisms (SNP) in IFN- γ and IL-10 genes are associated with susceptibility and/or are markers of prognosis regarding chronic hepatitis C outcomes. IFN γ (+874T/A) and IL-10 (-1082G/A) genotypes were determined in 75 HCV genotype 4 patients with different disease severities (chronic hepatitis, n=25, liver cirrhosis and hepatocellular carcinoma (HCC) on top of liver cirrhosis, n=50) and 25 healthy participants using allele-specific polymerase chain reaction. No statistical differences in allele or genotype distributions of IFN γ and IL-10 genes were detected between patients and controls or between patientgroups. No significant difference in the frequency of IL-10 SNP at position -1082 or IFN-γ at position +874T/A was found between chronic HCV genotype 4 and with progression of disease severity in liver cirrhosis or HCC. In conclusion; interferon-γ and interleukin-10 gene polymorphisms are not predictors of disease progression in patients with chronic hepatitis C (Genotype-4).
    Asian Pacific journal of cancer prevention: APJCP 07/2015; 16(12):5025-5030. DOI:10.7314/APJCP.2015.16.12.5025 · 2.51 Impact Factor
    • "Egypt has the highest prevalence of hepatitis C virus (HCV) infection in the world [1]. The prevalence of HCV viremia was estimated to be 7.3% for the year 2013 [2] [3] on the basis of data from the 2008 Egypt Demographic and Health Survey [4]. Egypt also has the greatest number of patients with genotype 4 HCV, more than 90% of those infected or approximately six million people [5]. "
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    ABSTRACT: Egypt has the highest prevalence of chronic hepatitis C virus (HCV) infection in the world, and more than 90% of patients are infected with genotype 4 virus. We evaluated the efficacy and safety of the HCV polymerase inhibitor sofosbuvir in combination with ribavirin in HCV genotype 4 patients in Egypt. Treatment-naïve or treatment-experienced patients with genotype 4 HCV infection (N=103) were randomly assigned to receive either 12 or 24 weeks of sofosbuvir 400 mg and ribavirin 1000-1200 mg daily. Randomization was stratified by prior treatment experience and by presence or absence of cirrhosis. The primary endpoint was the percentage of patients with HCV RNA < 25 IU/mL 12 weeks after therapy (SVR12). Among all patients, 52% had received prior HCV treatment and 17% had cirrhosis at baseline. SVR12 rates were 90% (46/51) with 24 weeks and 77% (40/52) with 12 weeks of sofosbuvir and ribavirin therapy. Patients with cirrhosis at baseline had lower rates of SVR12 (63% 12 weeks, 78% 24 weeks) than those without cirrhosis (80% 12 weeks, 93% 24 weeks). The most common adverse events were fatigue, headache, insomnia, and anemia. Two patients experienced serious adverse events (cerebral ischemia, dyspnea). No adverse events resulted in treatment discontinuation. Sofosbuvir plus ribavirin for 12 or 24 weeks is effective in treating both treatment-naïve and treatment-experienced Egyptian patients with genotype 4 HCV. Copyright © 2015. Published by Elsevier B.V.
    Journal of Hepatology 04/2015; 63(3). DOI:10.1016/j.jhep.2015.04.023 · 11.34 Impact Factor
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