There has been many speculations about recently discovered medications to cure hepatitis-C patients. Thus, it is our duty to shed light on and investigate the effectiveness of these medications, as well as the global efforts exerted to vanquish the disease in the very near future.
Hepatitis C is a contagious disease that negatively affects the liver; it is caused by the hepatitis C virus, which results in acute and chronic inflammation of the liver. Hepatitis C is known to be transferred through blood; there are several means of infection, including reusing medical tools such as syringes, or not sterilizing them correctly, in addition to transfusion of infected blood.
Previously, Interferon was used together with Ribavirin for 48 weeks as a primary treatment for hepatitis C; they were known to be of low effectiveness and substantial side effects. Based on some studies conducted globally, the viral response to these medicines was 41%, indicated by the absence of the virus in the blood 24 weeks after the end of the treatment; another study conducted in Egypt indicated a viral response of 45-55%.
A leap in the treatment of hepatitis C occurred with the recent discovery of new medications known as Direct Acting Antivirals (DAAs), which are characterized with high effectiveness and slight side effects. They have proven effective in the treatment of genotype 4, where recovery rates increased and the viral response reached 90% using a group of medicines. These medicines are divided into two groups; their effectiveness varies according to the genotype and target.
In reality, there are many global efforts to eradicate virus C; here we shed light on efforts exerted in Egypt—where the greatest number of patients are—setting an example to be followed in the wake of launching a massive campaign to eliminate the disease.
Surveying the number of patients is one of the most important steps for the success of the campaign; according to statistics, 92.5% are infected with genotype 4, 3.6% are infected with genotype 1, 3.2% are infected with multiple genotypes, and less than 1% are infected with other genotypes. The spread of the disease dates back to the period between 1960 and 1980, when glass syringes were used with more than one person without sterilization during the wide-range campaigns to eradicate schistosomiasis.
There are six genotypes of the hepatitis C virus, numbered 1 to 6; there are also subtypes indicated by letters; for example, genotype 1A or 1B, etc. The majority of patients are infected with a single genotype, but sometimes a patient is infected with multiple genotypes at the same time; the method of treatment varies according to the genotype a patient is infected with.
That is why extensive efforts have been exerted in Egypt in recent years to eradicate virus C. When Sofosbuvir was proven to cure more than 90% in comparison to Interferon in the USA, the Egyptian Government negotiated successfully in 2014 with American drug companies to make the medicine available for a reasonable price in Egypt with a treatment duration of 12 weeks.
With the success of the negotiation, the Egyptian Government opened 56 treatment centers in 2016, aiming to reach 100 centers, in addition to establishing a database to record all the patients, who have reached 1.8 million, with follow ups after one, three, and six months, to monitor the recession of symptoms. The Government also acquired the license to produce the medicine locally. As a result, the price of the medicine went down to less than USD 100 for a three-month treatment course; moreover, public hospitals provide the medicine for free, and the efforts are continuing to eliminate the disease.
Furthermore, the Egyptian Ministry of Health cooperated with global entities, including the World Health Organization (WHO), to achieve a strategic plan revolving around seven points to get rid of virus C:
- Reinforcing a monitoring system to follow the spread of hepatitis C and how it spreads, as well as measuring the effectiveness of prevention programs.
- Executing prevention programs to end the spread of virus C using different means, such as safe injection, and evaluation programs to ensure the quality of implementing these practices.
- Improving transfusion services to reduce the spread of the disease by testing the donor's blood and ensuring the proper use of blood products.
- Preventing other types of the disease, such as hepatitis A and hepatitis B, using the appropriate vaccination and vaccinating newborns and people who are vulnerable to infection by virus B.
- Raising the communities awareness of the means by which virus C spreads and how to avoid them.
- Making full care and appropriate treatment available to reduce the spread of the disease.
- Prioritizing scientific research into the disease and converting these into practices.
It is necessary to follow these guidelines, in addition to medical treatment, to reap the fruit of the Egyptian Government's efforts to vanquish virus C in the very near future.
References
ncbi.nlm.nih.gov
treatmentactiongroup.org
who.int/news-room/fact-sheets/detail/hepatitis-c
worldbank.org