Global pharma majors are developing newer drugs like interferons to tackle the chronic Hepatitis C Virus (HCV) which is a major cause of acute infection after a blood transfusion.
Although details of pharma companies were unavailable, Dr Rohit Gupta, assistant professor and consultant gastroenterology, department of internal medicine, Himalayan Institute Hospital, Dehradun stated in his paper focusing on newer therapies for HCV that interferons like alfa-2b and ribavirin alternatives or taribavirin are being developed to improve the effectiveness, safety, and tolerability of therapy during a chronic HCV infection. Even the 44 new protease inhibitors like telaprevir and boceprevir are actively being investigated in phase III trials. Future, multi-drug regimens will probably be used in combination with interferon and ribavirin.
Standard therapy for the treatment of chronic HCV infection is pegylated interferon and ribavirin. Oral ribavirin monotherapy is not effective for inducing sustained virologic response, The new therapy objective is to slow or halt the development of cirrhosis, thereby helping patients live longer, symptom-free lives, he added.
Global prevalence of HCV infection is around 2 per cent, with 170 million persons chronically infected with the virus and 3 to 4 million new cases. The dreaded infection is also reported to be one of the common causes for liver cirrhosis and transplantation in the US.
In India, studies specifically looking at professional blood donors have reported prevalence of 55.3 per cent and 87.3 per cent. But studies on voluntary or mixed donors have noted a hepatitis C prevalence below 2 per cent. This highlights the need for more stringent screening of blood donors in India, he said.
There is a paucity of large population based studies which give an accurate index of the health burden of hepatitis C in the country. Six such population based studies have been reported from various regions in the country.
Two studies from Andhra Pradesh have reported prevalence between 1.4 per cent and 2.02 per cent. A smaller study from Arunachal Pradesh showed a much higher hepatitis C prevalence of 7.89 per cent. Another rural survey from Maharashtra involving more than 1000 villagers showed a low prevalence rate of 0.09 per cent. The most systematic population based study has been reported from West Bengal, where by a 1:3 sampling method, 3,579 individuals were selected from 10,737 inhabitants of 9 villages where HCV was detected in 26 patients by ELISA among 2,973 patients who were finally willing to participate. A total of 21 patients were finally true positive. Most of the reported studies on genotype seem to suggest a north south divide. Here genotype 3 predominates in the north, east and west India, whereas genotype 1 is commoner in south India., stated Dr Gupta.
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