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World J Gastroenterol. Oct 14, 2018; 24(38): 4330-4340
Published online Oct 14, 2018. doi: 10.3748/wjg.v24.i38.4330
Towards hepatitis C virus elimination: Egyptian experience, achievements and limitations
Dalia Omran, Mohamed Alboraie, Rania A Zayed, Mohamed-Naguib Wifi, Mervat Naguib, Mohamed Eltabbakh, Mohamed Abdellah, Ahmed Fouad Sherief, Sahar Maklad, Heba Hamdy Eldemellawy, Omar Khalid Saad, Doaa Mohamed Khamiss, Mohamed El Kassas
Dalia Omran, Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo 11651, Egypt
Mohamed Alboraie, Mohamed Abdellah, Department of Internal Medicine, Al-Azhar University, Cairo 11651, Egypt
Rania A Zayed, Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo 11651, Egypt
Mohamed-Naguib Wifi, Mervat Naguib, Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo 11599, Egypt
Mohamed Eltabbakh, Ahmed Fouad Sherief, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
Sahar Maklad, National Hepatology and Tropical Medicine Research Institute, Cairo 11599, Egypt
Heba Hamdy Eldemellawy, Department of Internal Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt
Omar Khalid Saad, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
Doaa Mohamed Khamiss, Department of Clinical and Chemical Pathology, El-monera hospital, Ministry of Health, Cairo 11562, Egypt
Mohamed El Kassas, Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11599, Egypt
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision, editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dalia Omran, MD, Professor, Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Egypt. daliaomran@kasralainy.edu.eg
Telephone: +20-10-00087802 Fax: +20-2-23682030
Received: March 27, 2018
Peer-review started: March 27, 2018
First decision: April 3, 2018
Revised: September 13, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: October 14, 2018
Abstract

Worldwide, more than one million people die each year from hepatitis C virus (HCV) related diseases, and over 300 million people are chronically infected with hepatitis B or C. Egypt used to be on the top of the countries with heavy HCV burden. Some countries are making advances in elimination of HCV, yet multiple factors preventing progress; remain for the majority. These factors include lack of global funding sources for treatment, late diagnosis, poor data, and inadequate screening. Treatment of HCV in Egypt has become one of the top national priorities since 2007. Egypt started a national treatment program intending to provide cure for Egyptian HCV-infected patients. Mass HCV treatment program had started using Pegylated interferon and ribavirin between 2007 and 2014. Yet, with the development of highly-effective direct acting antivirals (DAAs) for HCV, elimination of viral hepatitis has become a real possibility. The Egyptian National Committee for the Control of Viral Hepatitis did its best to provide Egyptian HCV patients with DAAs. Egypt adopted a strategy that represents a model of care that could help other countries with high HCV prevalence rate in their battle against HCV. This review covers the effects of HCV management in Egyptian real life settings and the outcome of different treatment protocols. Also, it deals with the current and future strategies for HCV prevention and screening as well as the challenges facing HCV elimination and the prospect of future eradication of HCV.

Keywords: Hepatitis C virus, Egypt, Direct acting antivirals, Screening, Elimination, Limitations

Core tip: Egypt started a large treatment program intended to provide therapy for Egyptian hepatitis C virus (HCV)-infected patients. The Egyptian National Committee for the Control of Viral Hepatitis provides a model of care that could help other countries with high HCV prevalence rate in their battle against HCV. This review covers the results of HCV management in Egyptian real life settings and the outcome of different treatment protocols. Also, it covers the current and future strategies for HCV prevention and screening. Lastly, we discussed the challenges facing HCV elimination and the prospect of future eradication of HCV.