oa The epidemiology of hepatitis C virus in Qatar: A systematic review and meta-analysis

Abstract (342 words) Background: The scale and nature of hepatitis C virus (HCV) disease burden in Qatar is poorly known. In addition to establishing the level of infection among the Qatari population, characterizing HCV disease burden is of particular relevance as Qatar has a large expatriate population some of whom are from countries with substantial HCV prevalence. Objective: To investigate the epidemiology of HCV in Qatar among Qataris and expatriate resident populations. Methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Sources of data included PubMed and Embase databases. Our analysis included all primary studies reporting HCV prevalence or incidence measures in Qatar. Extracted measures were then classified and analyzed on the basis of the study population's risk of acquiring HCV. Meta-analyses were conducted incorporating inverse variance weighting and using a random-effects model to pool summary estimates of HCV prevalence, among general population groups, for Qataris and the population as a whole. Results: We identified seven studies providing a total of 23 measures on HCV prevalence and none on incidence in Qatar. HCV prevalence in the general population was 0.51% (95% confidence interval (CI): 0.43-0.59) among Qataris, and 1.01% (95% CI: 0.43-1.82) overall. Among blood donors the prevalence ranged from 0.3-11.2% depending on country of origin. The highest prevalence was reported among Egyptian migrants followed, though by a large margin, by Pakistani migrants. Among high risk populations, HCV prevalence was as high as 44.6% in hemodialysis patients, 25.8% among cirrhosis patients, and 9.0% among lichen planus patients. Conclusions: National-level HCV prevalence in Qatar is comparable to that in developed countries, but higher prevalence is found in specific expatriate populations reflecting the higher prevalence in the countries of origin. The high prevalence found among high risk groups possibly dates back to exposures that occurred prior to the enforcement of stringent infection control and blood screening protocols, implemented in the 1990s after the virus discovery. Since HCV prevalence is rather low, HCV prevention policy in Qatar should focus mainly on prevention and infection control in clinical settings.