Strategy and Efficacy of Generic and Pan-genotypic Sofosbuvir/Velpatasvir in Chronic Hepatitis C Virus: A Myanmar Experience

Bwa, Aung Hlaing; Nangia, Gayatri; Win, Si T.S.; Maung, Soe; Han, Khin A.W.; Htar, Su S.; Wine, Lei Y.; Ko, Wint W.; Oo, Moe P.; Hlaing, Naomi Khaing Than; Palecki, Julia; Loza, Bao L.; Win, Khin Maung; Reddy, Rajender

doi:10.1016/j.jceh.2018.12.001

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…31 Similarly, sofosbuvir-daclatasvir pan-genotypic regimen resulted in 96.9% and 93.3% SVR for genotypes 3 and 6, respectively. 32 Thus, the high prevalence of HCV genotype 6 and to a lesser extent genotypes 3 and 1 from this study suggest that treatment with a pan-genotypic DAAs regimen is most appropriate and is expected to be highly safe and effective.…”

Section: Discussionmentioning

confidence: 75%

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination

Wasitthankasem

Pimsingh

Treesun

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Chronic hepatitis C virus (HCV) infection can lead to liver cirrhosis and hepatocellular carcinoma. To eliminate HCV infection in an endemic area, an epidemiological baseline of the current HCV infection in the population is required. We therefore aimed to evaluate the HCV burden in the Thai Province of Phetchabun, which has the highest HCV infection rate in the country. Toward this, a province-wide district-based representative sampling of 4,769 individuals ages 35-64 years previously shown to represent high-risk age-groups were tested for anti-HCV antibodies using the automated chemiluminescent microparticle assays. Active HCV infection and subsequent genotyping were determined from serologically reactive samples by amplification of the HCV core gene. We found that 6.9% (327/4,769) were anti-HCV positive, of which 75.8% (248/327) had detectable HCV RNA and 5.8% (19/327) were in the presence of hepatitis B virus coinfection. Nucleotide sequencing and phylogenetic analysis revealed that HCV genotype 6 was the most prevalent (41%, 101/248), followed by genotype 3 (31%, 78/248), and genotype 1 (28%, 69/248). Socioeconomic and demographic factors including male gender, education, and agricultural work were associated with HCV seropositivity. From these results, we defined the regional HCV genotypes and estimated the HCV burden necessary toward the implementation of pan-genotypic direct-acting antivirals, which may be appropriate and effective toward the diversity of genotypes identified in this study. Micro-elimination of HCV in Phetchabun may serve as a model for a more comprehensive coverage of HCV treatment in Thailand.

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Section: Discussionmentioning

confidence: 75%

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination

Wasitthankasem

Pimsingh

Treesun

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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“…Generic drugs and their combinations produced by companies under the license of the Medicines Patent Pool and prequalified by WHO and/or other regulatory authorities have been shown to generate similar results to the original compounds, with similar safety and tolerability. [157][158][159][160][161][162][163][164][165][166][167] The panel recognises the heterogeneity of per capita incomes and health insurance systems across Europe and in other regions, and therefore the constraints that may necessitate continued utilisation of regimens described in previous versions of these recommendations but no longer recommended. In settings where none of the IFN-free, ribavirin-free options proposed in this document are available, options proposed in previous versions of these recommendations remain acceptable for patients likely to respond to these regimens until new DAAs become available and affordable; see prior EASL Recommendations on Treatment of Hepatitis C. 120,[168][169][170][171] In particular, in many lowand middle-income countries where the pangenotypic DAA combinations recommended in the present document are not available and/or not affordable, the combination of generic sofosbuvir and daclatasvir is safe and well tolerated and provides high SVR rates at a very low price.…”

Section: Treatment Of Chronic Hepatitis C In Patients Without Cirrhosmentioning

confidence: 99%

EASL recommendations on treatment of hepatitis C: Final update of the series☆

Pawlotsky¹,

Negro²,

Aghemo³

et al. 2020

Journal of Hepatology

857

632

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Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. Clinical care for patients with HCV-related liver disease has advanced considerably thanks to an enhanced understanding of the pathophysiology of the disease, as well as developments in diagnostic procedures and improvements in therapy and prevention. These therapies make it possible to eliminate hepatitis C as a major public health threat, as per the World Health Organization target, although the timeline and feasibility vary from region to region. These European Association for the Study of the Liver recommendations on treatment of hepatitis C describe the optimal management of patients with recently acquired and chronic HCV infections in 2020 and onwards.

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“… 17 , 18 , 19 Recent studies on the treatment effectiveness of DAA‐based regimens in HCV infected patients in Myanmar have shown mixed SVR12 achievements ranging from 77% to 98.6%. 20 , 21 , 22 , 23 , 24 , 25 Most of them studied on general populations 20 , 21 , 22 , 23 , 24 with only one study having more than half of their study patients as HIV/HCV co‐infected patients 25 making our study a valuable addition to the existing evidence of the real‐world effectiveness of DAA‐based regimens among HIV/HCV co‐infected patients in Myanmar.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics and real‐world treatment outcomes of hepatitis C among HIV/HCV co‐infected patients in Myanmar: A prospective cohort study

Swe

Johnson

Mar

et al. 2023

Health Science Reports

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Background and Aims In Myanmar, public sector treatment programs for hepatitis C virus (HCV) infection were nonexistent until June 2017. WHO highlights the importance of simplification of HCV service delivery through task‐shifting among health workers and decentralization to the primary health care level. Between November 2016 and November 2017, a study was conducted to describe the epidemiological data and real‐world outcomes of treating HIV/HCV coinfected patients with generic direct acting antiviral (DAA) based regimens in the three HIV clinics run by nonspecialist medical doctors in Myanmar. Methods HCV co‐infection among people living with HIV (PLHIV) from two clinics in Yangon city and one clinic in Dawei city was screened by rapid diagnostic tests and confirmed by testing for viral RNA. Nonspecialist medical doctors prescribed sofosbuvir and daclatasvir based regimens (with or without ribavirin) for 12 or 24 weeks based on the HCV genotype and liver fibrosis status. Sustained virologic response at 12 weeks after treatment (SVR12) was assessed to determine cure. Results About 6.5% (1417/21,777) of PLHIV were co‐infected with HCV. Of 864 patients enrolled in the study, 50.8% reported history of substance use, 27% history of invasive medical procedures and 25.6% history of incarceration. Data on treatment outcomes were collected from 267 patients of which 257 (96.3%) achieved SVR12, 7 (2.6%) failed treatment, 2 (0.7%) died and 1 (0.4%) became loss to follow‐up. Conclusion The study results support the integration of hepatitis C diagnosis and treatment with DAA‐based regimens into existing HIV clinics run by nonspecialist medical doctors in a resource‐limited setting. Epidemiological data on HIV/HCV co‐infection call for comprehensive HCV care services among key populations like drug users and prisoners in Yangon and Dawei.

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Strategy and Efficacy of Generic and Pan-genotypic Sofosbuvir/Velpatasvir in Chronic Hepatitis C Virus: A Myanmar Experience

Cited by 7 publications

References 24 publications

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination

Prevalence of Hepatitis C Virus in an Endemic Area of Thailand: Burden Assessment toward HCV Elimination

EASL recommendations on treatment of hepatitis C: Final update of the series☆

Epidemiological characteristics and real‐world treatment outcomes of hepatitis C among HIV/HCV co‐infected patients in Myanmar: A prospective cohort study

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