Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt

F. De Wolfe Miller, Laith Aburaddad

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

Egypt has the highest prevalence of antibodies to hepatitis C virus (HCV) in the world, estimated nationally at 14.7%. An estimated 9.8% are chronically infected. Numerous HCV prevalence studies in Egypt have published various estimates from different Egyptian communities, suggesting that Egypt, relative to the other nations of the world, might be experiencing intense ongoing HCV transmission. More importantly, a new national study provided an opportunity to apply established epidemiologic models to estimate incidence. Validated mathematical models for estimating incidence from age-specific prevalence were used. All previous prevalence studies of HCV in Egypt were reviewed and used to estimate incidence provided that there was sufficient age-specific data required by the models. All reports of anti-HCV antibody prevalence were much higher than any single other national estimate. Age was the strongest and most consistently associated factor to HCV prevalence and HCV RNA positivity. It was not possible to establish a prior reference point for HCV prevalence or incidence to compare with the 2009 incidence estimates. The modeled incidence from the national study and collectively from the modeled incidence from the previous community studies was 6.9/1,000 [95% confidence interval (CI), 5.5-7.4] per person per year and 6.6/1,000 (95% CI, 5.1-7.0) per person per year, respectively. Projected to the age structure of the Egyptian population, more than 500,000 new HCV infections per year were estimated. Iatrogenic transmission is the most likely, underlining exposure to the ongoing transmission. The study demonstrates the urgency to reduce HCV transmission in Egypt.

Original languageEnglish
Pages (from-to)14757-14762
Number of pages6
JournalProceedings of the National Academy of Sciences of the United States of America
Volume107
Issue number33
DOIs
Publication statusPublished - 17 Aug 2010
Externally publishedYes

Fingerprint

Egypt
Hepacivirus
Incidence
Hepatitis C Antibodies
Cross-Sectional Studies
Confidence Intervals
Virus Diseases
Cohort Studies
Theoretical Models
RNA
Population

Keywords

  • Iatrogentic transmission
  • Incidence
  • Mathematical modeling
  • Middle east and north africa
  • Parenteral transmission

ASJC Scopus subject areas

  • General

Cite this

Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt. / Miller, F. De Wolfe; Aburaddad, Laith.

In: Proceedings of the National Academy of Sciences of the United States of America, Vol. 107, No. 33, 17.08.2010, p. 14757-14762.

Research output: Contribution to journalArticle

@article{bf57d3bc158f4d3093249386f7371a29,
title = "Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt",
abstract = "Egypt has the highest prevalence of antibodies to hepatitis C virus (HCV) in the world, estimated nationally at 14.7{\%}. An estimated 9.8{\%} are chronically infected. Numerous HCV prevalence studies in Egypt have published various estimates from different Egyptian communities, suggesting that Egypt, relative to the other nations of the world, might be experiencing intense ongoing HCV transmission. More importantly, a new national study provided an opportunity to apply established epidemiologic models to estimate incidence. Validated mathematical models for estimating incidence from age-specific prevalence were used. All previous prevalence studies of HCV in Egypt were reviewed and used to estimate incidence provided that there was sufficient age-specific data required by the models. All reports of anti-HCV antibody prevalence were much higher than any single other national estimate. Age was the strongest and most consistently associated factor to HCV prevalence and HCV RNA positivity. It was not possible to establish a prior reference point for HCV prevalence or incidence to compare with the 2009 incidence estimates. The modeled incidence from the national study and collectively from the modeled incidence from the previous community studies was 6.9/1,000 [95{\%} confidence interval (CI), 5.5-7.4] per person per year and 6.6/1,000 (95{\%} CI, 5.1-7.0) per person per year, respectively. Projected to the age structure of the Egyptian population, more than 500,000 new HCV infections per year were estimated. Iatrogenic transmission is the most likely, underlining exposure to the ongoing transmission. The study demonstrates the urgency to reduce HCV transmission in Egypt.",
keywords = "Iatrogentic transmission, Incidence, Mathematical modeling, Middle east and north africa, Parenteral transmission",
author = "Miller, {F. De Wolfe} and Laith Aburaddad",
year = "2010",
month = "8",
day = "17",
doi = "10.1073/pnas.1008877107",
language = "English",
volume = "107",
pages = "14757--14762",
journal = "Proceedings of the National Academy of Sciences of the United States of America",
issn = "0027-8424",
number = "33",

}

TY - JOUR

T1 - Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt

AU - Miller, F. De Wolfe

AU - Aburaddad, Laith

PY - 2010/8/17

Y1 - 2010/8/17

N2 - Egypt has the highest prevalence of antibodies to hepatitis C virus (HCV) in the world, estimated nationally at 14.7%. An estimated 9.8% are chronically infected. Numerous HCV prevalence studies in Egypt have published various estimates from different Egyptian communities, suggesting that Egypt, relative to the other nations of the world, might be experiencing intense ongoing HCV transmission. More importantly, a new national study provided an opportunity to apply established epidemiologic models to estimate incidence. Validated mathematical models for estimating incidence from age-specific prevalence were used. All previous prevalence studies of HCV in Egypt were reviewed and used to estimate incidence provided that there was sufficient age-specific data required by the models. All reports of anti-HCV antibody prevalence were much higher than any single other national estimate. Age was the strongest and most consistently associated factor to HCV prevalence and HCV RNA positivity. It was not possible to establish a prior reference point for HCV prevalence or incidence to compare with the 2009 incidence estimates. The modeled incidence from the national study and collectively from the modeled incidence from the previous community studies was 6.9/1,000 [95% confidence interval (CI), 5.5-7.4] per person per year and 6.6/1,000 (95% CI, 5.1-7.0) per person per year, respectively. Projected to the age structure of the Egyptian population, more than 500,000 new HCV infections per year were estimated. Iatrogenic transmission is the most likely, underlining exposure to the ongoing transmission. The study demonstrates the urgency to reduce HCV transmission in Egypt.

AB - Egypt has the highest prevalence of antibodies to hepatitis C virus (HCV) in the world, estimated nationally at 14.7%. An estimated 9.8% are chronically infected. Numerous HCV prevalence studies in Egypt have published various estimates from different Egyptian communities, suggesting that Egypt, relative to the other nations of the world, might be experiencing intense ongoing HCV transmission. More importantly, a new national study provided an opportunity to apply established epidemiologic models to estimate incidence. Validated mathematical models for estimating incidence from age-specific prevalence were used. All previous prevalence studies of HCV in Egypt were reviewed and used to estimate incidence provided that there was sufficient age-specific data required by the models. All reports of anti-HCV antibody prevalence were much higher than any single other national estimate. Age was the strongest and most consistently associated factor to HCV prevalence and HCV RNA positivity. It was not possible to establish a prior reference point for HCV prevalence or incidence to compare with the 2009 incidence estimates. The modeled incidence from the national study and collectively from the modeled incidence from the previous community studies was 6.9/1,000 [95% confidence interval (CI), 5.5-7.4] per person per year and 6.6/1,000 (95% CI, 5.1-7.0) per person per year, respectively. Projected to the age structure of the Egyptian population, more than 500,000 new HCV infections per year were estimated. Iatrogenic transmission is the most likely, underlining exposure to the ongoing transmission. The study demonstrates the urgency to reduce HCV transmission in Egypt.

KW - Iatrogentic transmission

KW - Incidence

KW - Mathematical modeling

KW - Middle east and north africa

KW - Parenteral transmission

UR - http://www.scopus.com/inward/record.url?scp=77957054972&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957054972&partnerID=8YFLogxK

U2 - 10.1073/pnas.1008877107

DO - 10.1073/pnas.1008877107

M3 - Article

VL - 107

SP - 14757

EP - 14762

JO - Proceedings of the National Academy of Sciences of the United States of America

JF - Proceedings of the National Academy of Sciences of the United States of America

SN - 0027-8424

IS - 33

ER -