Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 27, 2018; 10(9): 549-557
Published online Sep 27, 2018. doi: 10.4254/wjh.v10.i9.549
Challenge of hepatitis C in Egypt and hepatitis B in Mauritania
Issam I Raad, Anne-Marie Chaftari, Harrys A Torres, Ehab Mouris Ayoub, Liliane Iskander Narouz, Jalen Bartek, Ray Hachem
Issam I Raad, Anne-Marie Chaftari, Harrys A Torres, Ray Hachem, Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
Ehab Mouris Ayoub, Department of Internal Medicine, Harpur Memorial Hospital, Menouf 32951, Egypt
Liliane Iskander Narouz, Faculty of Nursing, Cairo University, Cairo 12613, Egypt
Jalen Bartek, Division of Internal Medicine, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
Author contributions: Raad II, Chaftari AM, Torres HA, Ayoub EM, Narouz LI, Bartek J and Hachem R contributed to conception, design, literature review, analysis, drafting, and critical revision, and all approved the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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:
Correspondence to: Anne-Marie Chaftari, MD, Associate Professor, Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, United States.
Telephone: +1-713-7923491 Fax: +1-713-7928233
Received: April 10, 2018
Peer-review started: April 11, 2018
First decision: May 2, 2018
Revised: May 14, 2018
Accepted: May 30, 2018
Article in press: May 31, 2018
Published online: September 27, 2018

Egypt has one of the highest prevalence rates of hepatitis C virus (HCV) in the world, mostly with genotype 4 that is highly associated with severe fibrosis. As a consequence, hepatocellular carcinoma has become the leading cause of cancer in this country. Mauritania is a highly endemic area for hepatitis B virus (HBV). HBV and HCV could both be iatrogenically transmitted through infected blood products, infected needles, and medical equipment improperly sterilized. Adequate and efficient healthcare and public health measures with good surveillance programs, access for screening, prevention strategies, and successful treatment are needed to halt the spread of these diseases. Herein, we have reviewed the epidemiology, modes of transmission, predisposing factors, and novel treatment modalities of these viruses. We have proposed practices and interventions to decrease the risk of transmission of HCV and HBV in the affected countries, including strict adherence to standard precautions in the healthcare setting, rigorous education and training of patients and healthcare providers, universal screening of blood donors, use of safety-engineered devices, proper sterilization of medical equipment, hepatitis B vaccination, as well as effective direct-acting antiviral agents for the treatment of HCV.

Keywords: Hepatitis B virus, Hepatocellular carcinoma, Hospital acquired infection, World Health Organization, Hepatitis delta virus, Hepatitis C virus

Core tip: Hepatitis C virus (HCV) and hepatitis B virus (HBV) are major public health concerns in Egypt and Mauritania. HCV and HBV can both be transmitted through medical and surgical procedures (healthcare-associated transmission) among others. Screening, prevention, and treatment strategies should be emphasized in Egypt and Mauritania to prevent the spread of these diseases. Direct-acting antivirals for the treatment of HCV are highly effective and well tolerated and should be made accessible and affordable to patients.