HIV in Egypt: from Silent Emergence to Concentrated Epidemic - A Narrative Review of Past, Present and Future

Introduction: Human immunodeficiency virus (HIV) continues to represent one of the most significant public health challenges, with Egypt facing a rapidly and silently growing epidemic masked by its low-prevalence classification. This narrative review tracks the historical trajectory of HIV in Egypt, from its silent beginning in 1986 to its current status. It aims to provide critical insight into how more effective and equitable interventions and policies can be framed to address this public health challenge. Methods: We synthesized data from a non-systematic search including national and international reports, estimates, surveys, and peer-reviewed papers addressing epidemiology, trends, social determinants, and health-system performance related to Egypt. Literature was identified through PubMed, Google Scholar, and reports from UNAIDS, WHO, and the Egyptian Ministry of Health. We prioritized literature published on data specific to Egypt. Where local data were unavailable, regional and global data were used to provide context and identify research gaps. Results: The review revealed Egypt’s transition to a concentrated epidemic. It identified significant gaps in local research and long-term health outcomes and showed that, despite National AIDS Program efforts, the availability of free antiretroviral therapy, and the adoption of a “Treat All” policy, gaps persist. Conclusion: The 40-year story of HIV in Egypt revealed rising incidence, critical gaps in the treatment cascade, and a lack of local data on non-infectious comorbidities. Addressing these challenges, promoting early diagnosis, reducing stigma, expanding access to treatment, and adopting innovative prevention strategies are essential to reverse current trends.