How Egypt has Reduced the Prevalence of Hepatitis C in College Students

Hepatitis C can be diagnosed in all age groups; however, people of college-age are often neglected in outreach programs. This is despite the fact that the college environment presents unique risk factors that increase the risk of hep C transmission.

In 2018,  a study was published by the hepatology, gastroenterology, and Infectious Diseases Department in Egypt, outlining the progress of hep C elimination in the college-age cohort in Egypt.

Hep C rates in Egypt

Egypt has the highest rate of hep C prevalence in the world.  In 2008, 15% of the population had hep C antibodies.¹

Having said that, the country has taken great measures to eliminate hep C through increased awareness through education programs, funding direct-acting antivirals, and improving screening and sanitation in medical facilities.¹

Testing for antibodies in college students

The study analyzed almost 50,000 students from the Menoufia University with a mean age of 19 years. All study participants were required to provide blood samples.

Those that were found to have antibodies to hep C were subsequently tested for their hep C virus RNA levels, which confirms whether an active infection is present.¹

The study found that overall, the hep c infection rates were lower than previously reported years back. Specifically:¹

• 1% of students had hep C antibodies, which means that they have either been exposed to hep C and cleared the virus on their own, or have a present active infection. That means 99% of the students had never been exposed nor are actively infected. This is a decline from a 2008 study based in Egypt that found that 4% of patients in that same age group were exposed to hep C.
• Of those that hep C antibodies, 71% of them had an active hep C infection. Therefore, this indicates that about 30% were exposed to the virus at one point but were able to clear the virus on their own.
• More women than men had hep C antibodies and an active infection.

Primary mode of infection

The study also analyzed the the primary source of infection for the college students. The main risk factors, including the percent of patients who tested positive for antibodies that had these risk factors, were found to be the following:¹

• History of dental procedures – 33.9%
• Family history of hep C.- 31.5%
• History of surgical operations – 8.6%
• Those with insulin treatment for their diabetes  - 7.6%
• History of blood transfusions – 5.2%

The study also found that students who grew up in rural, rather than urban areas, were more likely to have been exposed to hep C.¹

What do these findings mean?

This study confirmed that hep C rates are on the decline overall in Egypt. This is great news for anyone involved in advocating for hep C elimination.

It would be interesting to see how a similar study in college students, but based in North America, would compare to these findings.

Did you find any parts of this study to be surprising or particularly interesting? Share your thoughts below.