The Epidemiology of Hepatitis C Virus in the Fertile Crescent: Systematic Review and Meta-AnalysisReportar como inadecuado

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To characterize hepatitis C virus HCV epidemiology in countries of the Fertile Crescent region of the Middle East and North Africa MENA, namely Iraq, Jordan, Lebanon, Palestine, and Syria.


We systematically reviewed and synthesized available records of HCV incidence and prevalence following PRISMA guidelines. Meta-analyses were implemented using a DerSimonian-Laird random effects model with inverse weighting to estimate the country-specific HCV prevalence among the various at risk population groups.


We identified eight HCV incidence and 240 HCV prevalence measures in the Fertile Crescent. HCV sero-conversion risk among hemodialysis patients was 9.2% in Jordan and 40.3% in Iraq, and ranged between 0% and 3.5% among other populations in Iraq over different follow-up times. Our meta-analyses estimated HCV prevalence among the general population at 0.2% in Iraq range: 0–7.2%; 95% CI: 0.1–0.3%, 0.3% in Jordan range: 0–2.0%; 95% CI: 0.1–0.5%, 0.2% in Lebanon range: 0–3.4%; 95% CI: 0.1–0.3%, 0.2% in Palestine range: 0–9.0%; 95% CI: 0.2–0.3%, and 0.4% in Syria range: 0.3–0.9%; 95% CI: 0.4–0.5%. Among populations at high risk, HCV prevalence was estimated at 19.5% in Iraq range: 0–67.3%; 95% CI: 14.9–24.5%, 37.0% in Jordan range: 21–59.5%; 95% CI: 29.3–45.0%, 14.5% in Lebanon range: 0–52.8%; 95% CI: 5.6–26.5%, and 47.4% in Syria range: 21.0–75.0%; 95% CI: 32.5–62.5%. Genotypes 4 and 1 appear to be the dominant circulating strains.


HCV prevalence in the population at large appears to be below 1%, lower than that in other MENA sub-regions, and tending towards the lower end of the global range. However, there is evidence for ongoing HCV transmission within medical facilities and among people who inject drugs PWID. Migration dynamics appear to have played a role in determining the circulating genotypes. HCV prevention efforts should be targeted, and focus on infection control in clinical settings and harm reduction among PWID.

Autor: Hiam Chemaitelly , Karima Chaabna, Laith J. Abu-Raddad



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