Researchers at Weill Cornell Medicine-Qatar (WCM-Q), in partnership with the World Health Organization (WHO), have produced a comprehensive report on the hepatitis C virus epidemic in the Eastern Mediterranean region, offering guidance on how to eliminate the disease by the WHO’s 2030 target date.
The WHO report, entitled ‘Epidemiology of hepatitis C virus in the WHO Eastern Mediterranean Region: Implications for strategic action’, is the product of close collaboration between the WHO Regional Office for the Eastern Mediterranean (WHO-EMRO) and WCM-Q’s Infectious Disease Epidemiology Group (IDEG), which was recently designated as a WHO Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis. The report is one of the first outcomes of the WHO Collaborating Centre and synthesizes the findings of a series of scientific studies on viral hepatitis in the Eastern Mediterranean region that were conducted over a decade by IDEG. These studies were funded by Qatar National Research Fund, a member of Qatar Foundation, through the National Priorities Research Program grant 4-924-3-251, 9-040-3-008, and more recently 12S-0216-190094.
Hepatitis C is a blood-borne pathogen and one of the leading causes of liver diseases and liver cancer. The virus is mostly transmitted through sharing of unsterile needles and syringes, use of contaminated medical equipment, and transfusion of infected blood. It is only in the last few years that novel treatment regimens have permitted cure from this infection, thus reducing the toll of liver complications such as liver fibrosis, cirrhosis, and cancer in infected persons.
In the Eastern Mediterranean region, hepatitis C accounts for about two thirds of morbidity and mortality due to viral hepatitis, the 5th leading cause of death in this part of the world. The report provides comprehensive mapping for hepatitis C infection spread across all 22 countries comprising the region as well as a roadmap and priority actions for the achievement of national, regional, and global targets for the elimination of hepatitis C infection as a public health threat by 2030.
“By comprehensively mapping the spread of the infection across populations and countries, we identified the priority populations for scaling up coverage of hepatitis C testing and treatment services and the kind of interventions that are needed to control this epidemic.”, said Hiam Chemaitelly, senior epidemiologist at WCM-Q and lead author of the report. “Programs focused on testing and treating the general population are unlikely to be cost-effective as infection levels are low in the wider population in most countries in the eastern Mediterranean region and most often in the range of about 1%. The only two main exceptions are Egypt and Pakistan, where infection levels in the general population are higher by at least five-fold and where elimination of the infection will require mass scale-up of testing and treatment services,” she added.
Dr. Laith Abu-Raddad, principal investigator of this project and professor of population health sciences at WCM-Q said: “We aimed through this work to provide countries in the region with the foundation necessary to develop an evidence-informed national response and to justify the establishment of programs and allocation of resources for hepatitis C elimination, now that highly effective treatments for this infection have become available and at affordable prices. Without an appropriate public health response, the healthcare system in the region will continue to endure serious and costly health complications of hepatitis C infection in terms of liver diseases and cancer, and the region will not be able to achieve the WHO goal of eliminating this infection by 2030.”
Ms. Joumana Hermez, the regional advisor for HIV, hepatitis and sexually transmitted infections at the WHO’s Eastern Mediterranean region office, said: “We are at a very important juncture today where we have the tools to fully eliminate this infection in our region. The report provides strategic epidemiologic evidence to accomplish this through cost-effective programs for testing and treatment. The WHO is fully committed to work with countries to accomplish the elimination goal before the end of the next decade.”
Dr. Abdul Sattar Al-Taie, executive director at Qatar National Research Fund, said: “This accomplishment is a testimony of the impact of Qatar’s investment in scientific research on public health in our region, and the fruit of years of collective efforts and of hard and dedicated work at Qatar National Research Fund and Qatar Foundation to establish Qatar as a hub of research excellence and scientific innovation. I am excited to see, after a decade of capacity building, Qatar has now positioned itself as a leader in infectious disease epidemiology research in our region.”
The report can be read in full here.
Key findings of the report:
1. The report provided a comprehensive mapping for hepatitis C infection spread across all 22 countries constituting the Eastern Mediterranean region as well as a roadmap and priority actions for achieving the goal of hepatitis C elimination by 2030.
2. The report established the scientific foundation necessary to develop an evidence-informed national response and to justify the establishment of programs and allocation of resources for hepatitis C elimination now that highly efficacious treatments for this infection have become available and at affordable prices.
3. Populations with liver conditions, clinical populations frequently attending healthcare facilities, and people with a history of repeated and shared injections have the highest infection levels and should be at the core of every testing and treatment strategy.
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