Dr Laith Abu Raddad and Dr Diego Cuadros.
A new study by researchers at Weill Cornell Medical College in Qatar (WCMC-Q) shows that there is a large geographic variation in the distribution of the hepatitis C virus (HCV) in Egypt.
Egypt has the highest infection level of the disease in the world, with 14.7% of the population carrying HCV, but it is still not clear why this is so.
Treatment campaigns for bilharzia – a disease caused by parasitic worms - during the 1960s and 1970s, using parenteral antischistosomal therapy (PAT), contributed to the epidemic through wide-scale sharing of needles and syringes. However, these campaigns can explain only about 10% of HCV infections in the country. It is probable that most HCV infections in Egypt are linked to exposures in medical care settings.
These are some of the key findings of the study, which has been published in the journal Hepatology.
Dr Diego Cuadros, lead author of the study and postdoctoral associate at the Infectious Disease Epidemiology Group at WCMC-Q, explained what the research involved.
“We implemented a novel methodology with the aim of characterising the geographical clusters of HCV infection and PAT exposure all over Egypt,” he said. “We were able to identify six clusters of high HCV infection levels and three clusters of low HCV infection levels.
“We were also able to identify five clusters of high PAT exposure and four clusters of low PAT exposure. We further conducted different kinds of analyses on these clusters to identify the drivers of this unusual epidemic in this specific country (Egypt).”
What the study found, contrary to expectation, was a rather weak association between HCV infection and previous PAT exposure.
Dr Laith Abu Raddad, principal investigator of the study and associate professor of public health in the Infectious Disease Epidemiology Group at WCMC-Q, said: “This suggested that bilharzia treatment campaigns explained only a small fraction of HCV infections in Egypt. Most infections in the country occurred due to other modes of transmission, and probably linked to medical care. Our analyses also suggested that there must be considerable ongoing HCV transmission in Egypt today.”
Dr Cuadros said the results could help formulate more efficient treatment plans.
The work described in the study was funded by a Junior Scientist Research Experience Programme (JSREP) grant from the Qatar National Research Fund (QNRF) and by the Biomedical Research Programme of Qatar Foundation, which supports the research effort at WCMC-Q.
The JSREP was recently launched by QNRF with the aim of supporting junior scientists to initiate their own research careers.
The study can be found at http://onlinelibrary.wiley.com/doi/10.1002/hep.27248/abstract;jsessionid=F7D26EE132B9DCF09930CE34AF61C3F9.f01t04
