HEPATITIS C VIRUS – WHAT IS THE TREATMENT

Hepatitis C virus (HCV) is a single stranded RNA virus that causes Acute and Chronic viral hepatitis which if untreated can progress to the development of Liver Cirrhosis and Liver Cancer. There are no vaccines for Hepatitis C but Hepatitis C can be cured with the current Directly Acting Antivirals (DAAs) which are oral medications with very potent antiviral properties and excellent safety profile. There are 6 genotypes of HCV (Genotypes 1 to 6) and treatment depends on the HCV genotype. The treatment of HCV is with a combination therapy of DAAs. Examples of DAAs include Sofosbuvir, Simeprevir, Velpatasvir, Daclatasvir, Ledipasvir etc. Some of the DAAs are effective in all genotypes (pangenotypic), thus knowledge of the specific genotype is not necessary before initiating treatment with pangenotypic DAAs. The duration of treatment in non-cirrhotics is usually for 12 weeks but may be longer in cirrhotics. Treatment regimens involving the use of Pegylated interferon are no longer widely used as the DAAs are more preferred. DAAs are now readily available in Nigeria for the treatment of Hepatitis C virus infection. All patients who are HCV RNA positive (or with chronic HCV infection) should be treated. Patients with Acute hepatitis C after 12 weeks of observation with no fall in HCV RNA titre should also be treated.

HEPATITIS C VIRUS – WHO SHOULD BE SCREENED / TESTED

• Any individual who is positive to HBsAg or HIV

• Prospective blood donors

• Pregnant women

• People who inject drugs (IVDU)

• Children born to HCV-infected mothers

• Individuals with unexplained liver disease or abnormal liver function test

• Health care workers

• Persons who have had scarification marks, injection from quacks, tattoos, or piercings

• Commercial sex workers

• Patients with sexually transmitted infection

• Sexual partners of HCV-infected persons

• Men who have sex with men

• Persons who have received multiple blood transfusions

• Prospective organ donors and recipients

HCV STATISTICS

WORLDWIDE (Source WHO)

• About 58 million people are chronically infected globally.
• About 1.5 million new infections occur every year.
• About 15-30% of chronic HCV patients progress to liver cirrhosis within 2 decades.
• About 300,000 deaths occur each year from liver cirrhosis & liver cancer.

NIGERIA (Source SOGHIN)

• About 0.5 – 4% (with an average of 1.1%) are chronically infected in the general population.
• This translates to about 2 million Nigerians being chronically infected.
• Majority of Nigerians do not know their HCV status.