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Hepatitis C Virus in the Middle East and North Africa

Its Epidemiology and the Way Forward
  • Hiam ChemaitellyEmail author
  • Sarwat Mahmud
  • Ghina R. Mumtaz
  • Lenka Benova
  • Houssein H. Ayoub
  • Silva P. Kouyoumjian
  • Zaina Al-Kanaani
  • Laith J. Abu-Raddad
Living reference work entry

Abstract

This chapter presents the findings of the Middle East and North Africa (MENA) Hepatitis C Virus (HCV) Epidemiology Synthesis Project, the most comprehensive study on HCV epidemiology in this region to date. MENA is the region most affected by HCV worldwide. Two MENA countries, Egypt and Pakistan, are facing HCV epidemics of historic proportions. HCV prevalence in the rest of MENA is, however, comparable to global levels. About a third of a variety of clinical populations across countries have been exposed to HCV, with populations with high-risk healthcare exposures being particularly affected. Nearly half of people who inject drugs in MENA are also HCV infected. Substantial exposure to HCV infection has been further confirmed in populations with liver-related conditions. Medical care appears to be the primary source of past and current HCV exposures. Injecting drug use seems also to have played a role in the HCV epidemic, though relatively a much smaller role. Other modes of HCV transmission in MENA include mother-to-child transmission and community-related exposures. The molecular epidemiology of HCV in MENA indicated genotype 1 as ubiquitous in most countries. Genotype 3 (centered in Pakistan) and genotype 4 (centered in Egypt), however, account for most chronic HCV infections. Two-thirds of individuals ever exposed to HCV in MENA are chronically infected and in need of treatment. The scale-up of HCV treatment as prevention (TasP) is likely to yield immense and immediate reductions in HCV incidence and chronic infection prevalence, suggesting the feasibility of achieving the World Health Organization HCV elimination goal by 2030. HCV-TasP cost-effectiveness can be further optimized by prioritizing screening and testing for individuals at higher risk of exposure.

Keywords

Hepatitis C virus Middle East North Africa HCV epidemiology HCV infection HCV transmission HCV prevalence HCV incidence HCV genotypes Mother-to-child transmission 

Notes

Acknowledgments

This publication was made possible by NPRP grant number 4-924-3-251 and NPRP grant number 9-040-3-008 from the Qatar National Research Fund (a member of Qatar Foundation). The findings achieved herein are solely the responsibility of the authors. The authors are also grateful for infrastructure support provided by the Biostatistics, Epidemiology, and Biomathematics Research Core at Weill Cornell Medicine-Qatar.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Hiam Chemaitelly
    • 1
    Email author
  • Sarwat Mahmud
    • 1
  • Ghina R. Mumtaz
    • 1
  • Lenka Benova
    • 1
    • 2
  • Houssein H. Ayoub
    • 3
  • Silva P. Kouyoumjian
    • 1
  • Zaina Al-Kanaani
    • 1
  • Laith J. Abu-Raddad
    • 1
    • 4
  1. 1.Infectious Disease Epidemiology Group, Weill Cornell Medicine-QatarCornell University, Qatar Foundation – Education CityDohaQatar
  2. 2.Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
  3. 3.Department of Mathematics, Statistics, and PhysicsQatar UniversityDohaQatar
  4. 4.Department of Healthcare Policy & Research, Weill Cornell MedicineCornell UniversityIthacaUSA

Section editors and affiliations

  • Amal Saad-Hussein
    • 1
  1. 1.Environmental Research Division, Environmental & Occupational Medicine DepartmentNational Research CentreCairoEgypt

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