| |
HCV in Pakistan....and India...."new era in Hepatitis-C Virus (HCV) therapy ......time for government to make new options available at affordable price"
|
| |
| |
EASL: HCV in India at EASL: IDUs, Burden, Limited Access - (05/09/14).......There are strong advocacy groups.......They can start working with the government.
"The world may be moving toward a treatment landscape that allows for one-size-fits-all therapy. Experts believe this is a minor revolution; what is coming is truly revolutionary. Within a year, the FDA will approve other drugs for hepatitis C. It is now being said that Hepatitis C is going to be completely treatable, 'except for the cost,' Dr. Saleem Qureshi said while quoting renowned international experts. It is now for the government to make these new options available to patients in Pakistan at an affordable price."
HCV in Pakistan, thoughts from a HCV treater in Pakistan.......
Gone are the days of conventional treatment of Hepatitis-C, says Dr Qureshi
http://www.thenews.com.pk/Todays-News-6-252668-Gone-are-the-days-of-conventional-treatment-of-Hepatitis-C,-says-Dr-Qureshi
Islamabad
Shahina Maqbool
Wednesday, May 28, 2014
From Print Edition
The treatment landscape of Hepatitis-C infection has undergone sudden and rapid transformation. With the explosion of research leading to an unprecedented number of potential treatment options, and the development of newer directly acting antiviral agents, the world is at the beginning of a new era in Hepatitis-C Virus (HCV) therapy. For the first time, Interferon-free regimens are increasingly becoming a reality.
Dr. Saleem Qureshi, the head of the department of medicine at KRL Hospital, and Dr. Musarrat Iqbal, chairperson of the Alliance for Diabetes and Liver Diseases-Islamabad, shared this positive piece of information while exclusively talking to this scribe here on Tuesday.
According to Dr. Qureshi, the treatment and management of HCV has evolved dramatically since it was discovered in 1989. When testing became available in early 1991, the standard of care treatment was three weekly doses of Interferon. "A major breakthrough came in 1998 with the addition of Ribavirin (RBV). The mechanism of action for RBV is still not completely understood, although it doubled the overall sustained virologic response (SVR) rate when added to interferon. Three years later, long acting pegylated Interferon was developed with once-weekly dosing, and these two drugs were the standard of care until the advent of first-generation protease inhibitors (PI) Telaprevir and Boceprevir in 2011," Dr. Qureshi recalled.
Now, just two years later, Dr. Saleem Qureshi informed, Simiprevir and Sofosbuvir (SOF) have been approved for treatment of HCV in genotype 1 infection in combination with peg-interferon and RBV. "Perhaps even more of a milestone is the approval of the first all-oral, interferon-free regimen for HCV in the form of SOF plus RBV for patients infected with HCV genotypes 2 and 3," he added.
With many new agents for HCV infection progressing rapidly through the development pipeline, Dr. Qureshi said, "we are now seeing dramatic improvements in SVR, even in the more difficult-to-treat populations, with fewer adverse effects using all-oral, interferon-free-and in some cases even RBV-free-regimens." Both specialists opined that while the breakthrough by western researchers is a major milestone in the eradication of this deadly scourge, an equally important development is the provision of this drug at literally a fraction of the staggering cost at which it is available in the west-approximately US $3,000 per treatment in our country versus US $80-90,000. "The credit for this quiet but landmark achievement goes to Osman Waheed of Ferozesons, Gilead, the World Health Organisation (WHO) and the Ministry of National Health Services, Regulations and Coordination," they stated.
An estimated 130-170 million people are infected with Hepatitis-C worldwide, leading to significant morbidity, mortality, and financial burden on healthcare. The burden of hepatitis C infection in Pakistan is becoming exponential. After acquiring the virus, the disease passes through a silent phase and 80% i.e., a vast majority of the patients, passes into the chronic phase. "Patients who do not seek treatment in this phase, or who are unaware that they have the disease as there are no symptoms, pass into the phase of cirrhosis or that of Hepatocellular carcinoma. To this is added the burden of relapse and re-infection in patients who have been treated with current available treatments," Dr. Saleem Qureshi reminded. A national survey conducted by PMRC showed a prevalence of 5% in Sindh, 6.7% in Punjab, 1.1% in NWFP and 1.5% in Balochistan.
According to a WHO fact-sheet on transmission, the Hepatitis-C virus is a blood-borne virus which is commonly transmitted through injecting drug use through the sharing of injection equipment; in healthcare settings due to the reuse or inadequate sterilization of medical equipment, especially syringes and needles; and in some countries, via transfusion of unscreened blood and blood products. HCV can also be transmitted sexually, and can be passed from an infected mother to her baby; however, these modes are less common.
"Out of 100 people who contract the infection, 75-85% will develop chronic infection, 60-70% will develop chronic liver disease, 5-20% will develop cirrhosis over the course of their chronic infection, and 1-5% will die of complications including hepatocellular carcinoma (HCC)," Dr. Musarrat Iqbal shared.
In many parts of the world, the virus remains unchecked because of continued unsafe medical practices, lack of public health education, and lack of funding for research and treatment. Egypt faces the largest burden of HCV infection in the world, with a 10% prevalence of chronic hepatitis C infection among persons aged 15-59 years, predominantly genotype 4. In many countries, only a small number of patients actually receive treatment.
"The world may be moving toward a treatment landscape that allows for one-size-fits-all therapy. Experts believe this is a minor revolution; what is coming is truly revolutionary. Within a year, the FDA will approve other drugs for hepatitis C. It is now being said that Hepatitis C is going to be completely treatable, 'except for the cost,' Dr. Saleem Qureshi said while quoting renowned international experts. It is now for the government to make these new options available to patients in Pakistan at an affordable price.
|
|
| |
| |
|
|
|
