Hepatitis C rates in Egypt now score among the highest in the world, following the release of new figures showing that at least five million residents have contracted the disease.
The findings show the country has outstripped the Eastern Mediterranean’s soaring rates of infection, claim Egypt’s newly formed National Hepatitis Committee, warning the high numbers need the urgent attention of policy-makers.
“The annual infection rate is more than 70,000 new cases, of which at least 35,000 have chronic hepatitis C,” said Dr Manal el-Sayed, committee member and professor of paediatrics at Cairo’s Ain Shams University. “By the year 2020 we are going to have so many patients who have liver failure and liver cancer. Treating them now is surely more effective than leaving them to that outcome.”
Egypt has one of the highest documented rates of hepatitis C virus (HCV), accompanied by high morbidity and mortality from chronic liver disease, cirrhosis, and hepatocellular carcinoma. An estimated 10-15% of the population, some 8-10 million people, are anti-HCV positive. Five million of those are actively infected, according to government figures.
According to the World Health Organisation, Egypt’s high incidence of HCV is largely the legacy of government campaigns prior to 1980 to treat rural populations for schistosomiasis. The treatment campaigns, which involved repeated injections, did not follow recommended hygiene standards and spread blood-borne HCV throughout the population. As HCV carriers can remain asymptomatic for up to 30 years, the full extent of the problem has only recently come to light.
“The Ministry treated people in the villages without using disposable syringes,” said Dr Amr Kandeel, director of the Communicable Disease Department at the Egyptian Ministry of Health and Population. “Now the main risk factor [for HCV] is treatment in the past for schistosomiasis.”
The National Hepatitis Committee is hopeful that the alarming figures will highlight the need for better methods of prevention and improve access to treatment. Treatment typically consists of a course of interferon. However, up to 90% of HCV in Egypt is genotype 4a, which has an estimated 40% resistance to the drug.
A second barrier is the financial burden of treatment. The Committee estimates that of the five million people actively infected with the virus, more than one million currently need treatment. A year’s treatment for a person costs up to US $4,500- a sum few can afford. Through fundraising efforts, el-Sayed said, the Committee hopes to provide free treatment to those most in need. “However, we would also like to appeal to the international community to help with this campaign by whatever means possible,” he adds.
Due to the cost and difficulty of treating chronic HCV patients, better preventive and detection strategies are vital, el-Sayed continues.
“We are going to promote screening for high-risk populations, including healthcare professionals who are at risk from needle injuries, and those who are undergoing repeated blood transfusion treatment,” he said.
As part of its Unite for Children, Unite Against Aids campaign, UNICEF Egypt has also been trying to raise awareness of the more common dangers of contracting HCV. Changing people’s behaviour and attitudes toward blood safety is key, according to Wessam el-Beih, UNICEF’s Unite Against Aids Egypt coordinator.
“Many people share razors and re-use syringes. So there is a big behavioural component to the plan,” she said.
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