Epidemiology and Modes of Transmission of HCV in Developing Countries

Approximately 3% of the world's population is estimated to have a chronic hepatitis C virus (HCV) infection and 500,000 individuals die from its consequences yearly. Currently, the majority of hepatitis C-infected persons live in developing countries. The modes of HCV transmission differ in developed and developing countries. In developed countries, illicit drugs injection and the recent epidemics of sexually transmitted HCV infections in HIV-infected men play an important role in HCV transmission. In developing countries, HCV is transmitted through health-related procedures because of poor infection control measures. In several resource-limited countries, traditional procedures such as circumcision and scarification contribute to HCV spread. Intrafamilial transmission is also frequent in developing countries. Although the recent HCV revolution of the new interferon-free, oral treatments seem to reshape the epidemiology of HCV in developed countries, the poor access of HCV-infected patients in developing countries limits the control of HCV. Thus, many challenges need to be addressed, including the poor uptake of HCV testing, the high cost of the new antiviral combinations, and the high frequency of reinfections after treatment in some populations.