Driving Naari Programme launched in Chandigarh
Over one lakh people get infected by the deadly Hepatitis C virus (HCV) in India every year. Medical doctors and patient groups across India have strongly advocated the need to recognize Hepatitis C as a national health priority and implementation of an integrated action plan to address the growing burden of the disease in the country.
People now believe that by 2030, the US may become free of Hepatitis C. So while India has been late in screening, diagnosis, treatment, our goal should be to scale up in these areas as soon as possible and aim to get rid of the disease from our country by 2040-50.
With the availability of Sofosbuvir base oral treatment in India, we hope more and more patients of HCV will benefit from it.
HCV: The silent killer
India accounts for a significant share of global HCV infections. It is estimated that 2,88,000 new HCV infections occurred in India in 2014.
Nearly 96,000 people die annually in India due to Hepatitis C, which has become a hidden epidemic according to WHO report, ‘Global policy report on prevention and control of viral Hepatitis’. The World Health Organization (WHO) has called the Hepatitis C virus (HCV) a “viral time bomb.”
It is essential that the policy makers pay the much needed attention towards this health issue, despite it being termed as a silent killer. At the 2010 World Health Assembly, it recognised the viral hepatitis epidemic as “a global public health problem,” calling for comprehensive programs that “enhance access to affordable treatment in developing countries.
HCV is not as rapid a killer as HBV or HIV; it is a slow and silent killer. If 100 people get infected with Hepatitis B and they are not treated for it, over the next six months 95% of those people will be free of the virus and only 5% will remain chronic carriers of HBV.
However, if people are injected with Hepatitis C, 80% people are at the risk of becoming chronic carriers. HCV is almost always chronic. Once the HCV enters the blood stream it is unlikely that a person can be rid of it without medication. This is why an infected person must not wait and start their treatment as early as possible.
Hepatitis C is now curable: Availability of new treatment
The treatment of Hepatitis C has evolved over the years and the availability of a simple once a day pop-up pill to treat the deadly disease as against the traditional injection therapy that was extremely difficult to cope with has really changed the HCV treatment landscape. Previously used IFN therapy posed multiple barriers including high cost, lengthy duration and potential side effects. The new treatment has fewer side effects and almost 90% survival rate.
Sofosbuvir is like a new magic drug for HCV infection and it has some of the following advantages:
It can be given at any stage of HCV disease.
It is almost 100% effective.
Its cost is very less compared to existing therapy.
Shorter duration of therapy is required with this medicine.
It is in form of tablets (unlike peginterferon which is injectable).
What the doctors say:
Dr Anil Arora, Chairman, Dept of Gastroentrology and Hepatology, Sir Ganga Ram Hospital said, “Its only 20 years after the discovery of the Hepatitis C virus (HCV), that a cure is now likely for most people affected by this chronic infection, which carries a substantial disease burden worldwide. The good news is that, direct acting antiviral (DAA) agents like sofosbuvir have emerged in the horizon of anti HCV therapy that have an efficacy of achieving upto 90% SVR unlike efficacy of PEG-IFN and RBV. Also since generic versions are available at a much lower cost, patients in limited resource settings can afford the cost of the drugs.”
Dr Parveen Malhotra, Head, Dept Of Medical Gastroenterology& Principal Nodal Officer for Hep C project, PGIMS, Rohtak said, “Hepatitis C is a huge problem in Haryana and Punjab. The good news is that safe and efficacious drugs with sofosbuvir base are now available for treating Hepatitis C patients. The initial results of sobosfuvir are encouraging even in relapser/failed cases i.e. after 4 weeks of therapy patients are becoming virus negative. The generic versions are available at a much lower cost and therefore patients in limited resource settings can also afford the treatment.”
Commenting on the Hepatitis C scenario, Dr Partha Sarathi Mukherjee, Project Director, Liver Foundation, West Bengal said “HCV is a major cause of mortality in India. Earlier, Hepatitis C could only be managed but the good news is that, it is now curable and the virus can be completely flushed out from the body.”
Way forward: Access to treatment
While lauding the availability of curative, direct-acting antiviral drugs against hepatitis C virus, experts have said that the government has still not spearheaded its efforts to fully utilise the benefits of the newer highly potent DAAs to tackle the growing disease burden. It is important to take necessary steps to expand access to these scientific innovations to the HCV infected people especially in low income groups and limited resource settings.
