Hepatitis C virus (HCV) currently infects around 2% of the world's population. Among all nations, HCV prevalence ranges from 0.01% in Scandinavia to 3% in North Africa, with one exception: Egypt. Egypt has the highest prevalence of HCV in the world, estimated nationally at 14.7%. Numerous HCV prevalence studies have published various estimates from different Egyptian communities, suggesting that Egypt, relative to the other nations of the world, might be experiencing an intense ongoing HCV transmission.

To review all the evidence on the epidemiology of HCV transmission among different population groups in Egypt.

This was a systematic review following the PRISMA guidelines of all prevalence data on HCV infection in Egypt. Sources of data included PubMed, international organizations' reports and databases, and country-level reports and databases. Measures were classified into different population categories according to risk of infection.

Seventy-four studies have measured HCV prevalence in Egypt in populations at varying levels of risk. Among Egypt's general population, HCV prevalence in pregnant women was 8.6%, and among blood donors it ranged between 9.0% and 23.2%. A nationally representative survey reported a prevalence of 14.7%. Among populations at high risk of infection, HCV prevalence was found to be as high as 58.3% in multi-transfused children, and 87.5% in adult dialysis patients. Among populations at intermediate risk, diabetic children had a prevalence of 3.1%, barbers a prevalence of 12.3%, health care workers a prevalence of 15.7%, and prisoners a prevalence of 31.4%. Common risk factors appear to be parenteral anti-schistosomal therapy, frequent transfusions, injections or surgical procedures.

Egypt has experienced, and possibly continues to experience, a large HCV epidemic. Prevention measures need to be implemented targeting HCV transmission routes such as better infection control practices in health and dental care facilities, hemodialysis centers, and reducing the excessive numbers of non-therapeutic injections.


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