Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
Department of Healthcare Policy & Research, Weill Cornell Medicine, Cornell University, New York, USA.
Sci Rep. 2018 Jan 26;8(1):1661. doi: 10.1038/s41598-017-17936-4.
Egypt is the most affected nation by hepatitis C virus (HCV) and needs a comprehensive characterization of HCV epidemiology to inform the scale-up of treatment and prevention programs. Systematic reviews, meta-analyses, and meta-regressions were conducted. A total of 25 incidence, 259 prevalence, and 47 genotype studies were identified. Incidence and prevalence levels were high across all populations. Genotype 4 accounted for 94.1% of infections with a relative Shannon Diversity Index of only 14.4%. Pooled mean HCV prevalence was estimated at 11.9% (95% CI = 11.1-12.6%) among the general population, 55.6% (95% CI = 49.4-61.7%) among populations at high risk, 14.3% (95% CI = 10.3-18.8%) among populations at intermediate risk, 56.0% (95% CI = 50.4-61.6%) among populations with liver-related conditions, and 35.0% (95% CI = 27.3-43.1%) among special clinical populations. Mean HCV viremic rate was estimated at 66.7% (95% CI = 61.7-71.5%). Meta-regression indicated 6% lower odds for HCV prevalence for each one-year increment in publication year (AOR = 0.94; 95% CI = 0.92-0.96). HCV prevalence is high with evidence for ongoing transmission mainly through healthcare. Genotype diversity is low with genotype 4 dominance. Two-thirds of antibody-positive Egyptians are chronically infected and need treatment. Clinical populations should be prioritized for screening. Despite the large-scale epidemic, prevalence appears to be declining rapidly consistent with a contracting epidemic.
埃及是受丙型肝炎病毒（HCV）影响最严重的国家，需要对 HCV 流行病学进行全面描述，以为扩大治疗和预防计划提供信息。进行了系统评价、荟萃分析和荟萃回归分析。共确定了 25 项发病率、259 项患病率和 47 项基因型研究。所有人群的发病率和患病率都很高。基因型 4 占所有感染的 94.1%，相对 Shannon 多样性指数仅为 14.4%。普通人群中丙型肝炎病毒总流行率估计为 11.9%（95%CI=11.1-12.6%），高危人群为 55.6%（95%CI=49.4-61.7%），中危人群为 14.3%（95%CI=10.3-18.8%），与肝脏相关疾病人群为 56.0%（95%CI=50.4-61.6%），特殊临床人群为 35.0%（95%CI=27.3-43.1%）。丙型肝炎病毒病毒血症率估计为 66.7%（95%CI=61.7-71.5%）。荟萃回归分析表明，发表年份每增加一年，HCV 患病率的几率降低 6%（OR=0.94；95%CI=0.92-0.96）。HCV 患病率较高，表明存在持续传播，主要通过医疗保健进行传播。基因型多样性较低，以基因型 4 为主导。三分之二的抗体阳性埃及人慢性感染，需要治疗。应优先考虑对临床人群进行筛查。尽管疫情规模庞大，但流行率似乎在迅速下降，这表明疫情正在缩小。
