December 27, 2013

Egyptians hold their breath as new Hepatitis C drugs promise cure

In Egypt, millions suffering from genotype 4 Hepatitis C count the days until the official approval of new breakthrough drugs, hoping for affordable prices

Ingy Deif, Tuesday 24 Dec 2013

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Photo: Reuters

A development paving the road to the possible future eradication of Hepatitis C has emerged, causing the world to buzz with hope.

Recently, a number of Hepatitis C drugs had been introduced worldwide by five companies leading the research in that field. The aim was to produce a drug that, for the first time, was presented in the form of pills rather than injections – like the traditional Interferon – with minimal side effects, and with the ability to treat all 6 genotypes of Hepatitis C, with no drug interaction.

"Two drugs in particular were approved by the FDA a month ago," Dr Gamal Esmat, Professor of Hepatology and vice president of Cairo University, told Ahram Online. "Now the testing process is focusing on more than one drug in that regard, and those drugs under trial are either used by themselves or with other traditional Hepatitis C drugs depending on the programme, with a treatment duration varying from three to six months.”

Dr Wahid Doss, dean of the Liver Institute in Cairo and head of the National Committee for Control of Viral Hepatitis, told Ahram Online that although one of the new drugs – Sofosbuvir – was approved by the FDA, its introduction must probably be delayed until April. "The drug was tested on Egyptians abroad and proved effective, but we still have to make sure it complies with and suits the citizens living inside the country.”

Doss stressed that the new drug use cannot be officially initiated until those who undergo trial prove to be Hepatitis C free three months after the termination of drug administration.

Esmat spoke to Ahram Online about the strategy of introducing the new Hepatitis drugs in Egypt. “Five years ago the world witnessed a new approach of handling the disease which relies on tackling the enzymes that contribute to the reproduction and thriving of the virus," he said.

He added that in 2011 two new drugs – Tela Previr and Boceprevir – were introduced in Egypt, but they were not suitable with the genotype 4 Hepatitis C from which 90 percent of Egyptian patients suffer, and they caused side effects and drug interaction.

Of the six genotype strains of the virus, the fourth – previously treated with two combined drugs: Interferon, which targets the immune system, and Ribavirin – causes the majority of infections in Egypt.

Hepatitis C infection is notoriously the foremost step to the possibility of liver cirrhosis, liver failure, and ultimately liver cancer – the third leading cause of cancer-related deaths worldwide, which has spiked in Egypt from four percent in 1993 to 8.5 percent in 2005.

Although the primary tests hold very optimistic results and promise a breakthrough in eradicating the disease, the cost is unaffordable to the majority, with a price tag reaching $90,000.

"A classic case in that regard worldwide was the reduction of HIV medications provided to developing countries to put a halt to the ever increasing number of sufferers," Esmat said, adding that the government is currently negotiating ways to attain one of the new Hepatitis C drugs at an affordable price, exactly as was done with Interferon when it was provided in 23 government-related treatment centres in exchange for almost 10 percent of its original price, with the rest paid by medical insurance.

"Let’s hope that the same happens again with the new approved drug and an even better price reduction is offered to people. The upcoming months will hold the answer to that," he said.

In Egypt – which tops the list of countries suffering from this chronic disease – the soaring numbers of individuals carrying the Hepatitis C virus has been on the rise, causing much alarm.

The number had reached 8 million in 2008, according to the Health Ministry registry of that year, translating into nearly 10 percent of the population, while in some Upper Egypt and the Delta areas, the percentage is a staggering 20 percent.

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