Egypt screened almost 30 million people for hepatitis C in
the first four months of a national screening programme that kicked off in
October 2018, Egyptian researchers announced at The International Liver
Congress in Vienna on Thursday.
Egypt had the highest prevalence of hepatitis C in the world
in 2008, said Wahed Doss, Head of Egypt’s National Commission for Control of Viral
Hepatitis, but treated 2.5 million people by 2016 using direct-acting
antivirals. Since then, momentum has begun to slow as the national treatment programme
has treated almost all those diagnosed.
A national screening programme was launched in 2018 that
aims to screen 62 million adults and 15 million adolescents by 2020.
The free hepatitis C screening programme is integrated with
screening for diabetes, high blood pressure and obesity. People diagnosed with
hepatitis C receive a free 12-week course of treatment with generic versions of
direct-acting antivirals. The drugs cost the Egyptian government US$45 per
treatment course and the overall cost per cure including diagnostics is $75.
Rather than going door-to-door, the screening programme is
offering testing at a combination of screening centres and mobile screening
units at mosques, subway stations, sports grounds and factories. The country
has been divided into three regions, each covered by up to 7000 screening
sites that operate 12 hours a day, seven days a week.
People diagnosed with hepatitis C are booked for referral to
a treatment centre and followed up if they don’t attend evaluation
appointments. A total of 134 treatment centres provide hepatitis C treatment, delivered by
The Egyptian screening programme reached 78% of the eligible
population in areas where screening has already taken place. Screening
identified 1.2 million people who were hepatitis C virus (HCV) antibody positive, of whom 900,000
are chronically infected and in need of treatment. Overall, 4.5% of the
screened population were HCV antibody positive but the prevalence of HCV
antibodies rose to 12.5% in people aged 65 and over.
Dr Doss said that the scale of Egypt’s national treatment
programme was a result of pressure from civil society and political will to
eliminate hepatitis C, along with the low cost of generic direct-acting
antivirals and mass procurement of drugs. Two million people are expected to
start treatment by the end of 2019, he said.