Zee Media Bureau


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New Delhi: Mr Arun is now dying in a hospital in Chennai. He was diagnosed to have HIV almost 6 years ago and was leading a healthy life after getting registered at the ART center in Manipur.


He was very regular with treatment. However, he developed severe jaundice recently. No one had suspected that he also carried another deadly virus, hepatitis C virus (HCV), which also he had acquired when he used to be injecting drug user. The doctors told him there are some injections which he will have to take almost for a year, without assurance of any cure. He simply has no means to bear the cost.


It is estimated that prevalence of Hepatitis C infection in India is more than 6 times the prevalence of HIV infection. However no community level data are available. Unfortunately, in case of HCV, there does not exist the same level of visibility to the public or to policy makers and has received less budgetary attention globally when compared to HIV.


Globally, around 150 million people are estimated to be infected with hepatitis C virus (HCV). India contributes a large proportion of this HCV burden. The prevalence of HCV infection is estimated at between 0.5% and 1.5%, though there is certainly a need for more robust data to understand the wide variations in the distribution of HCV in India.


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 recognized the viral hepatitis epidemic as “a global public health problem,” calling for comprehensive programs that “enhance access to affordable treatment in developing countries. There exists a possibility to make an impact on a disease that has potential to be eradicated.”


So far, very few drugs were available and the treatment was only 20% successful; and were extremely costly. The scenario is now evolved and we have successful treatment available. This treatment, although is much cheaper and has shorter duration of treatment, even at the current cost is out of reach of most of the people infected with HCV.


However, we should use this opportunity and by all means make it accessible to people who need it. It is encouraging to see that cheaper versions of the direct-acting antivirals (DAAs) like Sobosfuvir, having the ability to successfully treat Hepatitis C patients, are now available. 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.


Dr Vinay Kulkarni, Founder Trustee, Prayas Health Group said, “The availability of an easy, affordable and efficacious treatment to combat the disease from spreading poses a brilliant prospect. The new oral treatment would not only prevent infection and complications but also prevent transmission which is a huge step to contain the epidemic.


There is no readymade solution for ensuring access to effective treatment. It is important that integrated action is undertaken by the government and the medical fraternity to work the public health system skillfully to ensure that the treatment remains accessible to and available for every Indian citizen.”


HCV shares the same modes of transmission with HIV, so co-infections are also common. HCV progresses faster and causes more liver-related health problems among people with HIV than among those who do not have HIV. Hepatitis C virus is 100 times more virulent in nature. Criticality of government intervention to tackle Hepatitis C is evident in the recently accomplished HIV and polio success story.


HIV/AIDS provides a useful illustration of effective industry-based treatment assistance programs. As medical conditions, HIV and HCV have so much in common, be it the mode of transmission or the treatment methods. It will merit using the experience with HIV control as well as the use of health systems that have been strengthened with evolution of the HIV control program, to improve access to effective treatment as prevention and cure towards a Hepatitis C free generation.”


A Hepatitis C free nation is an achievable goal if all stakeholders work together and seize the opportunity offered by availability of new scientific innovations.