Tropical Medicine Medical Research Division, National Research Center, Giza, Egypt.
Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
Lancet Gastroenterol Hepatol. 2022 Jul;7(7):658-665. doi: 10.1016/S2468-1253(21)00464-7. Epub 2022 Apr 28.
Until 2018, Egypt had the highest prevalence of hepatitis C virus (HCV) infection globally, affecting approximately 7% of the population. Despite efforts in diagnosis and treatment since 2006, nearly 2 million individuals with chronic HCV infection had yet to be diagnosed as of early 2018. In December, 2018, a mass HCV screening campaign for adolescents aged 15-18 years was initiated. Among 3 024 325 adolescents screened, the HCV antibody seroprevalence was 11 477 (0·38%), of whom 8187 (78·7%) were HCV RNA-positive. Sustained virological response 12 weeks after completion of treatment (SVR12) was attained by 7327 (99·6%) adolescents with a fixed-dose combination of generic ledipasvir 90 mg plus sofosbuvir 400 mg. Although mass screening in this age group might not be regularly adopted by many health systems and its cost-effectiveness might be lower than the screening of adults and high-risk groups (eg, patients on haemodialysis, people who inject drugs), breaking the chain of transmission in younger populations should lead to a reduction in HCV incidence and complications, and hasten the elimination of the disease.
直到 2018 年，埃及仍是全球丙型肝炎病毒（HCV）感染率最高的国家，约有 7%的人口受到影响。尽管自 2006 年以来一直在努力进行诊断和治疗，但截至 2018 年初，仍有近 200 万慢性 HCV 感染者尚未得到诊断。2018 年 12 月，启动了一项针对 15-18 岁青少年的 HCV 大规模筛查活动。在接受筛查的 3 024 325 名青少年中，HCV 抗体血清阳性率为 11 477（0·38%），其中 8187 人（78·7%）HCV RNA 阳性。接受通用索菲布韦 400mg 联合雷迪帕韦 90mg 固定剂量复方制剂治疗 12 周后，7327 名（99·6%）青少年获得持续病毒学应答（SVR12）。尽管许多卫生系统可能不会定期对这一年龄组进行大规模筛查，其成本效益可能低于对成年人和高危人群（如血液透析患者、注射毒品者）的筛查，但在年轻人群中阻断传播链应可降低 HCV 的发病率和并发症，并加速消灭该疾病。
