Washington: Massive treatment of a population with chronic hepatitis C infection has produced high cure rates, according to a study.
The research, conducted in Punjab, evaluated the feasibility of decentralized care and the provision of free direct-acting antiviral agents (DAA) in a population of nearly 20,000 individuals.
Validated the efficacy and safety of generic DAA regimens administered through a decentralized public health model based on algorithms.
"We have shown in our study that it is possible to cure more than 90% of people with HCV infection in a highly dispersed population using well-trained teams in government medical schools and district hospitals, and widely available DAA", said lead author Radha Krishan Dhiman.
"We believe that the Punjab Model could be applied to many different populations with the aim of eliminating HCV."
Infection with the hepatitis C virus (HCV) represents a major health burden in India, with approximately 12-18 million people infected. The burden is particularly heavy in the Indian state of Punjab, due to the high prevalence of risk factors such as unsafe medical practices, which include unsafe medical injections, blood transfusions and dental procedures, and the use of intravenous drugs. Similar to other geographical regions in India, genotype 3 predominates in the state of Punjab.
The study presented by Dhiman was part of a concerted effort in the Punjab region for both, reducing the HCV reservoir by treating established cases and reducing the incidence of new cases, and made possible by the foundation in 2016 of the Mukh Mantri Punjab Hepatitis C Relief Fund, which provides free treatment to all people with chronic HCV infection.
The study evaluated the feasibility of providing decentralized HCV care through three government medical colleges and 22 district hospitals and required the training of approximately 90 specialist physicians, pharmacists and data administrators.
A total of 29,371 patients (61.7% men, with a mean age of 42 years) were enrolled in 1 year, of which 19,646 patients completed the treatment with a sustained virological response (SVR) at 12 weeks 92.5%. The cure rates between individuals with cirrhosis (93.1%) and without cirrhosis (92.4%), and those with genotype 3 (92.6%) and other genotypes (93.1%) were similar. No major adverse events were reported.
"This study is an impressive example of how to improve the treatment of hepatitis C, which is important to reduce the complications related to hepatitis C, particularly the development of hepatocellular carcinoma," said researcher Markus Cornberg.
The study was reported at The International Liver Congress2018 in Paris, France.