Hepatitis C distribution across diverse population groups in the Eastern Mediterranean Region: An umbrella review

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Key populations: 31.0% (95% CI: 27.0-38.0%); Co-infected patients: 31.0% (95% CI: 12.0-49.0%); Clinical/healthcare exposure: 28.0% (95% CI: 23.0-32.0%); Apparently healthy: 2.0% (95% CI: 1.0-2.0%)

• Primary Outcome: HCV prevalence across population groups in Eastern Mediterranean Region

• Nnt Or Sensitivity: Prevalence declined from 29% to 10% in clinically exposed populations after 2015, suggesting impact of DAAs and infection control measures

• Confidence Interval: Varies by population group, with some very wide intervals indicating imprecision

Clinical Application

Findings support targeted screening and prevention strategies for high-risk populations Limited direct applicability to Australia given different epidemiological context, but methodology relevant for similar prevalence studies in high-risk populations Healthcare providers and public health officials in Eastern Mediterranean Region and similar endemic areas

Abstract

BACKGROUND: Hepatitis C virus (HCV) remains a major public health challenge in the Eastern Mediterranean Region (EMR), with prevalence varying across population groups. This umbrella review summarizes the distribution of HCV infection across diverse populations in the region. METHODS: We conducted an umbrella review of systematic reviews with meta-analyses reporting HCV prevalence in the EMR. PubMed, Web of Science, Scopus, Iranian databases, including Magiran and the Scientific Information Database (SID), were searched. Google Scholar was additionally screened to ensure comprehensive coverage. Pooled estimates were extracted across four population groups: apparently healthy individuals; those with clinical or healthcare-associated exposure risk; patients co-infected with hepatitis viruses or other liver-related diseases; and key populations at increased risk (groups disproportionately affected due to their behaviors and higher vulnerability). For time-period analyses, meta-analyses were grouped into two intervals (before 2015 vs. 2015 and after) based on the median year of data collection of primary studies. Pooled prevalence was calculated using a random-effects model in STATA version 17. RESULTS: A total of 55 meta-analyses were included. The pooled HCV prevalence was 31.0% (95% CI: 27.0-38.0) among key populations, and also 31.0% (95% CI: 12.0-49.0) among patients co-infected with other hepatitis viruses or liver-related diseases. Those with clinical or healthcare-associated exposure risk showed a prevalence of 28.0% (95% CI: 23.0-32.0), whereas the apparently healthy population had the lowest prevalence at 2.0% (95% CI: 1.0-2.0). Subgroup analysis indicated a decline in prevalence among clinically exposed populations after 2015, from 29% to 10%, coinciding with the direct-acting antivirals (DAAs) and strengthened infection-control practices. The highest prevalence was observed among key populations in Libya, healthcare-exposed populations in Morocco, and apparently healthy individuals in Egypt. CONCLUSION: Variation in HCV prevalence across populations in the EMR highlights the need for population-specific strategies to support progress toward World Health Organization elimination targets.

References

1. 1.Abdolahinia, Z., Eybpoosh, S., Jangipour Afshar, P., Karamoozian, A., Azadmanesh, K., & Sharifi, H. (2026). Hepatitis C distribution across diverse population groups in the Eastern Mediterranean Region: An umbrella review. PLoS One. https://doi.org/10.4236/ojgas.2017.73013