Comparative epidemiology of hepatitis C in Egypt and global populations: a secondary analysis of cohort and surveillance data

Hepatitis C virus (HCV) infection remains a major global public health problem, and Egypt has historically carried one of the highest burdens worldwide. This study aimed to compare the prevalence and incidence of HCV in an Egyptian patient cohort with global estimates and to assess the relative excess burden observed in Egypt. A comparative epidemiological approach was used to analyse secondary data provided by an Egyptian patient-level cohort study of 1385 people and country-level surveillance estimates through the World Health Organization Global Health Observatory. Descriptive, comparative, exploratory multivariable, and health economic analyses were performed to examine prevalence, incidence, prevalence ratio, attributable fraction, clinical characteristics, treatment-response patterns, and public health implications. The analysis showed that HCV prevalence in Egypt was 4.5% and the incidence was 85 per 100,000 population, both markedly higher than the corresponding global estimates of 1.1% and 15 per 100,000 population. The prevalence ratio was 4.09, while the attributable fraction was 75.56%, indicating a substantially greater HCV burden in Egypt than the global average. Clinical profiling showed widespread hepatic and haematological abnormalities within the Egyptian cohort. Exploratory multivariable analyses revealed minimal associations among baseline demographic, clinical, and laboratory variables, while treatment-response patterns in this dataset remained limited. Overall, the findings indicate that Egypt continues to face a disproportionate HCV burden and requires continued surveillance, targeted prevention, and integrated healthcare strategies to support national and global elimination efforts.