Expert opinion on the management of hepatitis C infection in Kuwait

Abstract

Chronic hepatitis C virus (HCV) infection is a leading cause of death, especially in immunocompromised patients. The lack of clear prevalence data in the Middle East makes it difficult to estimate the true morbidity and mortality burden of HCV. In Kuwait, estimating the burden of disease is complicated by the constant flow of expatriates, many of whom are from HCV-endemic areas. The development of new and revolutionary treatments for HCV necessitates the standardization of clinical practice across all healthcare institutions. While international guidelines from the American Association for the Study of Liver Diseases (AASLD) and European Association for the Study of the Liver (EASL) do address this evolving treatment landscape, the cost-driven treatment prioritization of patients by these guidelines and unique HCV genotype presentation in the Kuwaiti population prompted the development of a more tailored approach. The predominant HCV genotypes prevalent in Kuwait are genotypes 4 and 1. The Kuwait Hepatology Club (KHC), comprising hepatologists across all major institutions in Kuwait, conducted several consensus meetings to develop the scoring criteria, evaluate all current evidence, and propose screening, diagnosis, and treatment suggestions for the management of HCV in this population. While these treatment suggestions were largely consistent with the 2016 AASLD and 2015 EASL guidelines, they also addressed gaps in the unmet needs of the Kuwaiti population with HCV.

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Keywords:

• hepatitis C
• diagnosis
• treatment
• management
• Kuwait

Acknowledgments

The following members of the Kuwait Hepatology Club (listed alphabetically by last name) contributed significantly to the writing and review of the article: Ali Abdulhamid (Gastroenterology and Hepatology Unit, Al-Sabah Hospital), Bader Alenezi (Gastroenterology and Hepatology Unit, Al-Jahra Hospital), Wafaa Alhashash (Gastroenterology and Hepatology unit, Al-Sabah Hospital), Raed Alzafiri (Gastroenterology and Hepatology Unit, Al-Jahra Hospital), Ramadan Hassan Eldamarawy (Gastroenterology and Hepatology Unit, Al-Adan Hospital), Ahmed Elfadhly (Haya Al-Habib Gastroenterology and Hepatology Center, Mubarak Alkabir Hospital), Hasan Elgarem (Gastroenterology and Hepatology Unit, Al-Sabah Hospital), Amal Gad (Thunayan Al-Ghanim Gastroenterology and Hepatology Center, Al-Amiri Hospital), Amr Hamed (Gastroenterology and Hepatology Unit, Al-Jahra Hospital), Fuad Hassan (Haya Alhabib Gastroenterology and Hepatology Center, Mubarak Alkabir Hospital, Faculty of Medicine, Kuwait University), Jafer Ismael (Gastroenterology and Hepatology Unit, Al-Adan Hospital), Ali A Ismaiel (Gastroenterology and Hepatology Unit, Farwaniya Hospital, Kuwait), Tamer Mansour (Thunayan Al-Ghanim Gastroenterology and Hepatology Center, Al-Amiri Hospital), Sherif Saeed Mehrem (Gastroenterology and Hepatology Unit, Al-Sabah Hospital), Samuel Sobhy Shaker (Gastroenterology and Hepatology Unit, Al-Adan Hospital), and Heba Zaki (Thunayan Al-Ghanim Gastroenterology and Hepatology Center, Al-Amiri Hospital). We acknowledge Aarati Rai, PhD, MBA, OPEN Health Dubai, for providing medical writing support for this article. Medical writing support was funded by Abbvie. Abbvie had no contribution to the content of the article.

Disclosure

The authors report no conflicts of interest in this work.