Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2020; 26(30): 4415-4427
Published online Aug 14, 2020. doi: 10.3748/wjg.v26.i30.4415
Accelerating the elimination of hepatitis C in Kuwait: An expert opinion
Fuad Hasan, Ahmad Alfadhli, Abeer Al-Gharabally, Mahmoud Alkhaldi, Massimo Colombo, Jeffrey V Lazarus
Fuad Hasan, Ahmad Alfadhli, Department of Internal Medicine, Faculty of Medicine, Kuwait University, Kuwait 12037, Kuwait
Abeer Al-Gharabally, Department of Gastroenterology, Amiri Hospital, Kuwait 13041, Kuwait
Mahmoud Alkhaldi, Public Health Department, Ministry of Health, Kuwait 13110, Kuwait
Massimo Colombo, Head Center of Translational Research in Hepatology, Humanitas Clinical and Research Center, Rozzano 20089, Italy
Jeffrey V Lazarus, Barcelona Institute for Global Health, Barcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona 08036, Spain
Author contributions: All authors equally contributed to this paper in terms of conception, literature review, critical revision, editing, and final approval for submission.
Conflict-of-interest statement: All authors declare no conflicts of interest related to the study. Writing support was provided by Turacoz Healthcare Solutions which was funded by Gilead Sciences.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Fuad Hasan, FACP, MD, Doctor, Professor, Department of Internal Medicine, Faculty of Medicine, Kuwait University, Jamal Abdul Nasser St, PO Box 24923 Safat 13110, Kuwait 12037, Kuwait.
Received: March 30, 2020
Peer-review started: March 30, 2020
First decision: May 21, 2020
Revised: June 4, 2020
Accepted: July 22, 2020
Article in press: July 22, 2020
Published online: August 14, 2020

The hepatitis C virus (HCV) is estimated to affect 71 million people worldwide. In 2016, the World Health Organization adopted the first global health sector strategy to eliminate viral hepatitis as a public health threat by 2030. In December 2018, the European Association for the Study of the Liver, International Liver Foundation convened an expert panel to address the elimination of HCV in Kuwait. Several steps have already been taken to eliminate HCV in Kuwait, including free HCV treatment for Kuwait’s citizens, high blood safety standards, and the implementation of screening and awareness programs. The expert panel made several recommendations aimed at accelerating the elimination of HCV in Kuwait: The development of a national strategy and action plan to guide all HCV elimination activities; the formation of a coordination mechanism to support collaboration between hepatitis working committees; the prioritization of micro-elimination at primary, secondary or tertiary facilities, in prisons and rehabilitation centers; and ensuring the involvement of multiple stakeholders – including relevant civil society groups – in all activities. Enhanced screening and linkage to care should be prioritized in Kuwait, with the expansion of the prescriber base to primary healthcare providers and nurse practitioners to be considered. Raising awareness and educating people about HCV infection also remain essential to achieve the goal of HCV elimination. Lastly, a national HCV registry should be developed to help monitor the implementation of viral hepatitis plans and progress towards achieving national and international targets.

Keywords: Awareness, Hepatitis C virus, Kuwait, Micro-elimination, Registries, Prescribers

Core tip: Globally, hepatitis C remains a public health threat, causing substantial morbidity and mortality. In 2016, World Health Organization adopted a strategy to eliminate hepatitis C virus (HCV) infection as a public health threat by 2030. The expert panel convened in Kuwait explored how to eliminate HCV and developed seven recommendations to accelerate the response, which included developing a national strategy and action plan which outline national priorities for eliminating HCV; increasing awareness and educating people about HCV infection; micro-eliminating HCV in high-risk population groups; ensuring linkage to care; and developing a national HCV registry to monitor progress towards national and international goals in Kuwait.