Millions flock to free tests as Egypt seeks to eradicate hepatitis C

Millions flock to free tests as Egypt seeks to eradicate hepatitis C
Mahmoud Mourad, Lena Masri
MIT NAMA (Reuters) - When Houaida Mabrouk heard about a government campaign that offers free hepatitis C screenings, she hesitated, afraid of testing positive. But after many from her community started visiting health clinics to get checked, she changed her mind.

“I thought, ‘I should go too’,” Mabrouk said, speaking at a clinic in the Mit Nama village near Cairo before learning she did not have the virus.

Egypt, which has the highest rate of hepatitis C in the world, is carrying out an unprecedented campaign to detect and treat the disease in a bid to eliminate it by 2022. It aims to test the entire adult population — about 50 million people.

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https://www.reuters.com/article/us-health-egypt-hepatitis-c/millions-flock-to-free-tests-as-egypt-seeks-to-eradicate-hepatitis-c-idUSKBN1O21IO

Egyptian experience, achievements and limitations towards HCV elimination

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In The Journals 
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

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.

Full-text article-

https://www.wjgnet.com/1007-9327/full/v24/i38/4330.htm

American “Gilead Sciences” considers producing new Hepatitis C drug in Egypt

American “Gilead Sciences” considers producing new Hepatitis C drug in Egypt

Minister of Trade and Industry Tarek Kabil has announced that the American company Gilead Sciences for Pharmaceutical Production is currently considering producing a new drug to cure Hepatitis C in Egypt, in cooperation with one of the Egyptian companies working in the field of pharmaceuticals, creating a production and marketing axis for all African markets......

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Egypt Targets Spain, Belgium, Italy, Netherlands and the UK hepatitis C patients for medical tourism

Egypt targets hepatitis C patients for medical tourism

In mid 2016, Prime Pharma, a private Egyptian pharmaceutical company, launched Tour n’ Cure to revive therapeutic tourism in Egypt. The first target is hepatitis C patients from around the world. Countries targeted are Spain, Belgium, Italy, Netherlands and the UK.

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Hepatitis C in Egypt – past, present, and future

Review

Hepatitis C in Egypt – past, present, and future

Authors Elgharably A, Gomaa AI, Crossey MME, Norsworthy PJ, Waked I, Taylor-Robinson SD

Received 8 August 2016
Accepted for publication 28 September 2016
Published 20 December 2016 Volume 2017:10 Pages 1—6
DOI https://doi.org/10.2147/IJGM.S119301

Abstract: Hepatitis C viral infection is endemic in Egypt with the highest prevalence rate in the world. It is widely accepted that the implementation of mass population antischistosomal treatment involving administration of tartar emetic injections (from 1950s to 1980s) led to widespread infection. What is less well known, however, is that these schemes were implemented by the Egyptian Ministry of Health on the advice of the World Health Organization. There has been a spectrum of treatments to target the public health disaster represented by the hepatitis C problem in Egypt: from the use of PEGylated interferon to the recent use of direct acting antiviral drugs. Some new treatments have shown >90% efficacy. However, cost is a key barrier to access these new medicines. This is coupled with a growing population, limited resources, and a lack of infection control practices which means Egypt still faces significant disease control issues today.

Conclusion/Discussion Only

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Alternative treatments and future steps
It is clear that there is evidence of some good foundations for tackling the widespread prevalence of HCV in Egypt. At the time of writing, the development of effective DAAs has shown up to 90% efficacy against HCV genotype 4, and such treatment has been able to produce excellent SVR results in the Egyptian context. There is less ignorance and lack of awareness of the need to properly sterilize equipment and medical instruments than there has been in the past, although public awareness campaigns still need to be conducted, including to allied health care professionals. From a historical perspective, the Egyptian population has become much more aware of the threats associated with swimming and utilizing canal water which has led to a decrease in incidence rates of schistosomiasis in parallel. Effort must now be concentrated on treating the existing HCV patients, who are suffering from the failed treatments initiatives of the past.

The Egyptian Ministry of Health must take a two-pronged approach to tackling this disease. Currently, there are established DAAs that have the portent to eliminate HCV. In addition, local pharmaceutical companies should be aided in developing drug generic versions in order to make direct acting antiviral drugs more accessible for those who have not been able to gain access to treatment through governmentally subsidized schemes.

It is important to realize, however, that widespread DAA treatment will not solve all the associated problems of the HCV epidemic in Egypt. The complications of decompensated cirrhosis and hepatocellular carcinoma present a massive burden to Egyptian society and they still need to be addressed with adequate health care resource allocation.

Egypt has all the potential tools to tackle its HCV crisis. What is needed is ring-fenced governmental funding to enforce treatment policy, as well as clear medical and public health guidance in order to target treatment effectively. At the same time, the Egyptian Ministry of Health must continue to invest in research and development for the best emerging treatments to be implemented. However, it is important not to forget the essentials of education, infection control, equipment sterilization, and risk aversion to stop further growth of those who continue to become newly infected.

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New hep C treatment to hit Egyptian market in May

New hep C treatment to hit Egyptian market in May

CAIRO: A new drug for treating hepatitis C will be available on the Egyptian market early next month, Health Minister Adel al-Adawy announced Monday.

A 30,000-dose shipment of Olisio, the new treatment, has arrived in Egypt, and is currently undergoing tests before release on the market, the head of National Committee for the Control of Viral Hepatitis Waheed Doss told Youm 7.

Doss added that once Olisio is approved, the treatment protocol will be changed and the new drug will be used simultaneously with the currently-used American-made Sovaldi.

In recent months, around 58,000 hepatitis C patients have been treated using Sovaldi with a cure rate of 95 percent, according to official reports.

Last September, an online registration process had started for patients and officials say that more than 872,000 had signed up for receiving the state-subsidized Sovaldi.

Egypt has the highest rate of hepatitis C in the world, according to the United Nations Population Fund; 14.7 percent of people between ages 15-49 have tested positive for the virus. Doss said that fighting the infection from the disease itself is a top priority for the ministry as number of patients increase annually in between 150,000 to 200,000 persons.

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Lawsuit targets army officials claiming HIV, Hepatitis C cure

Lawsuit targets army officials claiming HIV, Hepatitis C cure
 Amira El-Fekki / January 5, 2015

Poor and helpless patients put high hopes on ‘army scam invention’, says lawyer 

High-profile lawyer Khaled Abou Bakr filed a lawsuit against army officials who promoted the controversial cure for AIDS and Hepatitis C curing device in 2014, he announced on his Twitter account on Sunday. 

The lawsuit was submitted on the grounds that they manipulated and failed to deliver their promise to the Egyptian people. 

Abou Bakr demanded investigations against the first administrator of the so-called cure, Maj. Ibrahim Abdel Atty El-Sayed. 

Abou Bakr demanded compensation for the poor, helpless patients, who gave up their original treatment plans following high hopes in light of the army’s announced breakthrough.

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Egypt has started distributing Sovaldi, a drug for treating Hepatitis C.

Egypt has started distributing Sovaldi, a drug for treating Hepatitis C.

Health Minister Adel Adawi announced at a press conference on Thursday that a new national plan was underway for the prevention of viral Hepatitis, which is rampant in Egypt.

The plan involves creating a database of patients in order to offer them future treatment strategies, and employing the latest treatment methods in hospitals.

Adawi had announced earlier that Egypt had received the first batch of Sovaldi – 50,000 doses - and his ministry was taking procedures to examine and distribute it. Media reports say that another 100,000 doses are expected by February.

Gilead Sciences will provide the drug for one percent of its market price, LE2,200 ($300), according to a previous statement by the health ministry.

Patients can register on a government website to receive the drug at their nearest medical centre. On 20 September, the ministry said over 171,000 people had registered to receive the drug.

Egypt has the highest rate of Hepatitis C in the world. Infections spiked from four percent in 1993 to 8.5 percent in 2005. The total estimated number of Egyptians infected is currently around 12 million.

In February, the Egyptian army claimed to have invented a device that detects and cures Hepatitis C. The claims were met with disbelief and ridicule by the international scientific community.

Source

The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis

The epidemiology of hepatitis C virus in Egypt: a systematic review and data synthesis

Yousra A Mohamoud, Ghina R Mumtaz, Suzanne Riome, DeWolfe Miller and Laith J Abu-Raddad 

BMC Infectious Diseases 2013, 13:288 doi:10.1186/1471-2334-13-288
Published: 24 June 2013

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Abstract (provisional)
Background

Egypt has the highest prevalence of hepatitis C virus (HCV) in the world, estimated nationally at 14.7%. Our study's objective was to delineate the evidence on the epidemiology of HCV infection among the different population groups in Egypt, and to draw analytical inferences about the nature of HCV transmission in this country.

Methods
We conducted a systematic review of all data on HCV prevalence and incidence in Egypt following PRISMA guidelines. The main sources of data included PubMed and Embase databases. We also used a multivariate regression model to infer the temporal trend of HCV prevalence among the general population and high risk population in Egypt.

Results
We identified 150 relevant records, four of which were incidence studies. HCV incidence ranged from 0.8 to 6.8 per 1,000 person-years. Overall, HCV prevalence among pregnant women ranged between 5-15%, among blood donors between 5-25%, and among other general population groups between 0-40%. HCV prevalence among multi-transfused patients ranged between 10-55%, among dialysis patients between 50-90%, and among other high risk populations between 10% and 85%. HCV prevalence varied widely among other clinical populations and populations at intermediate risk. Risk factors appear to be parenteral anti-schistosomal therapy, injections, transfusions, and surgical procedures, among others. Results of our time trend analysis suggest that there is no evidence of a statistically significant decline in HCV prevalence over time in both the general population (p-value: 0.215) and high risk population (p-value: 0.426).

Conclusions
Egypt is confronted with an HCV disease burden of historical proportions that distinguishes this nation from others. A massive HCV epidemic at the national level must have occurred with substantial transmission still ongoing today. HCV prevention in Egypt must become a national priority. Policymakers, and public health and medical care stakeholders need to introduce and implement further prevention measures targeting the routes of HCV transmission.

http://www.biomedcentral.com/1471-2334/13/288/abstract