HCV-discovery to elimination, “myth or reality”

Abstract

Hepatitis C virus (HCV) was discovered in 1989, before that it was commonly known as transfusion associated non A non B hepatitis. It rapidly assumed the role of leading cause of cirrhosis and liver cancer and a leading indication for liver transplant globally. For over two decades the treatment was suboptimal with the use of pegylated interferon and ribavirin combination across all genotypes. The vaccine development also failed for over two decades. However a major breakthrough happened in December 2013 when the Food and Drug Administration (FDA) approved the first pan genotypic oral directly acting drug Sofosbuvir. Since then many new directly acing drugs have been approved through fast track by the FDA. Today we have directly acting antiviral agents for all HCV patients providing cure rates of over 90%. Looking into this success the World Health Organization has set targets for 2030 for HCV elimination. There are several countries which have formed strategies to achieve this goal and others are still thinking to develop their own strategies. The availability of generics have reduced the prices substantially, however the problem is so gigantic that unless proper operational strategies for elimination are developed by the developing world especially by China and Pakistan, the two counties having the largest existing pool of HCV patients, the goals of elimination may not come true.

Keywords

Hepatitis C virus / elimination / directly acting antiviral agents / Pakistan

References

[1] Block TM,London WT.A historical perspective on the discovery and elucidation of the hepatitis B virus.Antiviral Res2016;131:109-23

[2] Cope Z.Medical history of the Second World War Medicine and Pathology.Postgrad Med J1952;28:644-5

[3] Ezzell C.Candidate cause identified of non-A, non-B hepatitis.Nature1988;333:195

[4] Choo QL,Weiner AJ,Bradley DW.Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepititis genome.Science1989;244:359-62

[5] Purcell R.The hepatitis C virus: overview.Hepatology1997;26:11S-4S

[6] Neumann AU,Dahari H,Wiley TE,Perelson AS.Hepatitis C viral dynamics in vivo and the antiviral efficacy of interferon-alpha therapy.Science1998;282:103-7

[7] Rosenberg S.Recent advances in the molecular biology of hepatitis C virus.J Mol Biol2001;313:451-64

[8] Lauer GM.Hepatitis C virus infection.N Engl J Med2001;345:41-52

[9] Dubuisson J.Virology and cell biology of the hepatitis C virus life cycle–an update.J Hepatol2014;61:S3-13

[10] World Health Organization. Global hepatitis report, 2017. Available from: http://apps.who.int/iris/bitstream/handle/665/255016/9789?sequence=1. [Last accessed on 17 Aug 2018]

[11] Blach S,Manns M,Duberg AS,Waked I,Lee MH,Abaalkhail F,Abdulla M,Aho I,Al Ghazzawi I,Al Lawati F,Al Serkal Y,Al-Dabal L,Alghamdi AS,Al-Romaihi HE,Arendt V,Assiri AM,Bane A,Bergin C,Bihl F,Blachier M,Mello CE,Brunton CR,Chan HL,Cheinquer H,Chien RN,Christensen PB,Chulanov V,Clausen MR,Craxi A,Dalgard O,de Ledinghen V,El-Sayed MH,Esmat G,Falconer K,Ferraz ML,Flisiak R,Gamkrelidze I,García-Samaniego J,Gountas I,Gottfredsson M,Gschwantler M,Gunter J,Hajelssedig O,Hamoudi W,Himatt SM,Hrstic I,Hunyady B,Jafri W,Janjua NZ,Jeruma A,Kamel Y,Kaymakoglu S,Khamis J,Kondili L,Krajden M,Lai MS,Lao WC,Lázaro P,Lesi O,Li M,Lim YS,Mahomed A,Makara M,Marinho RT,Mauss S,Correa MC,Merat S,Mohamed R,Mourad FH,Murphy K,Njouom R,Norris S,Oguche S,Oltman M,Omuemu C,Øvrehus AL,Oyunsuren TS,Pasini K,Phillips RO,Poustchi H,Qureshi H,Razavi-Shearer D,Redae B,Ridruejo E,Roberts LR,Rosenberg WM,Ryder SD,Sagalova O,Sanai FM,Saraswat V,Sarrazin C,Schréter I,Shah SR,Sharma M,Shiha GE,Sonderup M,Speiciene D,Stärkel P,Stedman C,Su TH,Tan SS,Thompson AJ,Tomasiewicz K,Van Damme P,van Thiel I,Vince A,Wedemeyer H,Wong VW,Yosry A,Yunihastuti E,Zuckerman E.Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study.Lancet Gastroenterol Hepatol2017;2:161-76

[12] World Health Organization. Eliminate hepatitis: WHO. Available from: http://www.who.int/mediacentre/news/releases/2017/eliminate-hepatitis/en/.[Last accessed on 17 Aug 2018]

[13] ConferenceReportsforNATAP. Five million Americans infected with the hepatitis C virus: a corrected estimate. Available from: http://www.natap.org/2005/AASLD/aasld_49.htm.[Last accessed on 17 Aug 2018]

[14] Lavanchy D.The global burden of hepatitis C.Liver Int2009;29:74-81

[15] Umer M.Hepatitis C virus prevalence and genotype distribution in Pakistan: comprehensive review of recent data.World J Gastroenterol2016;22:1684-700 PMCID:PMC4721999

[16] Waheed Y,Safi SZ.Hepatitis C virus in Pakistan: a systematic review of prevalence, genotypes and risk factors.World J Gastroenterol2009;15:5647-53 PMCID:PMC2789216

[17] Bosan A,Bile KM,Hafiz R.A review of hepatitis viral infections in Pakistan.J Pak Med Assoc2010;60:1045-58

[18] Qureshi H,Jooma R,Afridi HU.Prevalence of hepatitis B and C viral infections in Pakistan: findings of a national survey appealing for effective prevention and control measures.East Mediterr Health J2010;16 Suppl:S15-23

[19] Centers for Disease Control and Prevention (CDC).Establishment of a viral hepatitis surveillance system--Pakistan, 2009-2011.MMWR Morb Mortal Wkly Rep2011;60:1385-90

[20] Gower E,Blach S,Razavi H.Global epidemiology and genotype distribution of the hepatitis C virus infection.Journal of hepatology. J Hepatol2014;61:S45-57

[21] Lim AG,Mahmood H,Davies CF,Glass N,Fraser H,Mukandavire C,Martin NK,Averhoff F.Curbing the hepatitis C virus epidemic in Pakistan: the impact of scaling up treatment and prevention for achieving elimination.Int J Epidemiol2018;47:550-60 PMCID:PMC5913612

[22] Estes C,Abdel-Razek W,Abuzeid M,Osman W,Zaghla H.Economic burden of hepatitis C in Egypt: the future impact of highly effective therapies.Aliment Pharmacol Ther2015;42:696-706 PMCID:PMC5034818

[23] EMCDDA. European drug report 2017: trends and developments. Available from: http://www.emcdda.europa.eu/system/files/publications/4541/TDAT17001ENN.pdf.[Last accessed on 17 Aug2018]

[24] Grebely J,Conway B,Bruggmann P,Amin J,Hellard M,Marks P,Siriragavan S,Swan T,Lacalamita M,Matthews GV,Shaw D,Weltman M,Cooper C,Fraser C,Read P,Dore GJ.Sofosbuvir and velpatasvir for hepatitis C virus infection in people with recent injection drug use (SIMPLIFY): an open-label, single-arm, phase 4, multicentre trial.Lancet Gastroenterol Hepatol2018;3:153-61

[25] Lazarus JV,Stumo SR,Maticic M,Schatz E,Harris M.Restrictions on access to direct-acting antivirals for people who inject drugs: the European Hep-CORE study and the role of patient groups in monitoring national HCV responses.Int J Drug Policy2017;47:47-50

[26] Frank C,Strickland GT,Arthur RR,El Khoby T,Aly Ohn ES,Sallam I.The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt.Lancet2000;355:887-91

[27] Razavi H,Sarrazin C,Idilman R,Vogel W,Hézode C,Akarca U,Balık I,Bihl F,Blasco AJ,Bruggmann P,Calleja JL,Christensen PB,Coelho HS,Dore GJ,Duberg AS,Ergör G,Falconer K,Ferraz ML,Frankova S,Gerstoft J,Gonçales FLJr,Gschwantler M,Hindman SJ,Husa P,Kaita KD,Kaymakoglu S,Krarup H,Lavanchy D,Marotta P,Moreno C,Negro F,Örmeci N,Parkes J,Peltekian KM,Reis N,Rosenberg WM,Ryder SD,Semela D,Shiha GE,Sperl J,Stauber RE,Urbanek P,van Thiel I,Vandijck D,Weis N,Yosry A,Cornberg M,Estes C.The present and future disease burden of hepatitis C virus (HCV) infection with today’s treatment paradigm.J Viral Hepat2014;21 Suppl 1:34-59

[28] El-Akel W,El Kassas M,Khairy M,Kabil K,Shawky A,Shaker MK,Waked I,Doss W.National treatment programme of hepatitis C in Egypt: hepatitis C virus model of care.J Viral Hepat2017;24:262-7

[29] Ismail FW,Mawani M,Hamid SS.Training in emerging advances in chronic hepatitis C infection in Pakistan: the Teach-Pak project.Adv Med Educ Pract2018;9:99-106 PMCID:PMC5810529