Dr. Homi Razavi
Image source: CDA Foundation
Analysis of global data provides hepatologists and other caregivers with insights into how the introduction of second-generation direct-acting antiviral drugs affects the treatment of hepatitis C virus.
The findings, presented at the American Association for the Study of Liver Diseases 2023 Liver Meeting, suggest that adding next-generation direct-acting antivirals could help increase uptake of hepatitis C treatments, with the effect being most pronounced among low-risk populations. and middle-income countries.
“To achieve global elimination of (hepatitis C virus), the cumulative number of patients treated (in low- and middle-income countries) will need to continue to grow exponentially, while continuing to expand access to generic medicines,” the researchers wrote.
Hepatitis C virus is the most common chronic viral infection in the bloodstream of Americans and represents a challenge to both management and public health systems. The National Institutes of Health estimates that the prevalence of chronic hepatitis C in the United States ranges from 2.7 to 3.9 million people, a number that has been increasing since 2006. According to recent estimates, the annual economic burden of chronic hepatitis C in the United States may exceed $10 billion. USA only2,3
From 2011 to 2016, the community witnessed an explosion of new therapies, with 10 different drugs receiving indications for at least one hepatitis C genotype during this period. Much to the chagrin of the medical community, a common theme in healthcare is the significant lag between the introduction of new treatments and their optimal adoption. 2
In the current study, a team led by Dr. Homie Razavi, founder and managing director of the Foundation Center for Disease Analysis, and colleagues sought to determine how the emergence of these second-generation direct-acting antiviral therapies has impacted the treatment of: Hepatitis C Virus. With this in mind, the researchers designed their study to analyze data from multiple national databases, drug sales data, government reports, treatment center reports and drug supplier reports.1
For the purpose of the analysis, the researchers specifically looked for data related to treatment regimens, including sofosbuvir, ombitasvir/paritaprevir/ritonavir, glecaprevir/pibrentasvir and elbasvir/grazoprevir-based treatments.1
Overall, the researchers identified 13.2 million people with hepatitis C who were treated with direct-acting antiviral drugs between 2014 and 2022. In this cohort, 10.9 million people received sofosbuvir-based regimens, accounting for 82% of all HCV treatments. The most common form of direct-acting antiviral treatment is the generic sofosbuvir/daclatasvir.1
The researchers noted that 89% of HCV infections in the study occurred in low- and middle-income countries, while only 3.7 million treatments occurred in high-income countries. The researchers also noted that the peak percentage of sofosbuvir-based regimens observed in 2019 was a result of the high uptake of HCV treatments in Egypt’s elimination program. Following this peak in 2019, use of other direct-acting antiviral drugs has increased, with the number of patients receiving treatment increasing from 1.6 million in 2019 to 2.4 million in 2022.1
“With 89% of (hepatitis C virus) infections occurring in (low- and middle-income countries), immediate access to generic versions of the latest medicines is needed to achieve global elimination goals. High-income countries have been very aggressive in treating their (hepatitis C virus) hepatitis virus) infect the population and lift all restrictions,” the researchers added.1
refer to:
- Voeller A, Razavi-Shearer D, Gamkrelidze I, Razavi-Shearer K, Blach S, Razavi H. Total number of HCV patients treated with direct-acting antivirals since 2014. Paper presented at: AASLD Liver Conference, November 10-14, 2023. Accessed November 21, 2023.
- Hepatitis C – NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed: November 21, 2023. https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-c.
- Gedawi A, Ibrahim YF, Elbashi NM, Ibrahim MA. Direct-acting anti-hepatitis C virus drugs: clinical pharmacology and future directions. Translation International Medical Journal. 2017;5(1):8-17. Published March 31, 2017. doi:10.1515/jtim-2017-0007