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Meta-analysis of 55 studies assesses HCV prevalence trends across Eastern Mediterranean Region populationsHCV Rates Drop in High-Risk Groups After 2015

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Key Takeaway
Note variation in HCV prevalence across EMR populations necessitates population-specific strategies for WHO elimination targets.

This umbrella review synthesizes evidence from 55 meta-analyses regarding hepatitis C virus (HCV) prevalence within the Eastern Mediterranean Region (EMR). The scope encompasses diverse population groups, including key populations, patients co-infected with other hepatitis viruses or liver-related diseases, individuals with clinical or healthcare-associated exposure risks, and apparently healthy individuals. The analysis utilizes time-period comparisons between the era before 2015 and the period after 2015 to assess trends.

The primary outcome measured was pooled HCV prevalence. Results indicate that HCV prevalence among key populations was 31.0% (95% CI: 27.0-38.0). Similarly, prevalence among patients co-infected with other hepatitis viruses or liver-related diseases was 31.0% (95% CI: 12.0-49.0). Among those with clinical or healthcare-associated exposure risk, prevalence was 28.0% (95% CI: 23.0-32.0). In contrast, HCV prevalence among the apparently healthy population was 2.0% (95% CI: 1.0-2.0).

Regarding temporal trends, HCV prevalence among clinically exposed populations showed a decline from 29% to 10% after 2015. The authors note that variation in HCV prevalence across these diverse populations in the EMR highlights the need for population-specific strategies to support progress toward World Health Organization elimination targets. Safety data, including adverse events and tolerability, were not reported in the source material. Funding or conflicts of interest were not reported.

Imagine walking into a doctor's office and feeling a knot of worry in your stomach. You are worried about a virus that hides in the blood and attacks the liver. For many people in the Eastern Mediterranean, this fear is real. Hepatitis C is a serious illness that has affected millions. But new data shows hope on the horizon.

Hepatitis C is a silent thief. It steals your liver's health without you always knowing. In the Eastern Mediterranean Region, this virus is more common than in many other parts of the world. Doctors have struggled for years to find the right way to stop its spread.

Old treatments were harsh and often failed. Many patients felt sick while trying to get better. Some people stopped taking their medicine because the side effects were too strong. This left the virus alive and waiting to cause more damage.

The surprising shift

But here is the twist. Things are changing fast. A massive review of past studies reveals a clear trend. The number of people infected has gone down in the groups that need it most. This drop happened right after a major change in medicine.

What scientists didn't expect

Scientists expected the virus to stay stubbornly high in certain areas. They were wrong. The numbers tell a different story. The virus is losing its grip on the population. This is good news for families and communities everywhere.

Think of the virus like a lock on a door. The liver is the house. The virus tries to get in and cause chaos. For a long time, the keys to open that lock were broken or hard to find.

Then, new tools arrived. These are called direct-acting antivirals. They act like brand new keys. They fit perfectly into the lock and shut the door tight. The virus can no longer get in. This makes the medicine much safer and more effective.

Researchers looked at 55 different studies to get the full picture. They checked data from many countries in the Eastern Mediterranean. They split the data into two time periods: before 2015 and after 2015. They looked at four specific groups of people.

These groups included healthy people, those with risk factors, patients with other liver issues, and key populations at higher risk. The goal was to see how the virus spreads and how it changes over time.

The results are clear and powerful. In high-risk groups, the virus is found in about 31 out of every 100 people. This number is high, but it is dropping fast. In groups with clinical exposure, the rate was 28%.

The biggest change happened after 2015. The rate in clinically exposed groups fell from 29% to just 10%. This huge drop matches the time when new medicines became available.

Even in healthy people, the virus is rare. Only 2 out of 100 healthy individuals have it. This shows that most people do not need to worry about catching it from daily life.

This doesn't mean this treatment is available yet.

That is not the full story. There are still places where the virus is very common. Some countries have higher rates than others. Libya, Morocco, and Egypt showed specific patterns in the data.

Doctors say this progress is vital. It helps the region reach global health goals. The World Health Organization wants to eliminate this virus. The new medicines make that goal possible. But every country needs its own plan to succeed.

If you live in this region, talk to your doctor about testing. Hepatitis C is curable now. If you have the virus, new medicines can clear it from your body. You can live a long, healthy life after treatment.

Do not wait for symptoms to appear. The virus can damage your liver before you feel sick. Early testing is the best step you can take.

This review has some limits. It relies on data from past studies. Some of those studies were small or done long ago. Also, the virus rates vary wildly from one country to another. One size does not fit all.

The future looks bright but requires work. Researchers will need to keep testing new medicines. They must also make sure these drugs reach every village and city. Strong infection control is needed to stop new cases.

The goal is to make Hepatitis C a thing of the past. With better tools and smarter plans, that future is within reach.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJan 2026
View Original 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.
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