The World Health Organization (WHO) has issued its first ever guidance for the screening, care, and treatment of hepatitis C, a chronic infection that affects an estimated 130 to 150 million people, and one that is responsible for 350,000 to 500,000 deaths a year.
The hepatitis C virus is usually transmitted through exposure to contaminated blood. People undergoing invasive medical procedures and therapeutic injections with poor infection control are at risk. And people exposed to contaminated needles and skin piercing equipment, including through illicit drug use, tattooing, and body piercing, can get hepatitis C.
The new guidelines, which come on the heels of the release of more effective and safer oral hepatitis drugs, offer nine key recommendations. These include approaches that could increase the number of people screened for hepatitis C, advice on how to mitigate liver damage in those who are infected, and guidance for how to select and provide appropriate treatments.
New Medications Are Available
One recent drug to gain Food and Drug Administration (FDA) approval for hepatitis C is Janssen Therapeutics' Olysio (simeprevir). The protease inhibitor was approved in November 2013 for the treatment of chronic hepatitis C (CHC) infections as part of a combination antiviral treatment regimen.
In December 2013, the FDA also gave the nod to Gilead’s sofosbuvir. The drug, marketed as Sovaldi, is a new generation of nucleotide polymerase inhibitors and boasts a cure rate as high as 95 percent.
Reducing Deaths from Liver Cancer and Cirrhosis
Dr. Stefan Wiktor, who leads the WHO’s Global Hepatitis Program, said in a WHO press release that the new guidelines aim to help countries improve treatment and care for hepatitis, and thereby reduce deaths from liver cancer and cirrhosis.
“Hepatitis C treatment is currently unaffordable to most patients in need. The challenge now is to ensure that everyone who needs these drugs can access them,” Dr. Peter Beyer, senior advisor for the Essential Medicines and Health Products Department at the WHO, said in the statement.
Beyer went on to say that a multi-pronged strategy will be required to improve access to treatment, including creating demand for treatment by increasing the number of people screened for the infection.
Screening Tests Are Recommended
What does the WHO recommend? The organization suggests a screening test for people who are considered at high risk for infection, followed by another test for those who screen positive.
The WHO also advises that people with chronic hepatitis C receive an alcohol assessment to gauge how much they drink, as alcohol can also damage the liver. In addition, the WHO urges that counseling be offered to reduce alcohol intake for people with moderate or high alcohol use.
What’s more, the guidelines provide advice on the selection of the most appropriate test to measure the degree of liver damage in those with chronic hepatitis C.
The guidelines also provide recommendations for existing treatments, including immune-suppressing interferon injections and the new pill regimens.
Emphasizing that many people remain unaware, sometimes for decades, that they are infected with hepatitis C, Dr. Andrew Ball, senior advisor for Policy, Strategy and Equity for the WHO’s HIV/AIDS Department said, “Today’s launch highlights the need for more awareness and education on hepatitis for the general public. Greater awareness on the risks associated with hepatitis C should lead to a demand for services and expansion of laboratory capacity and clinical services so that more people can be tested, treated, and cured.”