Journal of Infectious Diseases & Therapy
Open Access

Abstract

Hepatitis C is an infectious disease affecting primarily the liver, caused by the hepatitis C virus (HCV).[1] HCV infection is a major problem in Egypt. Egypt has the highest prevalence of the Hepatitis C virus (HCV) in the world, with 14 percent of the population infected and 11.8 million patients, according to the World Health Organisation. Every year there are 170,000-200,000 new HVC cases in Egypt. It was discovered in 1989. The hepatitis C virus (HCV) is a small, enveloped, single-stranded, positive-sense RNA virus.[7] It is a member of the Hepacivirus genus in the family Flaviviridae.[2]There are seven major genotypes of HCV, which are known as genotypes one to seven.[43] It is transmitted by injection which means spread primarily by blood-to-blood contact associated with intravenous drug use, poorly sterilized medical equipment, and transfusions. Because Egypt is also endemic with Schistosomiasis , it was thought that treatment with tartar emetic was the principal cause of wide spread infection with HCV as sharing of syringes was done in a wide scale. Since start of HCV discovery there are terror of it not only for its effect on the liver as it causes chronic active hepatitis, cirrhosis will go on to develop liver failure, liver cancer but because of its effect on refusal of immigration between countries of Middle East with huge ecomonic burden resulted from that.So HCV cases tried any treatment prescribed by doctors or others to get rid off it without any scientific basis, like probiotic , milk and urine of camels, black pills, milk thistle, ginseng, and colloidal silver.[3] Also Ozone was tried. But all proved to be ineffective.Alpha-interferon given every other day proved also to be ineffective because the preparation of alpha interferon was against HCV genotype I while that found in Egypt is genotype IV. So it is supplemented by ribavirin as an antiviral working against mRNA, but percentage of cure was limited and a high rate of recurrence occurred. Then treatment consists of a combination of pegylated interferon alpha and the antiviral drug ribavirin for a period of 24 or 48 weeks,appear to be effective with more than 70% cure but still there are a rate of recurrence[4] .Recently a new drug appeared and thought to have high rate of cure. The new Hepatitis C drug called Sofosbuvir. Sofosbuvir ΓΆΒ?Β? commercial name Sovaldi ΓΆΒ?Β? was approved in the United States in December 2013 and entered Egypt on 16 October 2014. Government took the chance to offer it to HCV cases because of thought of its magic role in elimination of HCV. But discovered it must be taken in combination either as dual treatment (Sovaldi + Ribavirin) or triple treatment (Sovaldi + alpha interferon + Ribavirin). So still the major problem which is high cost of treatment. Government tried to produce locally but failed to reduce the cost. Because the new drug still recent the fear of recurrence make it hard to judge the effectiveness of the new drug.

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