PakMediNet Discussion Forum : Medicine : HCV- good news for pakistan
HCV- good news for pakistan
HCV is a major health problem in Pakistan. Full treatment is expensive. Luckily the genotype most commonly reported from Pakistan is 2 & 3, which have the overall best sustained viral response in the range of 80%. The standard recommended treatment is pegylated interferon + Ribavirin for 24 weeks. Recent evidence has suggested that a shorter duration ( 12-14 weeks) might be equally effective. There is documentation of HVC RNA becoming negative even after a single dose.
I feel it is of great interest & importance for Pakistan to address this issue. This is an excellent project for the collagues looking to do some clinical studies/research . A study designed to include early viral kinetics & response to therapy. One can imagine the impact if 1-4 doses of pegylated interferon can give a sustained viral response of even 50%.
Comments from physicians living in Pakistan are eagerly awaited although the forum is open to all.
Any current & ongoing studies on HCV treatment in Pakistan
?
[Edited by drkhawaja on 06-29-2005 at 09:12 PM GMT]
Posted by: drkhawaja Posts: 37 :: 29-06-2005 :: | Reply to this Message
Re: HCV- good news for pakistan
Thanks for your information.
Peg INF is quite expensive in Pakistan. It costs around Rs. 15,000. I am concerned about using it as a first line therapy. Why dont we try simple INF + Ribavarin combination first? I think we should reserve Peg INF only for relapse or treatment failure cases.
There are no. of studies going in Pakistan regarding HCV, but i dont think anybody is thinking about short course therapy of Peg INF.
I think, 50% virologic response with short course therapy is not sufficient. Treatment failure patients would ultimately need complete course then, which you know is quite expensive. Total course around 3.5 lac rupees ($5000).
Posted by: docosama Posts: 333 :: 30-06-2005 :: | Reply to this Message
Re: HCV- good news for pakistan
Thanks docosama for your comments. I am not suggesting we should settle for 50% sustained response but think of this from a different point of view. If one million patients were to be treated with current 24 weeks regemin & a sustained response of 80% then 800,000 patients will benefit. If a 4 week regemin was to be used then the same amount of injections would be sufficient for six million patients. Given a 50% sustained response three million patients could be cured.
Probably other benefits of less side effects, better compliance,rapid reduction in the infectious pool meaning better chance to control the spread & many other favourable factors.
Considering the numbers alone I feel this matter needs an urgent attention & studied as a TOP PRIORITY. I will be glad to help & participate in any capacity possible.
Best Regards & Good Luck
Posted by: drkhawaja Posts: 37 :: 05-07-2005 :: | Reply to this Message
Re: HCV- good news for pakistan
I agree with your point of view.
I wonder if anybody would try doing study of short course therapy of Peg INF, because of some problems. 1st, a lot of funding is required, 2nd. ethical issues ... patients who fail the regmin would have no further hope to get cure of HCV.
Thanks
Posted by: docosama Posts: 333 :: 05-07-2005 :: | Reply to this Message
Re: HCV- good news for pakistanPart of the purpose to study the viral kinetics in the local population is to come up with the regimen most suited for the local population. Chances of cure should not be any different as a failure to complete the recommended duration is to be treated as nieve cases especially for genotype 2 & 3. We must convince the drug companies to fund such studies as again the increased number of patients will still be profitable for them.
Posted by: drkhawaja Posts: 37 :: 06-07-2005 :: | Reply to this Message
Re: HCV- good news for pakistan
check pls
http://www.wjgnet.com/1007-9327/11/6188.asp
Posted by: drkhawaja Posts: 37 :: 05-01-2006 :: | Reply to this Message
Re: Re: HCV- good news for pakistanThis study suggests daily dose of IFN-2a for 24 weeks (for genotype 3). I am really concerned on unforunate poor patients of Hepatitis C. Isnt is hard to have daily injections for such a long period? This study wont have any clinical benefit in our setup where getting IFN itself is quite a problem.
Posted by: docosama Posts: 333 :: 05-01-2006 :: | Reply to this Message
Re: HCV- good news for pakistan
This is the point. we should design a study to see the feasibility of a regeimen which should be suitable for our patients who cannot afford longer treatment. I hope someone in hepatology pick up this task. I have a feeling regular interferon three times a week will probobly bring the same results & as this study suggests an ealy viral clearance at 4 weeks can let you select the patients with a favourable response.
Where are the young doctors looking for a clincal problem to study. Good luck.
Posted by: drkhawaja Posts: 37 :: 06-01-2006 :: | Reply to this Message
Re: HCV- good news for pakistan
Dear Sir,
I would like to know about the current status of treatment and cost of treatment for Hept C. What are possible diagnosis.
Though I have gonethrough some literature on net, but mostly related with out of Pakistan studies.
Dr Habib-ur-Rehman Athar
Assistant Professor
Bahauddin Zakariya University
Multan Pakistan
Posted by: habibathar Posts: 2 :: 20-04-2014 :: | Reply to this Message