Expected increase in hepatitis C-related mortality in Egypt due to pre-2000 infections

Background/Aims: Egypt has the highest prevalence of Hepatitis C Virus (HCV) in the world, apparently due to mass parenteral antischistosomal therapy. Estimating the future burden of HCV in Egypt is important to support health policies to combat the epidemic. Methods: A previous back calculation model was adapted to the situation in Egypt. It combines a model of the natural history of HCV infections with available epidemiological data to back calculate the past HCV incidence from observed 1980-1999 hepatocellular carcinoma (HCC) mortality. In turn, the HCV-related mortality burden is projected in the future due to pre-2000 infections. Results: Compared with the observed number of HCC deaths in 1999, the model predicts a 3.5-fold increase in this mortality in the next 20 years. Globally, the model predicts a 2.4-fold increase in the HCV-related mortality. These predictions do not take into account the new infections that may occur after 2000, which would still increase the estimated future mortality burden. Conclusions: HCV-related mortality is expected at least to double in the next 20 years. The use of antiviral therapies can lower these predictions. Efficient prevention policies are needed to avoid these predictions being exceeded. D 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.