Hepatitis C Virus in North Africa: An Emerging Threat

Hepatitis C virus is a major public health threat associated with serious clinical consequences worldwide. North Africa is a unique region composed of seven countries that vary considerably in the predisposing factors to microbial diseases both historically and at the present time. The dynamics of HCV in the region are not well documented. The data are both limited and controversial in most of the countries in the region. In North Africa, the epidemiology of HCV is disparate and understanding it has been hampered by regional “epidemiological homogeneity” concepts. As the dynamics of HCV vary from country to country, context-specific research is needed. In this review, we assess studies performed in each country in the general populations as well as among blood donors and groups exposed to the HCV infection. The reported prevalence of HCV ranges from 0.6% to 8.4% in the Maghreb countries and is predominated by genotype 1. In the Nile valley region, it ranges from 2.2% to 18.9% and is dominated by genotype 4. In North African countries, HCV seems to be a serious problem that is driven by different vectors even in different geographical locations within the same country. Efforts should be combined at both the national and regional levels to implement efficient preventive and treatment strategies.

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Epidemiology of hepatitis C virus among hemodialysis patients in the Middle East and North Africa: systematic syntheses, meta-analyses, and meta-regressions

Epidemiology and Infection ◽

10.1017/s0950268817002242 ◽

2017 ◽

Vol 145 (15) ◽

pp. 3243-3263 ◽

Cited By ~ 10

Author(s):

M. HARFOUCHE ◽

H. CHEMAITELLY ◽

S. MAHMUD ◽

K. CHAABNA ◽

S. P. KOUYOUMJIAN ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Middle East ◽

Data Collection ◽

North Africa ◽

Genotype 4 ◽

Hcv Prevalence ◽

Genotype 2 ◽

Hcv Antibody ◽

Meta Analyses

SUMMARYWe aimed to investigate hepatitis C virus (HCV) epidemiology among hemodialysis (HD) patients in the Middle East and North Africa (MENA). Our data source was an HCV biological measures database populated through systematic literature searches. Descriptive epidemiologic syntheses, effects meta-analyses and meta-regressions, and genotype analyses were conducted. We analyzed 289 studies, including 106 463 HD patients. HCV incidence ranged between 0 and 100% as seroconversion risk, and between 0 and 14·7 per 1000 person-years as incidence rate. The regional pooled mean estimate was 29·2% (95% CI: 25·6–32·8%) for HCV antibody positive prevalence and 63·0% (95% CI: 55·4–70·3%) for the viremic rate. Region within MENA, country income group, and year of data collection were associated with HCV prevalence; year of data collection adjusted odds ratio was 0·92 (95% CI: 0·90–0·95). Genotype diversity varied across countries with four genotypes documented regionally: genotype 1 (39·3%), genotype 2 (5·7%), genotype 3 (29·6%), and genotype 4 (25·4%). Our findings showed that one-third of HD patients are HCV antibody positive and one-fifth are chronic carriers and can transmit the infection. However, HCV prevalence is declining. In context of growing HD patient population and increasing HCV treatment availability, it is critical to improve standards of infection control in dialysis and expand treatment coverage.

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Sofosbuvir Plus Daclatasvir in Treatment of Chronic Hepatitis C Genotype 4 Infection in a Cohort of Egyptian Patients: An Experiment the Size of Egyptian Village

International Journal of Hepatology ◽

10.1155/2018/9616234 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 18

Author(s):

Ossama Ashraf Ahmed ◽

Eslam Safwat ◽

Mohamed Omar Khalifa ◽

Ahmed I. Elshafie ◽

Mohamed Hassan Ahmed Fouad ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Adverse Events ◽

Chronic Hepatitis C ◽

Sustained Virologic Response ◽

Virologic Response ◽

World Health ◽

Genotype 4 ◽

Positive Results

Background and Aims. As indicated by the World Health Organization (WHO), Egypt is positioned as the country with the world’s highest prevalence of Hepatitis C virus (HCV). HCV is transmitted through unexamined blood transfusions, different employments of syringes, and poor cleansing, as per the WHO. Our study aimed at screening and management of chronic hepatitis C genotype 4 infected patients in Bardeen village, Sharkeya Governorate, Egypt, with Sofosbuvir plus Daclatasvir, as well as estimating the safety and efficacy of that regimen. Methods. Screening of adult patients in Bardeen village was done from March 2016 till November 2016 using hepatitis C virus antibodies by third-generation ELISA testing. Positive results were confirmed by PCR. Patients eligible for treatment received Sofosbuvir 400 mg and Daclatasvir 60 mg daily for 12 weeks and were assessed for sustained virologic response at 12 weeks following the end of treatment (SVR 12). Results. Out of 2047 subjects screened for hepatitis C virus, 249 (12.2%) showed positive results. 221 out of those 249 subjects (88.7%) had detectable RNA by PCR. Treatment of eligible patients (183 patients) with Sofosbuvir plus Daclatasvir for 12 weeks resulted in 96% achievement of sustained virologic response at week 12. Adverse events were tolerable. Conclusion. Sofosbuvir plus Daclatasvir regimen is safe and effective for treatment of chronic hepatitis C Genotype 4 infected patients with minimal adverse events. HCV eradication program implemented in Egypt can be a model for other countries with HCV and limited resources. The availability of generic drugs in Egypt will help much in eradication of the virus.

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IL‐28β gene polymorphism determines virological response to PEGylated interferon therapy in hepatitis C virus genotype 4 Egyptian patients

Journal of Cellular Biochemistry ◽

10.1002/jcb.28096 ◽

2018 ◽

Vol 120 (5) ◽

pp. 8154-8159 ◽

Cited By ~ 2

Author(s):

Nashwa El‐Khazragy ◽

Naglaa El Sayed ◽

Ahmed M. Salem ◽

Nahla S. Hassan ◽

Amal Tohamy Abdelmoeaz ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Gene Polymorphism ◽

Virological Response ◽

Interferon Therapy ◽

Pegylated Interferon ◽

Virus Genotype ◽

Genotype 4 ◽

Egyptian Patients

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Evaluation of treatment strategies for patients with hepatitis C virus 1B infection using Japanese health utilities index

Gastroenterology ◽

10.1016/s0016-5085(00)81784-9 ◽

2000 ◽

Vol 118 (4) ◽

pp. A1470-A1471

Author(s):

Hisashi Moriguchi ◽

Nobuyuki Enomoto ◽

Makoto Kobayashi ◽

Takamoto Uemura ◽

Chifumi Sato

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Treatment Strategies ◽

Health Utilities Index ◽

Health Utilities

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Effectiveness of sofosbuvir/pegylated-interferon plus ribavirin in treatment of hepatitis C virus genotype 4 patients

Clinical and Experimental Hepatology ◽

10.5114/ceh.2018.78123 ◽

2018 ◽

Vol 4 (3) ◽

pp. 191-196 ◽

Cited By ~ 3

Author(s):

Abel Abdel-Moneim ◽

Alaa Abood ◽

Mohamed Abdel-Gabaar ◽

Mohamed I. Zanaty ◽

Mohamed Ramadan

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Pegylated Interferon ◽

Virus Genotype ◽

Genotype 4 ◽

Pegylated Interferon Plus Ribavirin

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Recurrence of hepatitis C virus genotype-4 infection following orthotopic liver transplantation: Natural history and predictors of outcome

Annals of Saudi Medicine ◽

10.4103/0256-4947.51796 ◽

2009 ◽

Vol 29 (2) ◽

pp. 91-97 ◽

Cited By ~ 6

Author(s):

Hatim Mudawi ◽

Ahmed Helmy ◽

Yasser Kamel ◽

Mohammed Al Saghier ◽

Mohammed Al Sofayan ◽

...

Keyword(s):

Liver Transplantation ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Natural History ◽

Orthotopic Liver Transplantation ◽

Predictors Of Outcome ◽

Virus Genotype ◽

Genotype 4

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Dynamical analysis of a class of hepatitis C virus infection models with application of optimal control

International Journal of Biomathematics ◽

10.1142/s1793524516500388 ◽

2016 ◽

Vol 09 (03) ◽

pp. 1650038 ◽

Cited By ~ 6

Author(s):

Aida Mojaver ◽

Hossein Kheiri

Keyword(s):

Optimal Control ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Deterministic Model ◽

Treatment Strategies ◽

Dynamical Analysis ◽

Existence And Stability ◽

Direct Cell ◽

Infected Cells ◽

The Impact

In this paper, we deal with the problem of optimal control of a deterministic model of hepatitis C virus (HCV). In the first part of our analysis, a mathematical modeling of HCV dynamics which can be controlled by antiretroviral therapy as fixed controls has been presented and analyzed which incorporates two mechanisms: infection by free virions and the direct cell-to-cell transmission. Basic reproduction number is calculated and the existence and stability of equilibria are investigated. In the second part, the optimal control problem representing drug treatment strategies of the model is explored considering control parameters as time-dependent in order to minimize not only the population of infected cells but also the associated costs. At the end of the paper, the impact of combination of the strategies in the control of HCV and their effectiveness are compared by numerical simulation.

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