Long-term clinical and economic benefits of an inclusive national HCV program targeting mothers and infants, two often overlooked populations.
HCV test
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A new cost-effectiveness modeling study from Egypt shows that screening all pregnant women for hepatitis C virus (HCV), treating those who test positive during pregnancy, and providing treatment to infected children at age three would improve health outcomes and reduce healthcare costs. This approach was compared to Egypt’s current protocol, which involves limited antenatal screening and delayed treatment after breastfeeding.1
Using a Markov model, researchers evaluated multiple strategies. The current practice resulted in the highest lifetime healthcare costs per mother–child pair, the lowest life expectancy, and the greatest burden of disease measured by disability-adjusted life years. In contrast, the model showed that universal screening and treatment during pregnancy, followed by pediatric treatment at age three, lowered costs and improved health outcomes. These results remained consistent across a wide range of sensitivity analyses.1
Although Egypt has made progress through a national HCV elimination program, pregnant women and children are not yet included in formal care protocols. The modeling study highlights the clinical and economic value of integrating HCV services into routine antenatal care.1
This research aligns with global efforts to simplify and expand access to hepatitis C care. In the United States, a proposed National Hepatitis C Elimination Program has emphasized the need to streamline diagnostic and treatment pathways, especially for underserved populations. A recent JAMA commentary outlined how the multi-step nature of current care contributes to underdiagnosis and undertreatment.2
Supporting this, a separate multi-country study in Egypt, Ethiopia, and India assessed patient interest in long-acting HCV treatments. Among 400 individuals surveyed, 78 percent expressed openness to long-acting injections, and 55 percent were interested in microarray patches. Those who had never received HCV treatment showed more interest in simplified options than those previously cured, suggesting a potential avenue to reach individuals unaware of their infection.3
Universal HCV screening and treatment during pregnancy, followed by pediatric treatment at age 3, is cost-saving and improves health outcomes compared to current practices.
Including pregnant women and children in HCV elimination programs is crucial for meeting national and global elimination goals.
The study highlights that early treatment for mothers and infants can reduce HCV transmission and healthcare costs.
Real-world evidence from the country of Georgia demonstrates that national commitment can lead to measurable progress. Since launching its elimination program in 2015, Georgia has reduced chronic HCV infection by 67 percent. The strategy involved broad screening, accessible treatment, and partnership with global health agencies.4
Georgia’s experience shows that even countries with limited resources can make substantial progress when supported by strong public health infrastructure and consistent investment. Egypt, which has led global treatment efforts for adults, could close remaining gaps by expanding services to pregnant women and children.4
According to global advocates, including former World Hepatitis Alliance president Danjuma Adda, political will and financing are essential to reaching elimination targets in low- and middle-income countries. Egypt’s modeling study offers a path forward by demonstrating that early and inclusive intervention is clinically effective and economically feasible.
Together, these findings from Egypt, Georgia, and other low-resource settings support a growing international consensus. To eliminate hepatitis C, countries must adopt early, simplified, and broadly accessible care strategies that meet patients where they are.
