HCV prevalence: nationwide estimate through analysis of the 2008 Demographic Health Survey (DHS)

In 2007, the Egyptian Minister of Health requested estimates of nationwide HCV prevalence and incidence. For this purpose, a blood sampling was added to a subset of adults participating in the 2008 Demographic Health Survey (DHS). The survey confirmed on a nationwide representative sample of 11,126 individuals aged 15-59 years the extremely high anti-HCV prevalence observed in 1996: 14.7% (95% CI=13.9%-15.5%) were anti-HCV antibody positive, and 9.94% (95% CI=9.40%-10.5%) were viremic. Our group re-analysed the data to provide estimates stratified by age, gender, and residence, the three main characteristics associated with HCV distribution (Guerra et al., J Viral Hepatitis, 2012; see Figure below).


Figure HCV prevalence DHS


Our analysis showed that anti-HCV prevalence gradually increased with age, reaching in the 50-59 years 46.3% and 30.8% in males and females, respectively. Overall, it was higher in males compared to females (17.4% vs 12.2% respectively, p<0.001), and in rural compared to urban (18.3% vs 10.3% respectively, p<0.001). In multivariate analysis, age, male sex, poverty, past history of intravenous anti-schistosomiasis treatment, blood transfusion and living outside of the Frontier Governorates were all associated with an increased risk of HCV infection. In addition, in urban areas, lack of education and being circumcised for females were associated with an increased risk of HCV infection.


Main conclusion of this study: HCV antibody prevalence was 14.7% and HCV viremia 9.9%, in this representative sample of the 15-59 years population of Egypt, confirming that Egypt has the most severe HCV epidemic worldwide. It is estimated that 6 million Egyptians have chronic HCV infection.  


Read more: Guerra et al., J Viral Hepat, 2012


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